Rheumatoid neutrophilic dermatitis

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Rheumatoid neutrophilic dermatitis
Specialty Dermatology

Rheumatoid neutrophilic dermatitis, also known as rheumatoid neutrophilic dermatosis, [1] is a cutaneous condition associated with rheumatoid arthritis. [2]

Contents

Signs and symptoms

Rheumatoid neutrophilic dermatitis occurs more frequently in patients with severe, persistent seropositive arthritis; it presents clinically as erythematous papules, nodules, plaques, or lesions resembling urticaria without any accompanying symptoms. [3] [4] [5] Less common conditions include annular lesions, blisters, ulcers, and vesicles. [6] [7] Skin lesions are typically symmetrical, but they can occasionally be distributed asymmetrically. [8] [9] Dorsal surfaces of hands and arms are preferred sites, with an emphasis on the extensor surfaces of extremities and joints. [10] [11] [12]

Diagnosis

Histopathological findings include normal epidermis, that may show hyperkeratosis, parakeratosis, [13] focal ulceration with scaly crust, [14] or spongiosis with intraepidermal blistering, [15]

Treatment

Treatments include topical steroids, [16] cyclophosphamide, [17] dapsone, [13] and hydroxychloroquine. [14]

Outlook

Lesion resolution can happen on its own or as the rheumatoid arthritis progresses, but lesions usually recur when the condition gets worse. Although most lesions heal without leaving scars, hyperpigmentation may linger for a while. [18]

See also

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References

  1. ↑ James, William; Berger, Timothy; Elston, Dirk (2005). Andrews' Diseases of the Skin: Clinical Dermatology. (10th ed.). Saunders. Page 180. ISBN   0-7216-2921-0.
  2. ↑ Rapini, Ronald P.; Bolognia, Jean L.; Jorizzo, Joseph L. (2007). Dermatology: 2-Volume Set. St. Louis: Mosby. ISBN   978-1-4160-2999-1.
  3. ↑ Xue, Yun; Cohen, Jeffrey M.; Wright, Natalie A.; Merola, Joseph F. (December 9, 2015). "Skin Signs of Rheumatoid Arthritis and its Therapy-Induced Cutaneous Side Effects". American Journal of Clinical Dermatology. Springer Science and Business Media LLC. 17 (2): 147–162. doi:10.1007/s40257-015-0167-z. ISSN   1175-0561. PMID   26649439. S2CID   42706531.
  4. ↑ Ziemer, Mirjana; Müller, Anne-Katrin; Hein, Gert; Oelzner, Peter; Elsner, Peter (November 25, 2016). "Incidence and classification of cutaneous manifestations in rheumatoid arthritis". JDDG: Journal der Deutschen Dermatologischen Gesellschaft. Wiley. 14 (12): 1237–1246. doi:10.1111/ddg.12680. ISSN   1610-0379. PMID   27886444. S2CID   3424646.
  5. ↑ Hata, Tissa; Kavanaugh, Arthur (2006). "Rheumatoid arthritis in dermatology". Clinics in Dermatology. Elsevier BV. 24 (5): 430–437. doi:10.1016/j.clindermatol.2006.07.008. ISSN   0738-081X. PMID   16966022.
  6. ↑ Fujio, Yumi; Funakoshi, Takeru; Nakayama, Kaori; Amagai, Masayuki; Ohyama, Manabu (October 25, 2012). "Rheumatoid neutrophilic dermatosis with tense blister formation: A case report and review of the literature". Australasian Journal of Dermatology. Wiley. 55 (1): e12–e14. doi:10.1111/j.1440-0960.2012.00963.x. ISSN   0004-8380. PMID   23094684. S2CID   39668337.
  7. ↑ Filosa, Alessandra; Filosa, Giorgio (2018). "Neutrophilic dermatoses: a broad spectrum of disease". Italian Journal of Dermatology and Venereology. Edizioni Minerva Medica. 153 (2): 265–272. doi:10.23736/s0392-0488.18.05841-8. ISSN   2784-8671. PMID   29368857.
  8. ↑ Brown, Timothy S.; Fearneyhough, Paul K.; Burruss, Jyoti B.; Callen, Jeffrey P. (2001). "Rheumatoid neutrophilic dermatitis in a woman with seronegative rheumatoid arthritis". Journal of the American Academy of Dermatology. Elsevier BV. 45 (4): 596–600. doi:10.1067/mjd.2001.119031. ISSN   0190-9622. PMID   11568753.
  9. ↑ Chua-Aguilera, Carolyn Jean; Möller, Burkhard; Yawalkar, Nikhil (July 27, 2017). "Skin Manifestations of Rheumatoid Arthritis, Juvenile Idiopathic Arthritis, and Spondyloarthritides". Clinical Reviews in Allergy & Immunology. Springer Science and Business Media LLC. 53 (3): 371–393. doi:10.1007/s12016-017-8632-5. ISSN   1080-0549. PMID   28752373. S2CID   43240243.
  10. ↑ DeFaria, Doreen; Kroumpouzos, George (May 1, 2004). "Rheumatoid Neutrophilic Dermatitis as Presenting Sign of Seronegative Arthritis". Acta Dermato-Venereologica. Medical Journals Sweden AB. 84 (3): 236–237. doi: 10.1080/00015550310007724 . ISSN   0001-5555. PMID   15202847.
  11. ↑ Ashchyan, Hovik J.; Nelson, Caroline A.; Stephen, Sasha; James, William D.; Micheletti, Robert G.; Rosenbach, Misha (2018). "Neutrophilic dermatoses". Journal of the American Academy of Dermatology. Elsevier BV. 79 (6): 1009–1022. doi:10.1016/j.jaad.2017.11.063. ISSN   0190-9622. PMID   29653213. S2CID   4896415.
  12. ↑ Caucanas, Marie; Heylen, Alain; Rolland, Florence; Müller, Gebhard; Olemans, Catherine; Sass, Ursulla; Vanhooteghem, Olivier (September 23, 2013). "Associated pyoderma gangrenosum, erythema elevatum diutinum, and Sweet's syndrome: the concept of neutrophilic disease". International Journal of Dermatology. Wiley. 52 (10): 1185–1188. doi:10.1111/j.1365-4632.2011.05415.x. ISSN   0011-9059. PMID   24073904. S2CID   8539323.
  13. 1 2 Bouffard, D. (October 1, 1995). "Long-standing verrucous lesion. Chromomycosis". Archives of Dermatology. American Medical Association (AMA). 131 (10): 1195b–1196. doi:10.1001/archderm.131.10.1195b. ISSN   0003-987X. PMID   7574838.
  14. 1 2 Sánchez, Jorge L.; Cruz, Alma (1990). "Rheumatoid neutrophilic dermatitis". Journal of the American Academy of Dermatology. Elsevier BV. 22 (5): 922–925. doi:10.1016/0190-9622(90)70127-4. ISSN   0190-9622. PMID   2335586.
  15. ↑ Lowe, Lori; Kornfeld, Bruce; Clayman, Joseph; Golitz, Loren E. (1992). "Rheumatoid neutrophilic dermatitis". Journal of Cutaneous Pathology. Wiley. 19 (1): 48–53. doi:10.1111/j.1600-0560.1992.tb01558.x. ISSN   0303-6987. PMID   1556266. S2CID   31454442.
  16. ↑ Hirota, T K; Keough, G C; David-Bajar, K; McCollough, M L (October 1997). "Rheumatoid neutrophilic dermatitis". Cutis. 60 (4): 203–205. PMID   9347237.
  17. ↑ Mashek, Helen A. (1997-06-01). "Rheumatoid Neutrophilic Dermatitis". Archives of Dermatology. 133 (6): 757–760. doi:10.1001/archderm.1997.03890420097013. ISSN   0003-987X. PMID   9197831.
  18. ↑ Lazarov, A; Mor, A; Cordoba, M; Mekori, Ya (2002). "Rheumatoid neutrophilic dermatitis: an initial dermatological manifestation of seronegative rheumatoid arthritis". Journal of the European Academy of Dermatology and Venereology. 16 (1): 74–76. doi:10.1046/j.1468-3083.2002.00401.x. ISSN   0926-9959. PMID   11952297. S2CID   30236685.

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