A bullous neutrophilic dermatosis in a patient with severe rheumatoid arthritis and monoclonal IgA gammopathy

Lu, Ching-I; Yang, Cheng; Hong, Hong‐Shang

doi:10.1016/j.jaad.2003.12.054

Cited by 26 publications

(13 citation statements)

References 14 publications

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“…It is usually symmetric erythematous papules, nodules, plaques, urticarial-like lesions, or vesicles on the extensor surfaces of the extremities, joints, and trunk. Individual patients have been reported to respond to oral and topical corticosteroids, dapsone (100 mg/day), hydroxychloroquine, sulphamethoxypyridamine (500 mg twice daily), and cyclophosphamide (169)(170)(171)(173)(174)(175)(176)(177)(178). RND must be differentiated from rheumatoid nodules, Sweet's syndrome, erythema elevatum diutinum, and infectious causes.…”

Section: Rheumatoid Neutrophilic Dermatitismentioning

confidence: 99%

Management of neutrophilic dermatoses

Schadt

Callen

2012

Dermatol Ther

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Neutrophilic dermatoses, including Sweet's syndrome, pyoderma gangrenosum, and rheumatoid neutrophilic dermatitis, are inflammatory conditions of the skin often associated with underlying systemic disease. These are characterized by the accumulation of neutrophils in the skin. The associated conditions, potential for systemic neutrophilic infiltration, and therapeutic management of these disorders can be similar. Sweet's syndrome can often be effectively treated with a brief course of systemic corticosteroids. Pyoderma gangrenosum, however, can be recurrent, and early initiation of a steroid-sparing agent is prudent. Second-line treatment for both of these conditions includes medications affecting neutrophil function, in addition to immunosuppressant medications.

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Section: Rheumatoid Neutrophilic Dermatitismentioning

confidence: 99%

Management of neutrophilic dermatoses

Schadt

Callen

2012

Dermatol Ther

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“…erythematous, urticarial papules or plaques. A limited number of cases with tense vesiculobullous eruptions have been described (2). Sites usually aff ected are the extensor aspect of joints, the dorsum of the hands, and forearms, with the palms, soles, and face less commonly aff ected.…”

Section: Discussionmentioning

confidence: 99%

Acral Vesicles and Bullae in a Patient with Severe Rheumatoid Arthritis

Soza

Griffin

2015

Baylor University Medical Center Proceedings

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“…Since Lowe et al . first reported RND manifesting as vesiculobullous lesions, only five cases of vesiculobullous RND have been reported in the literature . All these patients had severe disabling RA; however, the exact mechanism of vesiculobullous formation is uncertain …”

Section: Discussionmentioning

confidence: 99%

Erythematous vesiculopapular eruptions on the extremities

Shin

Hong

et al. 2015

Clin Exp Dermatol

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A 64-year-old woman presented with a 2-year history of recurrent itchy vesiculopapular eruptions on her extremities. On physical examination, vesicles and erosions with crust were observed on both legs and both arms (Fig. 1). The patient had a 10-year history of seropositive rheumatoid arthritis (RA), and numerous therapeutic agents had been used to control it, including methotrexate 10 mg weekly and systemic steroid (5 mg daily). Aggravation of arthritis usually preceded the development of the skin lesions, which were not accompanied by fever. Laboratory findings showed strongly increased rheumatoid factor [158 IU/mL (normal range 0-15 IU/mL)] and normal leucocyte count [8.Histopathological examination of vesicular lesions showed a subepidermal blister filled with neutrophils and an extensive neutrophilic infiltrate in the upper dermis without vasculitis (Fig. 2). Direct immunofluorescence (DIF) studies of a perilesional skin biopsy revealed no deposits of C3, IgG, IgA, IgM or fibrinogen.What is your diagnosis? (a) (b) (c) (d) Figure 1 (a,b) Erythematous patch at site of healed bullae on the palms; (c) localized vesicles, papules and erosions with crust were seen on both soles; (d) a biopsy taken from the vesicle and direct immunofluorescence performed on the perilesional area on the lower leg.

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A bullous neutrophilic dermatosis in a patient with severe rheumatoid arthritis and monoclonal IgA gammopathy

Cited by 26 publications

References 14 publications

Management of neutrophilic dermatoses

Management of neutrophilic dermatoses

Acral Vesicles and Bullae in a Patient with Severe Rheumatoid Arthritis

Erythematous vesiculopapular eruptions on the extremities

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