Neutrophilic Dermatosis of the Dorsal Hand

Abstract

Neutrophilic dermatosis of the dorsal hands (NDDH) was originally described as pustular vasculitis (PV) of the hands. Recent debate focuses on categorizing this disorder in the family of neutrophilic dermatoses (ND), as opposed to a primary vasculitis. We present a case of NDDH with clinical and histologic features consistent with ND, and discuss the major concerns for this disease's reclassification.

The Relationship Between Neutrophilic Dermatosis of the Dorsal Hands and Sweet Syndrome

“…10 In 2000, Galaria et al Three additional cases have since been reported. [11][12][13] Many of these authors have commented on the morphologic similarity of NDDH to Sweet syndrome. [1][2][3][4] Clinical features of our 9 patients are summarized in Table 1.…”

Neutrophilic Dermatosis of the Dorsal Hands: Report of a Case and Review of the Literature

“…A thorough review of the literature reveals that only close to 100 cases have so far been reported [5–10]. Today, NDDH is most widely accepted to represent a ‘distributional or localized variant' of Sweet's syndrome which belongs to the spectrum of neutrophilic dermatoses, rather than a primary vasculitis and that any vasculitis seen histologically is a secondary phenomenon [11, 12]. It is likely that the timing of the biopsy during the evolutionary phases of the lesions may result in different findings with regard to presence or absence of vasculitis.…”

“…NDDH occurring after chemotherapy for AML has also been reported [31]. There are many occasions that no underlying cause can be found [12, 32]. The mainstay of treatment is oral corticosteroids, with strikingly rapid response.…”