Ann Dermatol.  2017 Dec;29(6):804-806. 10.5021/ad.2017.29.6.804.

Palisaded Neutrophilic Granulomatous Dermatitis in a Patient with Systemic Sclerosis-Rheumatoid Arthritis Overlap Syndrome

• Jung KH
• Jeong S
• Kwon SR
• Lim MJ
• Gwon J
• Shin J
• Park W

• KMID: 2395196
• DOI: http://doi.org/10.5021/ad.2017.29.6.804

Abstract

No abstract available.

MeSH Terms

Arthritis*
Dermatitis*
Humans
Neutrophils*

Figure

• 

  Fig. 1 (A) Whole-body bone scan shows increased uptake in both wrists, hands, ankles, and feet. (B) Nailfold capillary microscopy shows dilatated and tortuous capillary loops and giant capillary. (C) Erythematous annular nodules on both soles.

• 

  Fig. 2 (A) The low power view shows diffuse palisading granulomatous infiltrations in the entire dermis (H&E, ×40). (B) Interstitial and palisading histiocytes infiltration with degenerated collagen bundles surrounded by neutrophils (inset, ×400) in the deep dermis (H&E, ×200).

Reference

1. Bremner R, Simpson E, White CR, Morrison L, Deodhar A. Palisaded neutrophilic and granulomatous dermatitis: an unusual cutaneous manifestation of immune-mediated disorders. Semin Arthritis Rheum. 2004; 34:610–616.

2. Szücs G, Szekanecz Z, Zilahi E, Kapitány A, Baráth S, Szamosi S, et al. Systemic sclerosis-rheumatoid arthritis overlap syndrome: a unique combination of features suggests a distinct genetic, serological and clinical entity. Rheumatology (Oxford). 2007; 46:989–993.

3. Rosenbach M, English JC 3rd. Reactive granulomatous dermatitis: a review of palisaded neutrophilic and granulomatous dermatitis, interstitial granulomatous dermatitis, interstitial granulomatous drug reaction, and a proposed reclassification. Dermatol Clin. 2015; 33:373–387.

4. Kim YS, Lee JH, Lee JY, Park YM. Interstitial granulomatous dermatitis associated with rheumatoid arthritis. Ann Dermatol. 2016; 28:395–397.

5. Moinzadeh P, Aberer E, Ahmadi-Simab K, Blank N, Distler JH, Fierlbeck G, et al. Disease progression in systemic sclerosis-overlap syndrome is significantly different from limited and diffuse cutaneous systemic sclerosis. Ann Rheum Dis. 2015; 74:730–737.