Neutrophilic dermatoses Flashcards
What are the 5 Neutrophilic dermatoses
- Subcorneal pustular dermatosis
- Sweet’s syndrome
- Erythema elevatum diutinum
- Pyoderma gangrenosum
- Neutrophilic eccrine hidradenitis
* * 1 and 5 are rare
Sweet’s syndrome diagnostic criteria
Abrupt, tender erythematous/violaceous plaques or nodules
Predominantly neutrophilic infiltration in dermis without leukocytoclastic vasculitis
Classic patient w/ Sweets
Middle aged female with preceding URI
W/u of sweets
It is a marker of systemic illness
- associated with hematologic malignancy, IBD, strep infxn, other solid tumors, and pregnancy
- also a drug induced variant (Granulocyte- CSF)
Skin findings in Sweets
Tender erythematous nodules with an annular or arciform pattern on head, back of hands, legs (spares trunk)
DDx of Sweets
Erythema multiforme, erythema nodosum, adverse drug rxn, and urticaria
Gold standard tx for Sweets
Systemic steroids
Erythema Elevatum Diutinum skin findings
In a middle aged adult, persistent, non-purpuric, deep brown-red to purple papules/nodules/plaques on extensor surfaces of extremities (overlying joints)
Erythema Elevatum Diutinum associated conditions
May precede myeloproliferative disorders by several yrs
Erythema Elevatum Diutinum tx
Dapsone
Pyoderma Gangrenosum associated conditions
Chronic underlying inflammatory dz or malignancy such as UC, RA, chronic hepatitis, Crohns, hematologic/lymphoreticular malignancies, IgA monoclonal gammopathy
Pyoderma Gangrenosum skin findings
Commonly on lower leg, tender erythematous lesion that develops pustules/vesicles on surface and surrounding skin becomes dusky (take months to heal)
Tx for Pyoderma Gangrenosum
Systemic steroids and cyclosporine, can use IV infliximab
Schambergs Disease clinical presentation
More common in men than women and see asymptomatic irregular orange-brown patches of various shapes/sizes. “cayenne pepper spots” commonly on lower legs (not palpable)
Tx of Schambergs Disease
None needed, purely cosmetic problem
