Section 7- Neutrophil Mediated

Question 1

Painful, irregular, boggy, blue red ulcers with undermined borders and purulent necrotic bases

Characterized by neutrophilic infiltration, destruction of tissue

Commonly associated with systemic diseases

Answer 1

Pyoderma gangrenosum

Question 2

This phenomenon in pyoderma gangrenosum occurs when minimal trauma can trigger a lesion

Answer 2

Pathergy

Question 3

Diseases associated with pyoderma gangrenosum

Answer 3

Arthritis
IBD
Hematologic dyscrasia
Malignancy

Question 4

Superficial hemorrhagic pustule surrounded by erythematous halo

Very painful

Breakdown with ulcer formation— base purulent with hemorrhagic exudate

Answer 4

Acute pyoderma gangrenosum

Question 5

Most common sites involved in pyoderma gangrenosum

Answer 5

Lower extremities

Question 6

Management of pyoderma gangrenosum

Answer 6

Treat underlying disease

Oral or IV glucocorticoid pulse therapy (1-2g/day prednisolone)

Question 7

Uncommon acute recurrent cytokine induced skin reaction

Painful plaque forming inflammatory papules with massive exudations giving appearance of vesiculation

Fever, arthralgia, peripheral leukocytosis

Associated with febrile URTI

Answer 7

Sweet syndrome

Question 8

Treatment for sweet syndrome

Answer 8

Prednisone 30-50mg/day tapering in 2-3 weeks

Question 9

Reddish brown papules or small plaques primarily in the face with characteristic orange peel like surface

Answer 9

Granuloma faciale

Question 10

Painful nodules on lower legs

Lesions bright red and flat but nodular upon palpation

Cutaneous reaction pattern of subcutaneous fat to various etiologies

Answer 10

Erythema nodosum

Question 11

Most common type of panniculitis

Answer 11

Erythema nodosum

Question 12

Management of erythema nodosum

Answer 12

Spontaneous resolution in 6 weeks

Bed rest, compressive bandages, NSAIDS