[Neutrophilic dermatosis of the hands. A localized subset of Sweet's syndrome: 3 cases]

The term "pustular vasculitis of the hands" described by Strutton for an acute eruption of the hands was recently revisited. "Neutrophilic dermatosis of the hands" has been preferred. We observed 3 new cases.

Two women and a man, without notable past history, consulted for an acute and painful eruption of both hands with fever. Clinical examination showed erythematous papular or nodular or bullous lesions developed on thenar and hypothenar eminences, and on the finger. Histological findings were predominantly neutrophilic infiltration in the dermis, papillary dermal edema, with or without the presence of leukocytoclastic vasculitis. Diagnosis was Sweet's syndrome. No disease was associated. With indometacine (50-100 mg per day), all the lesions disappeared rapidly without relapse.

These 3 cases add to 19 other cases (review of literature) which confirm the existence of a homogenous entity that we think it a localized subset of Sweet's Syndrome, with a fast healing. Our observations are specific by the first localization on thenar and hypothenar eminences and by the excellent response to treatment with a non steroidal antiinflammatory agents such indometacine (50-100 mg per day). This treatment could be proposed as a first line therapy.