A rare case of idiopathic neutrophilic dermatosis of the hands

Neutrophilic dermatosis of the hands is a rare localized variant of Sweet syndrome. The following is a case report of a 68-year-old man who presented to our clinic with progressive redness, swelling, and decreased mobility of the fingers. Examination revealed symmetric, violaceous, edematous, annular plaques and nodules on the dorsal and lateral surfaces of the thumb and index fingers. Biopsy demonstrated a dense neutrophilic infiltrate in the papillary dermis without evidence of vasculitis, changes consistent with Sweet syndrome. A thorough work up revealed no concurrently associated condition. Treatment with prednisone 10 mg daily, colchicine 0.6 mg twice daily, and pentoxifylline 400 mg three times daily resulted in significant improvement in this case of idiopathic neutrophilic dermatosis of the hands.