Erythematous plaques on the bilateral dorsal hands

Area of Science:

• Dermatology
• Pathology

Background:

• Neutrophilic dermatosis of the dorsal hands is a rare cutaneous disorder.
• Characterized by sudden onset of painful, hemorrhagic, pustular bullae with violaceous rims on dorsal hands.

Observation:

• A 61-year-old male presented with a 1-week history of tender, hemorrhagic, and pustular bullae on both dorsal hands.
• Lesions evolved into ulcerative plaques with hemorrhagic crusting over 5 days.

Findings:

• Punch biopsy revealed diffuse dermal infiltrate of neutrophils, lymphocytes, and histiocytes.
• Epidermal changes included spongiosis and neutrophilic exocytosis.
• Leukocytoclastic vasculitis was notably absent.

Implications:

• Highlights the clinical and histopathological features of this rare inflammatory condition.
• Emphasizes the importance of accurate diagnosis for appropriate management of dorsal hand neutrophilic dermatosis.
• Contributes to the understanding of rare neutrophilic dermatoses.