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Rheumatoid neutrophilic dermatitis

M M Ichikawa1, Y Murata, Y Higaki

  • 1Department of Dermatology, Tokyo Women's Medical College, 8-1 Kawada-cho, Shinjuku-ku, Tokyo 162-8666, Japan.

European Journal of Dermatology : EJD
|July 31, 1998
PubMed
Summary

Rheumatoid neutrophilic dermatitis (RND) is a rare skin condition in severe rheumatoid arthritis patients. This case study highlights its presentation and suggests RND is a neutrophilic vascular reaction.

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Area of Science:

  • Dermatology
  • Rheumatology
  • Pathology

Background:

  • Rheumatoid neutrophilic dermatitis (RND) is a rare skin manifestation associated with severe rheumatoid arthritis.
  • Patients with RND often present with systemic inflammatory conditions like rheumatoid lung.

Observation:

  • A 63-year-old Japanese male with seropositive rheumatoid arthritis and rheumatoid lung presented with erythematous plaques and pustules on his extremities and buttocks.
  • Histopathological examination revealed dense neutrophilic infiltration in the upper dermis and dermal papillae, forming neutrophilic abscesses.
  • No obvious vasculitis was observed in the affected tissues.

Findings:

  • The observed skin lesions and histological findings are consistent with rheumatoid neutrophilic dermatitis.
  • The case supports the classification of RND within the spectrum of neutrophilic vascular reactions.

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  • The pathogenesis likely involves immune complex deposition and subsequent neutrophil-mediated vascular damage.

    • Implications:

    • RND should be considered in the differential diagnosis of neutrophilic dermatoses in rheumatoid arthritis patients.
    • Understanding RND's pathogenesis may lead to targeted therapies for associated vascular damage.
    • This case contributes to the literature on rare dermatological manifestations of rheumatoid arthritis.