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Palisaded neutrophilic and granulomatous dermatitis

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Connective tissue disease Medical condition
Palisaded neutrophilic and granulomatous dermatitis
SpecialtyDermatology

Palisaded neutrophilic and granulomatous dermatitis (PNGS) is usually associated with a well-defined connective tissue disease, lupus erythematosus or rheumatoid arthritis most commonly, and often presents with eroded or ulcerated symmetrically distributed umbilicated papules or nodules on the elbows.

Signs and symptoms

Typical clinical manifestations include erythematous to violaceous plaques that are symmetrically distributed, skin-colored linear cords involving the lateral trunks, and skin-colored or erythematous papules with crusting, perforation, or umbilication.

Causes

Palisaded neutrophilic and granulomatous dermaititis is associated with subacute bacterial endocarditis, ledipasvir/sofosbuvir, allopurinol, Hodgkin’s and non-Hodgkin’s lymphoma, chronic myelomonocytic leukemia, ulcerative colitis, Takayasu arteritis, systemic vasculitis, systemic lupus erythematosus (SLE), sarcoidosis, rheumatoid arthritis, eosinophilic granulomatosis with polyangiitis, chronic uveitis, and adult-onset Still’s disease.

Treatment

The underlying illness is the main focus of PNGD treatment. Up to 20% of patients may experience spontaneous resolution of the lesions. Topical corticosteroids, NSAIDs (non-steroidal anti-inflammatory drugs), dapsone, prednisone, colchicine, oral tacrolimus, and TNF inhibitors are among the available treatment options.

See also

References

  1. James, William; Berger, Timothy; Elston, Dirk (2005). Andrews' Diseases of the Skin: Clinical Dermatology. (10th ed.). Saunders. Page 181. ISBN 0-7216-2921-0.
  2. Rapini, Ronald P.; Bolognia, Jean L.; Jorizzo, Joseph L. (2007). Dermatology: 2-Volume Set. St. Louis: Mosby. ISBN 978-1-4160-2999-1.
  3. ^ Zabihi-pour, Dorsa; Bahrani, Bahar; Assaad, Dalal; Yeung, Jensen (2021). "Palisaded neutrophilic and granulomatous dermatitis following a long-standing monoclonal gammopathy: A case report". SAGE Open Medical Case Reports. 9. SAGE Publications: 2050313X2097956. doi:10.1177/2050313x20979560. ISSN 2050-313X. PMC 7882758. PMID 33628445.
  4. ^ Deen, Jacqueline; Banney, Leith; Perry-Keene, Joanna (December 11, 2017). "Palisading neutrophilic and granulomatous dermatitis as a presentation of Hodgkin lymphoma: A case and review". Journal of Cutaneous Pathology. 45 (2). Wiley: 167–170. doi:10.1111/cup.13076. ISSN 0303-6987. PMID 29226345. S2CID 43221453.
  5. Shenk, Mary Elizabeth Reed; Ken, Kimberly Marie; Braudis, Kara; Fernandez, Kristen Heins (2018). "Palisaded neutrophilic and granulomatous dermatitis associated with ledipasvir/sofosbuvir". JAAD Case Reports. 4 (8). Elsevier BV: 808–810. doi:10.1016/j.jdcr.2018.06.025. ISSN 2352-5126. PMC 6141673. PMID 30246134.
  6. Gordon, Katherine; Miteva, Maria; Torchia, Daniele; Romanelli, Paolo (January 18, 2012). "Allopurinol-induced palisaded neutrophilic and granulomatous dermatitis". Cutaneous and Ocular Toxicology. 31 (4). Informa UK Limited: 338–340. doi:10.3109/15569527.2011.647180. ISSN 1556-9527. PMID 22250812. S2CID 207619806.
  7. Kyriakou, Aikaterini; Patsatsi, Aikaterini; Papadopoulos, Vassilios; Kioumi, Anna; Efstratiou, Ioannis; Lazaridou, Elizabeth (February 20, 2019). "A case of palisaded neutrophilic granulomatous dermatitis with subsequent development of chronic myelomonocytic leukemia". Clinical Case Reports. 7 (4). Wiley: 695–698. doi:10.1002/ccr3.2072. ISSN 2050-0904. PMC 6452460. PMID 30997066.
  8. ^ Coutinho, Inês; Pereira, Neide; Gouveia, Miguel; Cardoso, José Carlos; Tellechea, Oscar (2015). "Interstitial Granulomatous Dermatitis". The American Journal of Dermatopathology. 37 (8). Ovid Technologies (Wolters Kluwer Health): 614–619. doi:10.1097/dad.0000000000000288. ISSN 0193-1091. PMID 25830722. S2CID 8324194.
  9. Terai, S; Ueda-Hayakawa, I; Nguyen, C T H; Ly, N T M; Yamazaki, F; Kambe, N; Son, Y; Okamoto, H (October 30, 2018). "Palisaded neutrophilic and granulomatous dermatitis associated with systemic lupus erythematosus: possible involvement of CD163 M2 macrophages in two cases, and a review of published works". Lupus. 27 (14). SAGE Publications: 2220–2227. doi:10.1177/0961203318809892. ISSN 0961-2033. PMID 30376790. S2CID 53108791.
  10. ^ Kwon, Eun J.; Hivnor, Chad M.; Yan, Albert C.; Forbes, Brian; Elenitsas, Rosalie; Albert, Dan; Pawel, Bruce; Honig, Paul; Pessler, Frank (2007). "Interstitial Granulomatous Lesions as Part of the Spectrum of Presenting Cutaneous Signs in Pediatric Sarcoidosis". Pediatric Dermatology. 24 (5). Wiley: 517–524. doi:10.1111/j.1525-1470.2007.00508.x. ISSN 0736-8046. PMID 17958801. S2CID 30684569.
  11. Sangueza, Omar P.; Caudell, Misty D.; Mengesha, Yebabe M.; Davis, Loretta S.; Barnes, Cheryl J.; Griffin, Julia E.; Fleischer, Alan B.; Jorizzo, Joseph L. (2002). "Palisaded neutrophilic granulomatous dermatitis in rheumatoid arthritis". Journal of the American Academy of Dermatology. 47 (2). Elsevier BV: 251–257. doi:10.1067/mjd.2002.124620. ISSN 0190-9622. PMID 12140472.

Further reading

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