title: Palisaded neutrophilic and granulomatous dermatitis associated with limited systemic sclerosis.
abstract: Palisaded neutrophilic and granulomatous dermatitis (PNGD) is a condition that is characterized histopathologically by a characteristic pattern of granulomatous inflammation in the presence or absence of leukocytoclastic vasculitis. It has been associated with systemic diseases, especially autoimmune conditions such as rheumatoid arthritis and Behçet's disease. A 44-year-old woman with underlying limited systemic sclerosis presented with painful erythematous nodules located on her face and scalp. Histopathologic analysis confirmed a diagnosis of PNGD, which self-resolved within weeks of the biopsy. To our knowledge, this is the first report of a case of PNGD associated with systemic sclerosis. A review of the literature revealed that PNGD is a female-predominant disease that is most commonly associated with rheumatoid arthritis, followed closely by lupus erythematosus. Most patients with PNGD respond to treatment of the underlying systemic disease, although spontaneous resolution is not uncommonly observed.
authors.affiliation: Department of Dermatology, Stanford University Medical Center, Stanford, California, USA.
authors.forename: Basil M
authors.initials: BM
authors.lastname: Hantash
authors.forename: David
authors.initials: D
authors.lastname: Chiang
authors.forename: Sabine
authors.initials: S
authors.lastname: Kohler
authors.forename: David
authors.initials: D
authors.lastname: Fiorentino
mesh_terms: D000328:Adult; D005148:Facial Dermatoses / Q000150:complications* / Q000473:pathology; D005260:Female; D006099:Granuloma / Q000150:complications* / Q000473:pathology; D006801:Humans; D020556:Neutrophil Infiltration; D012536:Scalp Dermatoses / Q000150:complications* / Q000473:pathology; D012595:Scleroderma, Systemic / Q000150:complications*