Palisaded neutrophilic and granulomatous dermatosis.
A 22-year-old woman with mixed connective-tissue disease presented with a 5-month history of recurrent episodes of tender, erythematous papules, nodules, and edematous plaques on the upper extremities and thighs. Cutaneous lesions occurred in the setting of livedo reticularis. A biopsy specimen showed interstitial and perivascular inflammation with lymphocytes, macrophages, neutrophils, nuclear dust, collagen alteration, extravasated erythrocytes, and fibrin within small superficial blood vessels. These changes were consistent with a diagnosis of palisaded neutrophilic and granulomatous dermatosis, which is a rare entity that includes a combination of a neutrophilic infiltrate, abnormal or altered collagen, granuloma formation, and leukocytoclastic debris in the context of an immune-mediated collagen vascular or systemic disease. The underlying mechanism remains poorly understood. Treatment is limited, and resolution of lesions typically occurs within several months to years.
Heidary
Noushin
N
Department of Dermatology, New York University, USA.
Mengden
Stephanie
S
Pomeranz
Miriam K
MK
D000328:Adult; D000974:Antibodies, Antinuclear / Q000276:immunology; D001706:Biopsy; D003872:Dermatitis / Q000276:immunology / Q000473:pathology*; D003937:Diagnosis, Differential; D005260:Female; D006099:Granuloma / Q000276:immunology / Q000473:pathology*; D006801:Humans; D020556:Neutrophil Infiltration
D000974:Antibodies, Antinuclear