[Chronic recurrent annular neutrophilic dermatosis].
BACKGROUND
Chronic recurrent annular neutrophilic dermatosis (CRAND) is a rare form of neutrophilic dermatosis characterised by chronic annular progression, histological impairment similar to that seen in Sweet's syndrome and the absence of association with generalised signs, abnormal laboratory values or underlying systemic disease. Herein we report two new cases.


METHODS
Case no1. A 41-year-old woman had presented with four annular lesions on the forearms and neckline which she had had for one year. Examination revealed a 5-cm annular lesion on the right forearm and four similar adjacent lesions. The condition spontaneously resolved after 4 weeks. Treatment with hydroxychloroquine 400mg per day for three months proved ineffective in preventing a further episode. However, following treatment with colchicine at a daily dose of 1mg for two months, no further relapses in the rash occurred over a 10-year observation period. Case no2. A 38-year-old woman consulted for recurrent annular erythema confined to the legs. Examination showed the presence of a red papular annular lesion on the right leg, encircling a yellowish macule with a central ring of fine scale; the lesion had been present for three weeks. Treatment with colchicine was initiated but the patient was lost to follow-up. In both cases, histological examination was evocative of Sweet's syndrome but no inflammatory or neutrophilic syndrome and no underlying systemic disease were demonstrated.


CONCLUSIONS
CRAND presents as a stereotypical and benign form of neutrophilic dermatosis. A diagnosis of chronic recurrent annular dermatosis with gyrate progression should be considered in the absence of general signs, neutrophilia or underlying systemic disease.
Département de dermatologie, hôpital Saint-Eloi, CHRU de Montpellier, 80, avenue Augustin-Fliche, 34295 Montpellier cedex 5, France.
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A
Croci-Torti
Département de dermatologie, hôpital Saint-Eloi, CHRU de Montpellier, 80, avenue Augustin-Fliche, 34295 Montpellier cedex 5, France; Université de Montpellier, 163, rue Auguste-Broussonnet, 34090 Montpellier, France; UFR de pharmacie, Inserm U1058, 15, avenue Charles-Flahaut, 34093 Montpellier cedex 5, France.
B
B
Guillot
Université de Montpellier, 163, rue Auguste-Broussonnet, 34090 Montpellier, France; Département d'anatomopathologie, hôpital Gui-de-Chauliac, CHRU de Montpellier, 34295 Montpellier, France.
V
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Rigau
Département de dermatologie, hôpital Saint-Eloi, CHRU de Montpellier, 80, avenue Augustin-Fliche, 34295 Montpellier cedex 5, France; Université de Montpellier, 163, rue Auguste-Broussonnet, 34090 Montpellier, France; UFR de pharmacie, Inserm U1058, 15, avenue Charles-Flahaut, 34093 Montpellier cedex 5, France. Electronic address: d-bessis@chu-montpellier.fr.
D
D
Bessis
D000328:Adult; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage*; D002908:Chronic Disease; D003078:Colchicine / Q000008:administration & dosage*; D005260:Female; D005542:Forearm / Q000473:pathology; D006801:Humans; D007866:Leg / Q000473:pathology; D009333:Neck / Q000473:pathology; D009504:Neutrophils / Q000187:drug effects* / Q000473:pathology*; D012871:Skin Diseases / Q000188:drug therapy* / Q000473:pathology*; D016896:Treatment Outcome
D000893:Anti-Inflammatory Agents; D003078:Colchicine
Dermatose annulaire récurrente; Dermatose neutrophilique; Erythema annular centrifugum; Neutrophilic dermatosis; Recurrent annular dermatosis; Sweet's syndrome; Syndrome de Sweet; Érythème annulaire centrifuge