Annular Neutrophilic Dermatoses.

Abstract

Neutrophilic dermatoses (NDs) are a group of diseases characterized by sterile neutrophilic infiltrations. Many of the NDs usually present with infiltrated erythematous plaques, nodules, urticarial plaques, or pustules. Lesions may show variability, and atypical presentations may develop among the NDs. Annular lesions have been reported in many NDs and may lead to diagnostic problems. Clinical features and histopathologic findings such as localization of the neutrophilic infiltrate, existence of other cell types, and absence of true vasculitis may be helpful to distinguish NDs. Some of these NDs are associated with infections, inflammatory diseases, and malignancies. In most NDs, systemic steroids and dapsone are very effective and usually first choices. Colchicine, antimicrobials, such as doxycycline, tetracycline, and sulphapyridine, and other immunosuppressants, such a cyclosporine, methotrexate, and mycophenolate mofetil have been used successfully in treating many NDs. TNF-α inhibitors have also been used successfully in many NDs. JAK kinase inhibitors are effective in CANDLE syndrome, anakinra in neutrophilic urticarial dermatosis, and intravenous immunoglobulin in resistant pyoderma gangrenosum. We discuss the diagnosis and management of the NDs that may present with annular lesions.