Neutrophilic Dermatosis Of Dorsal Hands Research Articles

Neutrophilic dermatosis of dorsal hands: A unilateral presentation

A rare localized version of Sweet syndrome known as neutrophilic dermatosis of dorsal hands is characterized by bluish or hemorrhagic papules, bullae, and nodules on the dorsal hands. Cases have been associated with myeloproliferative disorders, malignancy, inflammatory bowel disease, and rheumatoid arthritis. We are reporting a case of a 39-year-old male presented with sudden onset hyperpigmented raised lesions studded with fluid-filled vesicles on the left dorsal hands. Histology confirmed the clinical diagnosis of neutrophilic dermatosis of dorsal hands. Unilateral presentation of neutrophilic dermatosis of dorsal hands is rarely encountered in day-to-day practice. Hence, we are reporting this case.

Sweet’s syndrome: disease spectrum from an Indian perspective

<p class="abstract"><strong>Background:</strong> Sweet's syndrome is characterized by sudden onset of tender, erythematous papules, nodules, and plaques with a characteristic histopathology. It arises in three clinical settings- idiopathic, drug induced and malignancy induced. It has several clinical and histopathologic variants. Newer entities have been recently described in literature, thereby, emphasizing the need for continuous research. So, this study was conducted to add to scant data published in Indian literature with respect to this uncommon disease. The aims of the study were to bring insights into this rarely seen condition with special emphasis on histopathology; to highlight association of Sweet's syndrome with other systemic diseases, and its extra-cutaneous manifestations.</p><p class="abstract"><strong>Methods:</strong> A retrospective analysis of medical records from January 2013 to February 2017 of patients with Sweet’s syndrome was done in our dermatology department in a tertiary care hospital.<strong></strong></p><p class="abstract"><strong>Results:</strong> Out of total 13 patients, 6 (46%) were males and 7 (54%) were females. The age of patients ranged from 33 to 82 years. Five (39%) had idiopathic Sweet's syndrome, while 8 (61%) had non-idiopathic Sweet's syndrome, out of which three were associated with autoimmune diseases (ulcerative colitis, interstitial lung disease and crohn’s disease in 1 patient each), 3 cases were associated with malignancy (chronic neutrophilic leukemia, chronic myeloid leukemia and acute myelogenous leukemia in 1 patient each) and 2 cases were linked with infection. Bullous Sweet's syndrome was seen in 2 (15%) while neutrophilic dermatosis of dorsal hands was diagnosed in 5 (39%) cases. Four patients developed uncommon extracutaneous manifestations of Sweet's syndrome. In addition to classical histopathological findings of Sweet's syndrome, one case showed presence of immature neutrophils (histiocytoid Sweet's syndrome), fibrinoid necrosis was evident in 2 (15.4%), leucocytoclasia in 6 (46.2%), RBC extravasation in 3 (23.1%) and neutrophilic infiltration into vessel wall in 3 (23.1%) patients.</p><p><strong>Conclusions:</strong> Several unique variants were observed in the current study.</p>