CASE STUDY - Rheumatoid neutrophilic dermatitis: an initial dermatological manifestation of seronegative RA

[Guest guest]

J Eur Acad Dermatol Venereol. 2002 Jan;16(1):74-6.

Rheumatoid neutrophilic dermatitis: an initial dermatological manifestation

of seronegative rheumatoid arthritis.

Lazarov A, Mor A, Cordoba M, Mekori YA.

Dermatology Clinic, Department of Medicine, Meir General Hospital, Kfar

Saba, Israel. lazarov1@...

Rheumatoid neutrophilic dermatitis (RND) is an uncommon, but distinctive

manifestation of rheumatoid arthritis (RA). We describe the case of a

35-year-old female who developed RND as an early stage of seronegative RA.

Clinically, the lesions were presented by erythematous, slightly tender,

papules, 5-10 mm in diameter, on the extensor surface of the left arm. The

histopathological findings revealed a dense, dermal, mainly neutrophilic

infiltrate, with prominent leucocytoclasia, but without any features of

vasculitis. There was fibrinoid degeneration of collagen, resembling the

collagen changes present in rheumatoid nodules in a miniaturized form. RND

can be a reliable, early clinical sign of RA, as seen in our patient.

Furthermore, this case demonstrates that RND may be associated not only with

seropositive RA, as described in the literature, but also with seronegative

RA, never before reported. The histological findings in our case are

remarkable because of the fibrinoid collagen degeneration, which is

described here for the first time in RND. Thus, RND may, in fact, be the

initial phase of a spectrum that begins with a neutrophilic reaction and

mild fibrinoid collagen degeneration, and evolves into rheumatoid nodules at

the final stage.

PMID: 11952297

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve & db=PubMed & list_uids=1\

1952297 & dopt=Abstract

I'll tell you where to go!

Mayo Clinic in Rochester

http://www.mayoclinic.org/rochester

s Hopkins Medicine

http://www.hopkinsmedicine.org