Palisaded neutrophilic granulomatous dermatitis in rheumatoid arthritis

Palisaded neutrophilic granulomatous dermatitis (PNGD) is an entity that has not been clearly defined either clinically or histopathologically. It is seen in patients with rheumatoid arthritis and other connective tissue diseases. In the past, many cases of PNGD have been described under several dif...

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Bibliographic Details
Published in:Journal of the American Academy of Dermatology 2002-08, Vol.47 (2), p.251-257
Main Authors: Sangueza, Omar P., Caudell, Misty D., Mengesha, Yebabe M., Davis, Loretta S., Barnes, Cheryl J., Griffin, Julia E., Fleischer, Alan B., Jorizzo, Joseph L.
Format: Article
Language:English
Subjects:
Adult
Aged
Arthritis, Rheumatoid - complications
Biological and medical sciences
Dermatitis - diagnosis
Dermatitis - etiology
Dermatitis - pathology
Dermatology
Diseases of the osteoarticular system
Female
Granuloma - diagnosis
Granuloma - etiology
Granuloma - pathology
Humans
Inflammatory joint diseases
Medical sciences
Middle Aged
Neutrophils
Skin - pathology
Skin involvement in other diseases. Miscellaneous. General aspects
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Summary:Palisaded neutrophilic granulomatous dermatitis (PNGD) is an entity that has not been clearly defined either clinically or histopathologically. It is seen in patients with rheumatoid arthritis and other connective tissue diseases. In the past, many cases of PNGD have been described under several different names including palisaded neutrophilic and granulomatous dermatitis, linear subcutaneous bands, interstitial granulomatous dermatitis with cutaneous cords and arthritis, rheumatoid papules, and Churg-Strauss granuloma. We report 7 additional cases of PNGD. Clinically, 6 patients presented with erythematous to violaceous plaques, papules, and nodules on multiple body sites; one presented with subcutaneous linear bands on the shoulder. Five had rheumatoid arthritis; one had adult-onset Still's disease; and one showed clinical signs of rheumatoid arthritis, although serologically the rheumatoid factor was negative. On histologic examination, a spectrum of changes was observed ranging from urticaria-like infiltrates to leukocytoclastic vasculitis and granuloma annulare with neutrophils. We report these cases to expand the histologic spectrum of this entity and to further delineate the different forms of clinical presentation. (J Am Acad Dermatol 2002;47:251-7).
ISSN:0190-9622
1097-6787
DOI:10.1067/mjd.2002.124620