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Palisaded neutrophilic and granulomatous dermatitis

Palisaded neutrophilic and granulomatous dermatitis
SpecialtyDermatology

Palisaded neutrophilic and granulomatous dermatitis (PNGS) is usually associated with a well-defined connective tissue disease, lupus erythematosus or rheumatoid arthritis most commonly, and often presents with eroded or ulcerated symmetrically distributed umbilicated papules or nodules on the elbows.[1][2]

Signs and symptoms

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Typical clinical manifestations include erythematous to violaceous plaques that are symmetrically distributed, skin-colored linear cords involving the lateral trunks, and skin-colored or erythematous papules with crusting, perforation, or umbilication.[3]

Causes

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Palisaded neutrophilic and granulomatous dermaititis is associated with subacute bacterial endocarditis,[4] ledipasvir/sofosbuvir,[5] allopurinol,[6] Hodgkin’s and non-Hodgkin’s lymphoma,[4] chronic myelomonocytic leukemia,[7] ulcerative colitis,[8] Takayasu arteritis,[4] systemic vasculitis,[8] systemic lupus erythematosus (SLE),[9] sarcoidosis,[10] rheumatoid arthritis,[11] eosinophilic granulomatosis with polyangiitis,[8] chronic uveitis,[10] and adult-onset Still’s disease.[4]

Treatment

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The underlying illness is the main focus of PNGD treatment. Up to 20% of patients may experience spontaneous resolution of the lesions. Topical corticosteroids, NSAIDs (non-steroidal anti-inflammatory drugs), dapsone, prednisone, colchicine, oral tacrolimus, and TNF inhibitors are among the available treatment options.[3]

See also

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References

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  1. ^ James, William; Berger, Timothy; Elston, Dirk (2005). Andrews' Diseases of the Skin: Clinical Dermatology. (10th ed.). Saunders. Page 181. ISBN 0-7216-2921-0.
  2. ^ Rapini, Ronald P.; Bolognia, Jean L.; Jorizzo, Joseph L. (2007). Dermatology: 2-Volume Set. St. Louis: Mosby. ISBN 978-1-4160-2999-1.
  3. ^ a b Zabihi-pour, Dorsa; Bahrani, Bahar; Assaad, Dalal; Yeung, Jensen (2021). "Palisaded neutrophilic and granulomatous dermatitis following a long-standing monoclonal gammopathy: A case report". SAGE Open Medical Case Reports. 9. SAGE Publications: 2050313X2097956. doi:10.1177/2050313x20979560. ISSN 2050-313X. PMC 7882758. PMID 33628445.
  4. ^ a b c d Deen, Jacqueline; Banney, Leith; Perry-Keene, Joanna (December 11, 2017). "Palisading neutrophilic and granulomatous dermatitis as a presentation of Hodgkin lymphoma: A case and review". Journal of Cutaneous Pathology. 45 (2). Wiley: 167–170. doi:10.1111/cup.13076. ISSN 0303-6987. PMID 29226345. S2CID 43221453.
  5. ^ Shenk, Mary Elizabeth Reed; Ken, Kimberly Marie; Braudis, Kara; Fernandez, Kristen Heins (2018). "Palisaded neutrophilic and granulomatous dermatitis associated with ledipasvir/sofosbuvir". JAAD Case Reports. 4 (8). Elsevier BV: 808–810. doi:10.1016/j.jdcr.2018.06.025. ISSN 2352-5126. PMC 6141673. PMID 30246134.
  6. ^ Gordon, Katherine; Miteva, Maria; Torchia, Daniele; Romanelli, Paolo (January 18, 2012). "Allopurinol-induced palisaded neutrophilic and granulomatous dermatitis". Cutaneous and Ocular Toxicology. 31 (4). Informa UK Limited: 338–340. doi:10.3109/15569527.2011.647180. ISSN 1556-9527. PMID 22250812. S2CID 207619806.
  7. ^ Kyriakou, Aikaterini; Patsatsi, Aikaterini; Papadopoulos, Vassilios; Kioumi, Anna; Efstratiou, Ioannis; Lazaridou, Elizabeth (February 20, 2019). "A case of palisaded neutrophilic granulomatous dermatitis with subsequent development of chronic myelomonocytic leukemia". Clinical Case Reports. 7 (4). Wiley: 695–698. doi:10.1002/ccr3.2072. ISSN 2050-0904. PMC 6452460. PMID 30997066.
  8. ^ a b c Coutinho, Inês; Pereira, Neide; Gouveia, Miguel; Cardoso, José Carlos; Tellechea, Oscar (2015). "Interstitial Granulomatous Dermatitis". The American Journal of Dermatopathology. 37 (8). Ovid Technologies (Wolters Kluwer Health): 614–619. doi:10.1097/dad.0000000000000288. ISSN 0193-1091. PMID 25830722. S2CID 8324194.
  9. ^ Terai, S; Ueda-Hayakawa, I; Nguyen, C T H; Ly, N T M; Yamazaki, F; Kambe, N; Son, Y; Okamoto, H (October 30, 2018). "Palisaded neutrophilic and granulomatous dermatitis associated with systemic lupus erythematosus: possible involvement of CD163+ M2 macrophages in two cases, and a review of published works". Lupus. 27 (14). SAGE Publications: 2220–2227. doi:10.1177/0961203318809892. ISSN 0961-2033. PMID 30376790. S2CID 53108791.
  10. ^ a b Kwon, Eun J.; Hivnor, Chad M.; Yan, Albert C.; Forbes, Brian; Elenitsas, Rosalie; Albert, Dan; Pawel, Bruce; Honig, Paul; Pessler, Frank (2007). "Interstitial Granulomatous Lesions as Part of the Spectrum of Presenting Cutaneous Signs in Pediatric Sarcoidosis". Pediatric Dermatology. 24 (5). Wiley: 517–524. doi:10.1111/j.1525-1470.2007.00508.x. ISSN 0736-8046. PMID 17958801. S2CID 30684569.
  11. ^ Sangueza, Omar P.; Caudell, Misty D.; Mengesha, Yebabe M.; Davis, Loretta S.; Barnes, Cheryl J.; Griffin, Julia E.; Fleischer, Alan B.; Jorizzo, Joseph L. (2002). "Palisaded neutrophilic granulomatous dermatitis in rheumatoid arthritis". Journal of the American Academy of Dermatology. 47 (2). Elsevier BV: 251–257. doi:10.1067/mjd.2002.124620. ISSN 0190-9622. PMID 12140472.

Further reading

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