Diagnosis: Neutrophilic dermatosis of the dorsal hands (NDDH).
MICROSCOPIC AND LABORATORY FINDINGS AND CLINICAL COURSE
The laboratory findings showed a white blood cell count of 13 640 cells/µL (reference range, 3280-9290 cells/µL), with a neutrophil count of 9600 cells/µL (reference range, 1300-7000 cells/µL) (to convert white blood cell and neutrophil counts to x109/L, multiply by 0.001) and an erythrocyte sedimentation rate of 46 mm/h (reference range, 0-10 mm/h). The skin biopsy revealed compact orthokeratosis, epidermal spongiosis, and a prominent dermal neutrophilic infiltrate with prominent edema and extravasation of red blood cells into the papillary dermis. There was no evidence of leukocytoclastic vasculitis. These findings are consistent with "neutrophilic dermatosis of the dorsal hands" (NDDH).
After diagnosis, the patient continued methylprednisolone therapy and had complete resolution of the lesions and systemic symptoms after 1 week of treatment.
DISCUSSION
Neutrophilic dermatosis of the dorsal hands is a rare condition thought to be possibly related to Sweet's syndrome (SS) and atypical pyoderma gangrenosum (PG). Strutton et al1 reported . . . [Full Text of this Article]
