- Source: Palisaded neutrophilic and granulomatous dermatitis
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.
Signs and symptoms
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.
Causes
Palisaded neutrophilic and granulomatous dermaititis is associated with subacute bacterial endocarditis, ledipasvir/sofosbuvir, allopurinol, Hodgkin’s and non-Hodgkin’s lymphoma, chronic myelomonocytic leukemia, ulcerative colitis, Takayasu arteritis, systemic vasculitis, systemic lupus erythematosus (SLE), sarcoidosis, rheumatoid arthritis, eosinophilic granulomatosis with polyangiitis, chronic uveitis, and adult-onset Still’s disease.
Treatment
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.
See also
Skin lesion
List of cutaneous conditions
References
Further reading
Kalen, Jessica E.; Shokeen, Divya; Ramos-Caro, Francisco; Motaparthi, Kiran (2017). "Palisaded neutrophilic granulomatous dermatitis: Spectrum of histologic findings in a single patient". JAAD Case Reports. 3 (5). Elsevier BV: 425–428. doi:10.1016/j.jdcr.2017.06.010. ISSN 2352-5126. PMC 5594233. PMID 28932786.
Bremner, Rebecca; Simpson, Eric; White, Clifton R.; Morrison, Lynne; Deodhar, Atul (2004). "Palisaded neutrophilic and granulomatous dermatitis: An unusual cutaneous manifestation of immune-mediated disorders". Seminars in Arthritis and Rheumatism. 34 (3). Elsevier BV: 610–616. doi:10.1016/j.semarthrit.2004.06.001. ISSN 0049-0172. PMID 15609265.
External links
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