A case of unilateral neutrophilic dermatosis of the dorsal hands

Ana G. Lopes, Department of Dermatology, Hospital de Braga, Braga, Portugal Maria J. Guimarães, Department of Dermatology, Hospital de Braga, Braga, Portugal Catarina Cerqueira, Department of Dermatology, Hospital de Braga, Braga, Portugal Cristiana Macedo, Department of Dermatology, Hospital de Braga, Braga, Portugal Joana Gomes, Department of Dermatology, Hospital de Braga, Braga, Portugal Celeste Brito, Department of Dermatology, Hospital de Braga, Braga, Portugal

Our case focuses on a 60-year-old male patient, a farmer, with a previous diagnosis of myelodysplastic syndrome, under regular surveillance at the haemato-oncology department. The patient was referred to the emergency room with an inflammatory ulcerated plaque in the dorsum of his left hand, with 2 weeks evolution. There were two moderately swollen, very painful ulcerated plaques on the dorsal aspect of the left hand, with grayish borders and irregular margins. A skin biopsy showed panniculitis and a dense neutrophilic dermal infiltrate. Attending to his underlying disease, clinical hallmarks of the lesion, and skin biopsy, the diagnosis of a neutrophilic dermatosis of the dorsal hands was made. The patient was treated with oral prednisolone 0.5 mg/kg/day and colchicine 1mg/day with complete regression after 1 month. Neutrophilic dermatosis is a heterogeneous group of skin diseases characterized by dense infiltration of neutrophils in the affected tissue. Neutrophilic dermatosis of dorsal hands is one of them and is considered a localized variant of Sweet Syndrome. The etiology is unknown, but about half of the cases are associated with hematological diseases.

Palabras clave: Myelodysplastic syndrome. Neutrophilic dermatosis. Neutrophilic dermatosis of the dorsal hands. Sweet syndrome.