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2</a>&#41;&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">Neutrophilic Dermatosis of the Dorsal Hands &#40;NDDH&#41; is a rare variant of a neutrophilic dermatosis such as pyoderma gangrenosum and Sweet Syndrome&#46;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> Few cases have been reported in the literature so far&#44; and cutaneous involvement of the palms is seldomly described despite the radial dorsal surface of the hands as the most affected location&#44; especially in the area between the thumb and index finger&#46;<a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">2&#44;3</span></a> NDDH is characterized by erythematous plaques&#44; bullae&#44; pustules&#44; and nodules that might present necrosis and ulceration&#44; with progressive growth in a small period&#46;<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">A recent review of 123 cases of NDDH&#44; showed a female predominance in 58&#37; with a unilateral distribution in 78&#37; and a mean age of 62 years&#46; Due to its inflammatory pattern&#44; serological studies may present leukocytosis &#40;56&#46;5&#37;&#41; and neutrophilia &#40;83&#37;&#41; and mimic a soft skin tissue infection&#46; Besides the latter&#44; the differential diagnosis includes pyoderma gangrenosum&#44; Sweet syndrome&#44; and erythema elevatum diutinum&#46;<a class="elsevierStyleCrossRefs" href="#bib0015"><span class="elsevierStyleSup">3&#44;4</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">The histological presence of an intense neutrophil infiltrate through the dermis with associated edema is considered an indicator of neutrophilic dermatosis&#46; Other findings such as leukocytoclastic vasculitis may be found in the early stages of the disease due to endothelial damage but should not be considered as a criterion for making the diagnosis&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">The pathogenesis of NDDH is not completely understood&#46; Some authors have suggested trauma as a potential trigger and as with other neutrophilic dermatoses&#44; multiple systemic associations have been described&#46; Specifically&#44; in NDDH&#44; correlation with hematological or solid malignancies&#44; rheumatological conditions&#44; inflammatory bowel disease&#44; and co-morbidities such as diabetes and chronic renal disease as in our patient&#44; among others&#44; should be evaluated&#46;<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a></p><p id="par0030" class="elsevierStylePara elsevierViewall">Although self-resolution might occur&#44; treatment options for NNDH include systemic and topical corticosteroids&#44; oral dapsone&#44; and colchicine&#46;<a class="elsevierStyleCrossRefs" href="#bib0020"><span class="elsevierStyleSup">4&#44;5</span></a> Our patient was treated with occlusive clobetasol for two weeks with a complete response&#46; The patient refused to continue an extensive work-up and subsequent follow-up&#46;</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Financial support</span><p id="par0035" class="elsevierStylePara elsevierViewall">None declared&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Authors&#8217; contributions</span><p id="par0040" class="elsevierStylePara elsevierViewall">Carlos Barrera-Ochoa&#58; The study concept and design&#59; data collection&#44; or analysis and interpretation of data&#59; writing of the manuscript or critical review of important intellectual content&#59; data collection&#44; analysis&#44; and interpretation&#59; effective participation in the research guidance&#59; critical review of the literature&#59; final approval of the final version of the manuscript&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">Luis Enrique Cano-Aguilar&#58; Writing of the manuscript or critical review of important intellectual content&#59; data collection&#44; analysis&#44; and interpretation&#59; effective participation in the research guidance&#59; critical review of the literature&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">Hector Cant&#250;-Maltos&#58; Writing of the manuscript or critical review of important intellectual content&#59; 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Letter - Clinical
Neutrophilic dermatosis of the dorsal hands in a Mexican woman
Carlos Barrera-Ochoaa,
Corresponding author
cabaoch@gmail.com

Corresponding author.
, Luis Enrique Cano-Aguilara, Hector Cantú-Maltosb, Hector Proy-Trujilloc, Nixma Eljure-Lópezd, María Elisa Vega-Memijea
a Department of Dermatology, General Hospital “Dr Manuel Gea González”, Mexico City, Mexico
b Department of Dermatopathology, General Hospital “Dr Manuel Gea González”, Mexico City, Mexico
c Department of Dermatologic Surgery, Dermatology Center of Yucatán, Mérida, Mexico
d Department of Dermatology, Dermatology Center of Yucatán, Mérida, Mexico
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2</a>&#41;&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">Neutrophilic Dermatosis of the Dorsal Hands &#40;NDDH&#41; is a rare variant of a neutrophilic dermatosis such as pyoderma gangrenosum and Sweet Syndrome&#46;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> Few cases have been reported in the literature so far&#44; and cutaneous involvement of the palms is seldomly described despite the radial dorsal surface of the hands as the most affected location&#44; especially in the area between the thumb and index finger&#46;<a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">2&#44;3</span></a> NDDH is characterized by erythematous plaques&#44; bullae&#44; pustules&#44; and nodules that might present necrosis and ulceration&#44; with progressive growth in a small period&#46;<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">A recent review of 123 cases of NDDH&#44; showed a female predominance in 58&#37; with a unilateral distribution in 78&#37; and a mean age of 62 years&#46; Due to its inflammatory pattern&#44; serological studies may present leukocytosis &#40;56&#46;5&#37;&#41; and neutrophilia &#40;83&#37;&#41; and mimic a soft skin tissue infection&#46; Besides the latter&#44; the differential diagnosis includes pyoderma gangrenosum&#44; Sweet syndrome&#44; and erythema elevatum diutinum&#46;<a class="elsevierStyleCrossRefs" href="#bib0015"><span class="elsevierStyleSup">3&#44;4</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">The histological presence of an intense neutrophil infiltrate through the dermis with associated edema is considered an indicator of neutrophilic dermatosis&#46; Other findings such as leukocytoclastic vasculitis may be found in the early stages of the disease due to endothelial damage but should not be considered as a criterion for making the diagnosis&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">The pathogenesis of NDDH is not completely understood&#46; Some authors have suggested trauma as a potential trigger and as with other neutrophilic dermatoses&#44; multiple systemic associations have been described&#46; Specifically&#44; in NDDH&#44; correlation with hematological or solid malignancies&#44; rheumatological conditions&#44; inflammatory bowel disease&#44; and co-morbidities such as diabetes and chronic renal disease as in our patient&#44; among others&#44; should be evaluated&#46;<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a></p><p id="par0030" class="elsevierStylePara elsevierViewall">Although self-resolution might occur&#44; treatment options for NNDH include systemic and topical corticosteroids&#44; oral dapsone&#44; and colchicine&#46;<a class="elsevierStyleCrossRefs" href="#bib0020"><span class="elsevierStyleSup">4&#44;5</span></a> Our patient was treated with occlusive clobetasol for two weeks with a complete response&#46; The patient refused to continue an extensive work-up and subsequent follow-up&#46;</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Financial support</span><p id="par0035" class="elsevierStylePara elsevierViewall">None declared&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Authors&#8217; contributions</span><p id="par0040" class="elsevierStylePara elsevierViewall">Carlos Barrera-Ochoa&#58; The study concept and design&#59; data collection&#44; or analysis and interpretation of data&#59; writing of the manuscript or critical review of important intellectual content&#59; data collection&#44; analysis&#44; and interpretation&#59; effective participation in the research guidance&#59; critical review of the literature&#59; final approval of the final version of the manuscript&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">Luis Enrique Cano-Aguilar&#58; Writing of the manuscript or critical review of important intellectual content&#59; data collection&#44; analysis&#44; and interpretation&#59; effective participation in the research guidance&#59; critical review of the literature&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">Hector Cant&#250;-Maltos&#58; Writing of the manuscript or critical review of important intellectual content&#59; 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Article information
ISSN: 03650596
Original language: English
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