Cases reported "Hand Dermatoses"

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1/22. Sweet's syndrome associated with chronic myelogenous leukemia: demonstration of leukemic cells within a skin lesion.

    We report a case of acute febrile neutrophilic dermatosis, Sweet's syndrome, associated with chronic myelogenous leukemia (CML) in which we found rearrangement of the bcr gene in dna obtained from a skin lesion as well as in blood dna by Southern blot analysis. This indicated the presence of CML cells within the skin lesion. To our knowledge, this is the first report in which the presence of CML cells is shown within skin lesions of Sweet's syndrome. In our patient, leukocyte alkaline phosphatase activities returned to normal levels when he was suffering from Sweet's syndrome and decreased again to below normal levels after it subsided. Whether the normalization of leukocyte alkaline phosphatase activity is common among CML patients with Sweet's syndrome remains to be determined.
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ranking = 1
keywords = neutrophilic
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2/22. Pustular vasculitis of the hands.

    A case of pustular vasculitis of the hands with evidence of systemic involvement is described. A 64-year-old woman presented with a 2-day history of large, tense bullae arranged symmetrically over the dorsum of the three radial digits and extending on to the radial aspect of the dorsum of each hand. The bullae caused some discomfort and prevented normal use of her hands. There was no response to antibiotic therapy initiated prior to referral to hospital. Initial investigations revealed a raised white cell count with a neutrophilia, a raised erythrocyte sedimentation rate and a raised c-reactive protein. Abnormalities of liver function were detected. Aspirates from the bullae and blood cultures were sterile. The histology of debrided tissue demonstrated a florid neutrophilic dermal infiltrate with many blood vessels associated with prominent fibrin. A diagnosis of pustular vasculitis of the hands was made. The bullae were surgically debrided and treatment with oral corticosteroids was started. Two days after commencement of oral prednisolone, a crusted pustule appeared on her upper cutaneous lip. There was rapid resolution of both the vasculitis of the hands and the pustule on her upper lip following an increase in the dose of oral prednisolone. The patient was discharged on the seventeenth day following admission.
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ranking = 1
keywords = neutrophilic
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3/22. leukemia cutis in a patient with chronic neutrophilic leukemia.

    Chronic neutrophilic leukemia (CNL) is a rare myeloproliferative disorder. Less than 50 cases have been reported. We report the first case of CNL with an associated leukemia cutis. CNL was diagnosed in a 74-year-old white woman in 1998, based on neutrophilic infiltration of the bone marrow and absence of the philadelphia chromosome. The patient presented to the dermatology service in August 1998 with a 2-week history of a pruritic eruption on the arms, hands, and legs. physical examination revealed red to violaceous plaques on both thighs and knees, in addition to purpuric patches and plaques on the dorsal hands, arms, and legs. leukemia cutis was demonstrated on biopsy specimens of several lesional sites. The eruption progressed, despite treatment with topical and systemic corticosteroids. Treatment with systemic chemotherapy did affect partial resolution of the eruption, with parallel decreases in bone pain and white blood cell count, but the disease progressed and the patient ultimately died 5 months after her initial skin findings. Only one other case of CNL with dermatologic manifestations has been reported, CNL associated with a reactional neutrophilic dermatosis. Comparison to and differentiation from this case is discussed. The importance of distinguishing the specific infiltrates of leukemia from the nonspecific infiltrates of reactional dermatoses, such as Sweet's syndrome, is illustrated.
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ranking = 7
keywords = neutrophilic
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4/22. colchicine treatment in a patient with neutrophilic dermatosis associated with rheumatoid arthritis.

    Neutrophilic dermatoses (ND) are characterized by epidermal and dermal infiltrates of polymorphonuclear leukocytes (PMN), without any infectious or other detectable agents as a cause. We describe a case of ND, which very rapidly improved upon colchicine treatment. The patient was a 67-year-old female with an 8-month history of dusky-red, tender, swollen plaques and nodules with superimposed vesicles and bullae on the buttocks, hands, and ankles associated with rheumatoid arthritis. The diagnosis of ND was made on the basis of the clinical and histopathological features of the skin lesions. She was treated with 0.6 mg of oral colchicine twice daily. Within one week, the erythematous plaques and arthralgia began to recede and disappeared within four weeks. In our case, colchicine seemed to improve the signs and symptoms of ND and appeared to be more effective than the other drugs we had used.
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ranking = 4
keywords = neutrophilic
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5/22. Idiopathic palmoplantar eccrine hidradenitis in children.

    Idiopathic palmoplantar eccrine hidradenitis (IPPH) is a recently described disorder characterized by painful erythematous plantar nodules and in three cases, showed a typical neutrophilic infiltrate around and within the eccrine sweat apparatus. Five cases of IPPH on the soles of the feet in healthy children are reported. The disorder presented after intense physical activity in four cases. The course was benign and self-limiting. Complete bed rest for several days without any medical therapy led to alleviation of the pain and disappearance of all the lesions. Conclusion. Idiopathic palmoplantar eccrine hidradenitis may be more common than reported. Paediatricians should be aware of it in order to avoid unnecessary diagnostic tests and treatments.
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ranking = 60.699607892242
keywords = eccrine hidradenitis, hidradenitis, neutrophilic
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6/22. Pustular idiopathic recurrent palmoplantar hidradenitis: an unusual clinical feature.

    A 12-year-old boy had painful lesions on both soles. He had had a similar episode several months before that resolved spontaneously. physical examination showed erythematous, extremely tender nodules on both plantar surfaces and the toes. The second and third left toes had small pustules on top of the nodules. There was no palmar involvement. The clinical features, pathologic findings, and self-limited course suggested recurrent palmoplantar hidradenitis. This distinctive entity of unknown origin appears during childhood and is characterized histologically by a neutrophilic infiltrate affecting the eccrine glands. We report the case of a patient with unusual clinical features.
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ranking = 21.493684886427
keywords = hidradenitis, neutrophilic
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7/22. Recurrent palmoplantar hidradenitis with exclusive palmar involvement and an association with trauma and exposure to aluminum dust.

    Recurrent palmoplantar hidradenitis is a benign, self-limited inflammatory skin condition that has been reported to occur on the soles and palms of otherwise healthy children and young adults. patients with the disease present with tender, erythematous and edematous plaques and nodules on the palmoplantar skin. We describe a child who had recurrent palmoplantar hidradenitis that occurred after trauma and exposure to aluminum dust and manifested as lesions localized to only the palmar surfaces. This case is presented to add exclusive palmar involvement to the diagnostic spectrum of recurrent palmoplantar hidradenitis and to review the proposed pathogenesis of the disease.
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ranking = 28.691158840998
keywords = hidradenitis
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8/22. Neutrophilic dermatosis of the hands: four new cases and review of the literature.

    BACKGROUND: Isolated or predominantly hand involvement in Sweet's syndrome, pyoderma gangrenosum, or pustular vasculitis is a rare presentation in the spectrum of neutrophilic dermatoses and is often associated with an occult malignancy or other systemic inflammatory disorder. When these disorders occur on the hands, they are often clinically indistinguishable, but they can sometimes be separated histologically by the presence of papillary dermal edema (Sweet's syndrome), ulceration and necrosis (pyoderma gangrenosum), or vasculitis (pustular vasculitis). These distinctions may be arbitrary, however, and reflect differences in the temporal course of the disease and in the degree of inflammation at the time of biopsy. methods: We report four cases of neutrophilic dermatosis affecting the hands and a review of the literature for similar cases. RESULTS: Of the four patients presented, two had associated carcinomas and one had myelodysplasia in transition to leukemia. The cutaneous symptoms preceded the finding of an occult malignancy. Thirty-two reported cases of neutrophilic dermatoses presenting on the hands showed clinicopathologic features similar to those in our series. Taken together, the mean age at diagnosis was 60.5 years, and 58% of the patients were female. Twenty-five per cent (nine patients) also had myelodysplasia or leukemia, 14% (five patients) ulcerative colitis, 6% (two patients) carcinoma, 6% (two patients) Crohn's disease, and 6% (two patients) seropositive arthritis. CONCLUSIONS: These cases illustrate the importance of recognizing that neutrophilic dermatoses may present uniquely or predominantly on the hands. This presentation is distinctive, and prompt diagnosis may prevent unnecessary medical or surgical therapy and may lead to the earlier diagnosis and treatment of an associated malignancy or other systemic disorder.
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ranking = 4
keywords = neutrophilic
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9/22. Neutrophilic dermatosis of the dorsal hand.

    Neutrophilic dermatosis of the dorsal hands (NDDH) was originally described as pustular vasculitis (PV) of the hands. Recent debate focuses on categorizing this disorder in the family of neutrophilic dermatoses (ND), as opposed to a primary vasculitis. We present a case of NDDH with clinical and histologic features consistent with ND, and discuss the major concerns for this disease's reclassification.
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ranking = 1
keywords = neutrophilic
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10/22. Neutrophilic dermatosis of the dorsal hands in a farmer.

    Neutrophilic dermatosis of the dorsal hands is a recently described disorder, which is similar to Sweet's syndrome. It is characterized by erythematous plaques, pustules and haemorrhagic bullae located solely on the dorsal surface of the hands. We describe a 57-year-old man with neutrophilic dermatosis of the dorsal hands that occurred following exposure to a chemical fertilizer. There are few cases reported in the literature regarding neutrophilic dermatosis and the aetiology remains unclear. For the present case, we propose that neutrophilic dermatosis of the dorsal hands might have been induced by the chemical fertilizer.
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ranking = 3
keywords = neutrophilic
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