de Unamuno Bustos Blanca, Rabasco Ana García, Sánchez Rosa Ballester, de Miquel Víctor Alegre
Department of Dermatology, Servicio de Dermatología, Consorcio Hospital General Universitario de Valencia, Valencia, Spain.
Am J Dermatopathol. 2013 Dec;35(8):847-50. doi: 10.1097/DAD.0b013e3182964f26.
Palisaded neutrophilic granulomatous dermatitis (PNGD) is a rare neutrophilic dermatosis that shows a broad clinical and histopathological spectrum. The clinical presentation of PNGD varies from asymptomatic papules, to nodules, to annular plaques. The most common clinical presentation is erythematous papules on the extensor surface of extremities, especially fingers and elbows. Histopathological findings demonstrate a spectrum of changes that reflect the evolution of the lesions, from only sparse mixed perivascular infiltrates to interstitial or palisaded granuloma formation with dermal fibrosis. The cause of PNGD is unknown, but there is a prominent association with systemic conditions, particularly with autoimmune diseases, representing rheumatoid arthritis and systemic lupus erythematosus, the most common associations. It has also been described associated to systemic sclerosis, sarcoidosis, systemic vasculitis, inflammatory bowel disease, and lymphoproliferative disorders, and also drugs have been implicated. Recently, it has been described the potential association with tumor necrosis factor alpha inhibitors. This dermatosis should be considered as a marker of systemic disease and particularly it should be considered in patients with history of autoimmune disorders who present with papular eruptions on the extremities.
栅栏状中性粒细胞肉芽肿性皮炎（PNGD）是一种罕见的中性粒细胞性皮肤病，具有广泛的临床和组织病理学表现谱。PNGD的临床表现从无症状丘疹到结节，再到环状斑块不等。最常见的临床表现是四肢伸侧，尤其是手指和肘部出现红斑丘疹。组织病理学表现显示出一系列反映病变演变的变化，从仅有稀疏的混合血管周围浸润到伴有真皮纤维化的间质或栅栏状肉芽肿形成。PNGD的病因尚不清楚，但与全身状况，特别是与自身免疫性疾病有显著关联，其中类风湿关节炎和系统性红斑狼疮最为常见。它也被描述与系统性硬化症、结节病、系统性血管炎、炎症性肠病和淋巴增殖性疾病有关，药物也与之有关。最近，有人描述了它与肿瘤坏死因子α抑制剂的潜在关联。这种皮肤病应被视为全身疾病的标志物，特别是对于有自身免疫性疾病病史且四肢出现丘疹性皮疹的患者应予以考虑。
