Titeca G, Goudetsidis L, Laka A, Jardinet D, Poot F
Service de dermatologie, clinique Notre-Dame-de-Grâce, 212, chaussée de Nivelles, 6041 Gosselies, Belgique.
Service de dermatologie, clinique Notre-Dame-de-Grâce, 212, chaussée de Nivelles, 6041 Gosselies, Belgique.
Ann Dermatol Venereol. 2014 Oct;141(10):603-6. doi: 10.1016/j.annder.2014.06.018. Epub 2014 Aug 6.
Rhumatoid arthritis (RA) is a chronic inflammatory joint disease. It appears to be caused by a combination of genetic and environmental factors. It may be accompanied by well-known extra-articular damage (e.g. lung, kidney, heart), while cutaneous involvement such as rheumatoid neutrophilic dermatitis (RND) is much less frequent.
A 64-year-old woman was referred by rheumatologists after she developed a cutaneous eruption on the forearms, elbows and scalp in a setting of progressive RA. A skin biopsy showed a dermal neutrophilic infiltrate throughout its entire thickness as well as leukocytoclasia, with fibrinoid material visible in certain areas. No vasculitis was observed. This histological examination led to a diagnosis of RND. The eruption was successfully treated with topical corticosteroids.
RND is a rare sign in RA that presents clinically as plaques, erythematous nodules or urticarial lesions. The lesions tend to disappear naturally or on treatment of RA. Topical corticosteroids or systemic therapy, in particular dapsone, may be suggested to treat cutaneous damage.
类风湿关节炎（RA）是一种慢性炎症性关节疾病。它似乎是由遗传和环境因素共同引起的。它可能伴有众所周知的关节外损害（如肺、肾、心脏），而类风湿嗜中性皮病（RND）等皮肤受累则较为少见。
一名64岁女性在类风湿关节炎病情进展过程中，前臂、肘部和头皮出现皮疹后，被风湿病学家转诊。皮肤活检显示真皮全层嗜中性粒细胞浸润以及核碎裂，某些区域可见纤维蛋白样物质。未观察到血管炎。这种组织学检查结果导致诊断为RND。皮疹经外用糖皮质激素成功治疗。
RND是RA中一种罕见的体征，临床上表现为斑块、红斑结节或荨麻疹样损害。这些损害往往会自然消失或在RA治疗后消失。可建议使用外用糖皮质激素或全身治疗，尤其是氨苯砜，来治疗皮肤损害。
