Żuk Gabriela, Jaworecka Kamila, Samotij Dominik, Ostańska Elżbieta, Reich Adam
Department of Dermatology, University of Rzeszow, Poland.
Department of Pathology, University of Rzeszow, Poland.
Reumatologia. 2019;57(6):350-353. doi: 10.5114/reum.2019.90363. Epub 2019 Dec 31.
Rheumatoid neutrophilic dermatitis is a rare extra-articular manifestation of rheumatoid arthritis, both seropositive and seronegative for rheumatoid factor. The condition most often presents as symmetric erythematous papules, nodules, plaques, and urticaria-like lesions in patients with severe, long-lasting rheumatoid arthritis. We report a case of a 65-year-old man with well-controlled rheumatoid arthritis, who developed rheumatoid neutrophilic dermatitis on the right lower leg. The biopsy of skin lesions revealed an intense, neutrophilic dermal infiltrate, microabscesses, and leukocytoclasis without vasculitis. The patient responded well to pulses of intravenous methylprednisolone. We present this patient due to the rarity of the disease and atypical unilateral manifestation involving the flexural surfaces of the lower leg.
类风湿性嗜中性皮病是类风湿性关节炎一种罕见的关节外表现，类风湿因子血清学检查可呈阳性或阴性。这种病症在患有严重、长期类风湿性关节炎的患者中最常表现为对称性红斑丘疹、结节、斑块及荨麻疹样损害。我们报告一例65岁男性患者，其类风湿性关节炎病情控制良好，却在右小腿出现了类风湿性嗜中性皮病。皮肤病变活检显示真皮层有密集的嗜中性粒细胞浸润、微脓肿及白细胞破碎现象，但无血管炎表现。该患者对静脉注射甲泼尼龙冲击治疗反应良好。鉴于该病罕见且该例表现为累及小腿屈侧表面的非典型单侧表现，我们特此报告该病例。
