Case Number : CT0117 Adam_Bates

Neutrophilic dermatosis of dorsal hands. Dense neutrophilic dermal infiltrate with leucocytoclasia and vasculitis are the salient features. This is considered to be a localized variant of Sweet syndrome.

Agree with neutrophilic dermatosis of dorsal hands

I agree it as a neutrophilic dermatosis

can it be related to Bacillus Calmette-Guérin therapy which is given for bladder cancer- some thing like drug related sweet syndrome.

Agree with a neutrophilic dermatosis of dorsal hands, because of topography and neutrophilic infiltrate, but not sure about pathologic chapter of NDDH. In last picture I see a concentric lamellar onion skin fibrosis...why not an early stage ( of a new bulls entry ) of EED?

Thanks for the comments. I thought this was a nice recent example of neutrophilic dermatosis of the (dorsal) hands. This is a neutrophilic dermatosis on the spectrum of Sweet's, with a number of reported associations including malignancy, haematological disease and connective tissue diseases. As Krishnakumar mentions, drugs are sometimes implicated in Sweet's, but I am not certain for this case.

This case is also interesting because of a degree of epidermal and infundibular hyperplasia. There is some endothelial swelling which I highlighted, but I did not think there was genuine vasculitis, especially when one considers the density of the infiltrate. There are 2 schools: Either a) vasculitis is present, or b) is not present, in Sweet's. I am more in the second camp, but up for debate!