Images in Clinical Rheumatology
Neutrophilic Dermatosis of the Hands (Localized Sweet's Syndrome)
Dermatosis neutrofílica de las manos (Sweet de las manos)
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(b) Hematoxylin and eosin (10×). Dense dermic neutrophilic infiltrate with marked edema, without leukocytoclastic vasculitis.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">We present the case of a 67-year-old Caucasian woman, who had been diagnosed 9 months before with primary immune thrombocytopenia. She had developed painful palmar lesions 1 week earlier, but had no fever or other accompanying symptoms. We observed erythematous violaceous plaques on the ulnar border of both hands, with a pustule of about 4<span class="elsevierStyleHsp" style=""></span>cm on the right (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>a). A biopsy showed a dense dermic neutrophilic infiltrate, with marked edema, and no vasculitis (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>b). Cultures to detect bacteria, virus and fungi produced no evidence. Except for the patient's thrombocytopenia, her complete blood count was normal, and laboratory testing found a C-reactive protein of 1<span class="elsevierStyleHsp" style=""></span>mg/L. A study of the extension ruled out an underlying neoplastic disease. She responded completely to oral prednisone at 0.5<span class="elsevierStyleHsp" style=""></span>mg/kg/day for 2 weeks, with no recurrence after 1 year of follow-up. The neutrophilic dermatosis of dorsal hands, recently described,<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">1</span></a> consists of the presence of erythematous violaceous plaques on acral sites, with blisters or pustules, histologically constituted by a dermic neutrophilic infiltrate, with or without association of leukocytoclastic vasculitis.<a class="elsevierStyleCrossRefs" href="#bib0055"><span class="elsevierStyleSup">1–8</span></a> Generally, there is no respiratory involvement, fever or laboratory abnormalities, which differentiates it from conventional Sweet's syndrome.<a class="elsevierStyleCrossRefs" href="#bib0055"><span class="elsevierStyleSup">1–5,9</span></a> It has been associated with hematologic neoplasms (frequently, myelodysplasia and leukemias), carcinomas, inflammatory bowel disease and arthritis, among other conditions.<a class="elsevierStyleCrossRefs" href="#bib0055"><span class="elsevierStyleSup">1–5</span></a> Available data show a rate of association with hematological diseases similar to that of classical Sweet's syndrome.<a class="elsevierStyleCrossRefs" href="#bib0070"><span class="elsevierStyleSup">4,9,10</span></a> The case we report is the first that associates it with primary immune thrombocytopenia, a disease that has been found exceptionally in conventional Sweet's syndrome.<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">10</span></a> Our case, although the involvement is palmar, has a characteristic pustular morphology. Thus, we consider the term acral or hand neutrophilic dermatosis to be more correct.<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">9</span></a> The differential diagnosis should include skin infections, arthritis, vasculitis and cutaneous lymphomas. It responds well to oral corticosteroids or dapsone, and its recurrence is occasional.<a class="elsevierStyleCrossRefs" href="#bib0055"><span class="elsevierStyleSup">1–5</span></a></p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Ethical Disclosures</span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Protection of human and animal subjects</span><p id="par0010" class="elsevierStylePara elsevierViewall">The authors declare that no experiments were performed on humans or animals for this study.</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Confidentiality of data</span><p id="par0015" class="elsevierStylePara elsevierViewall">The authors declare that they have followed the protocols of their work center on the publication of patient data.</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Right to privacy and informed consent</span><p id="par0020" class="elsevierStylePara elsevierViewall">The authors declare that no patient data appear in this article.</p></span></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conflict of Interest</span><p id="par0025" class="elsevierStylePara elsevierViewall">The authors declare they have no conflict of interest.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:3 [ 0 => array:3 [ "identificador" => "sec0005" "titulo" => "Ethical Disclosures" "secciones" => array:3 [ 0 => array:2 [ "identificador" => "sec0010" "titulo" => "Protection of human and animal subjects" ] 1 => array:2 [ "identificador" => "sec0015" "titulo" => "Confidentiality of data" ] 2 => array:2 [ "identificador" => "sec0020" "titulo" => "Right to privacy and informed consent" ] ] ] 1 => array:2 [ "identificador" => "sec0025" "titulo" => "Conflict of Interest" ] 2 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Lozano-Masdemont B, Molina-López I, Parra-Blanco V, Suárez-Fernández R. Dermatosis neutrofílica de las manos (Sweet de las manos). Reumatol Clin. 2017;13:53–54.</p>" ] ] "multimedia" => array:1 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 850 "Ancho" => 1164 "Tamanyo" => 235899 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">(a) A large pustule in an erythematous violaceous plaque on the palm of the patient's hand. (b) Hematoxylin and eosin (10×). Dense dermic neutrophilic infiltrate with marked edema, without leukocytoclastic vasculitis.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:10 [ 0 => array:3 [ "identificador" => "bib0055" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Pustular vasculitis of the hands" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "G. Strutton" 1 => "D. Weedon" 2 => "I. 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| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 15 | 13 | 28 |
| 2024 October | 92 | 28 | 120 |
| 2024 September | 76 | 15 | 91 |
| 2024 August | 97 | 34 | 131 |
| 2024 July | 73 | 26 | 99 |
| 2024 June | 69 | 34 | 103 |
| 2024 May | 86 | 27 | 113 |
| 2024 April | 97 | 26 | 123 |
| 2024 March | 102 | 33 | 135 |
| 2024 February | 78 | 25 | 103 |
| 2024 January | 83 | 23 | 106 |
| 2023 December | 53 | 19 | 72 |
| 2023 November | 83 | 31 | 114 |
| 2023 October | 72 | 26 | 98 |
| 2023 September | 71 | 33 | 104 |
| 2023 August | 82 | 10 | 92 |
| 2023 July | 77 | 28 | 105 |
| 2023 June | 72 | 21 | 93 |
| 2023 May | 96 | 25 | 121 |
| 2023 April | 57 | 9 | 66 |
| 2023 March | 106 | 38 | 144 |
| 2023 February | 94 | 28 | 122 |
| 2023 January | 58 | 18 | 76 |
| 2022 December | 105 | 28 | 133 |
| 2022 November | 77 | 22 | 99 |
| 2022 October | 127 | 43 | 170 |
| 2022 September | 112 | 38 | 150 |
| 2022 August | 107 | 42 | 149 |
| 2022 July | 95 | 35 | 130 |
| 2022 June | 152 | 33 | 185 |
| 2022 May | 102 | 44 | 146 |
| 2022 April | 105 | 43 | 148 |
| 2022 March | 103 | 43 | 146 |
| 2022 February | 77 | 31 | 108 |
| 2022 January | 120 | 45 | 165 |
| 2021 December | 65 | 42 | 107 |
| 2021 November | 96 | 57 | 153 |
| 2021 October | 146 | 58 | 204 |
| 2021 September | 115 | 44 | 159 |
| 2021 August | 118 | 41 | 159 |
| 2021 July | 163 | 41 | 204 |
| 2021 June | 81 | 32 | 113 |
| 2021 May | 138 | 54 | 192 |
| 2021 April | 226 | 121 | 347 |
| 2021 March | 143 | 41 | 184 |
| 2021 February | 103 | 23 | 126 |
| 2021 January | 103 | 25 | 128 |
| 2020 December | 75 | 25 | 100 |
| 2020 November | 60 | 15 | 75 |
| 2020 October | 72 | 19 | 91 |
| 2020 September | 102 | 33 | 135 |
| 2020 August | 40 | 20 | 60 |
| 2020 July | 42 | 20 | 62 |
| 2020 June | 72 | 25 | 97 |
| 2020 May | 49 | 20 | 69 |
| 2020 April | 46 | 14 | 60 |
| 2020 March | 26 | 5 | 31 |
| 2020 February | 2 | 0 | 2 |
| 2019 January | 1 | 0 | 1 |
| 2018 May | 4 | 0 | 4 |
| 2018 April | 48 | 3 | 51 |
| 2018 March | 65 | 8 | 73 |
| 2018 February | 40 | 4 | 44 |
| 2018 January | 24 | 6 | 30 |
| 2017 December | 42 | 11 | 53 |
| 2017 November | 23 | 7 | 30 |
| 2017 October | 22 | 5 | 27 |
| 2017 September | 34 | 8 | 42 |
| 2017 August | 27 | 8 | 35 |
| 2017 July | 32 | 11 | 43 |
| 2017 June | 49 | 21 | 70 |
| 2017 May | 47 | 22 | 69 |
| 2017 April | 49 | 34 | 83 |
| 2017 March | 47 | 19 | 66 |
| 2017 February | 35 | 22 | 57 |
| 2017 January | 9 | 15 | 24 |
| 2016 December | 13 | 20 | 33 |
| 2016 November | 9 | 20 | 29 |
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