Neutrophilic dermatoses. Part II. Pyoderma gangrenosum and other bowel and arthritis associated neutrophilic dermatoses

Publication date: Available online 11 April 2018
Source:Journal of the American Academy of Dermatology
Author(s): Hovik J. Ashchyan, Caroline A. Nelson, Sasha Stephen, William D. James, Robert G. Micheletti, Misha Rosenbach
Neutrophilic dermatoses are a heterogeneous group of inflammatory skin disorders that present with unique clinical features, but are unified by the presence of a sterile, predominantly neutrophilic infiltrate on histopathology. The morphology of cutaneous lesions associated with these disorders is heterogeneous, which renders diagnosis challenging. Moreover, a thorough evaluation is required to exclude diseases that mimic these disorders and to diagnose potential associated infectious, inflammatory, and neoplastic processes. While some neutrophilic dermatoses may resolve spontaneously, most require treatment to achieve remission. Delays in diagnosis and treatment can lead to significant patient morbidity and even mortality. Therapeutic modalities range from systemic corticosteroids to novel biologic agents, and the treatment literature is rapidly expanding. Part II of this continuing medical education activity reviews the epidemiology, clinical characteristics, histopathological features, diagnosis, and management of pyoderma gangrenosum as well as bowel-associated dermatosis-arthritis syndrome and the arthritis-associated neutrophilic dermatoses: rheumatoid neutrophilic dermatitis and adult Still disease.