Palisaded neutrophilic and granulomatous dermatitis in a rheumatoid arthritis patient after treatment with adalimumab

摘要

Palisaded neutrophilic and granulomatous dermatitis (PNGD) is a rare disease occurring in patients with autoimmune diseases [1]. The clinical features are characterised by symmetrically distributed, skin coloured to erythematous, macropapular lesions with a smooth, ulcerated surface, mainly located on the extremities [1]. Histopathologically, PNGD is characterised by the presence of leukocyto-clastic vasculitis (LV), with dense neutrophilic infiltrates and degenerated collagen bundles in the early stage and palisaded granulomas with dermal fibrosis and scant neutrophilic debris in the late stage [1]. Here, we present a rheumatoid arthritis (RA) patient who developed PNGD, possibly induced by adalimumab.