Extensive Palisaded Neutrophilic Granulomatous Dermatitis with Systemic Lupus Erythematosus

Main Article Content

Luke J Maxfield
Laura S Tanner
Chelsea Schwartz

Keywords

Systemic lupus erythematosus, neutrophilic dermatosis, palisaded neutrophilic granulomatous dermatitis, autoimmune, connective tissue disease.

Abstract

Systemic lupus erythematosus (SLE) is a multi-system disease with a myriad of mucocutaneous and systemic findings. One of the atypical cutaneous manifestations is palisaded neutrophilic granulomatous dermatitis (PNGD). This uncommon condition presents as tender or asymptomatic, flesh-colored, red to violaceous subcutaneous nodules. The diagnosis may be suspected clinically but is confirmed by biopsy. The impact of the disease may be the direct result of pain, psychosocial, cosmetic concerns, or be the initial presentation of an underlying systemic disease. We present a patient with known SLE who developed PNGD. We also review similar clinical and microscopic disease entities with a summative comparison of neutrophilic dermatoses in patients with autoimmune connective tissue diseases. 

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