Rheumatoid neutrophilic dermatitis

Abstract Rheumatoid neutrophilic dermatitis (RND) is a dermatological condition typically associated with rheumatoid arthritis (RA). The low prevalence of RND and the wide spectrum of its possible clinical appearances make the diagnosis challenging. Current literature is still lacking a comprehensiv...

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Main Authors: Biagio Scotti, Cosimo Misciali, Yuri Merli, Federico Bardazzi, Diego Abbenante, Emi Dika, Bianca M. Piraccini
Format: Article
Language:English
Published: Wiley 2024-12-01
Series:JEADV Clinical Practice
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Online Access:https://doi.org/10.1002/jvc2.500
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author Biagio Scotti
Cosimo Misciali
Yuri Merli
Federico Bardazzi
Diego Abbenante
Emi Dika
Bianca M. Piraccini
author_facet Biagio Scotti
Cosimo Misciali
Yuri Merli
Federico Bardazzi
Diego Abbenante
Emi Dika
Bianca M. Piraccini
author_sort Biagio Scotti
collection DOAJ
description Abstract Rheumatoid neutrophilic dermatitis (RND) is a dermatological condition typically associated with rheumatoid arthritis (RA). The low prevalence of RND and the wide spectrum of its possible clinical appearances make the diagnosis challenging. Current literature is still lacking a comprehensive overview of this rare cutaneous disorder. The aim of this review is to summarize data from the existing literature on RND, focusing on its epidemiology, clinical manifestations, histopathology and treatment. Hence, a comprehensive literature search of case reports and series was made, starting from a Medline (via PubMed) and Scopus databases. We also included in the analysis one patient attending to our dermatology department and diagnosed with RND. Overall, 54 cases of RND were identified. The majority of patients were female (72.3%) with a median (IQR) age at the time of diagnosis of 58 (65‐45) years. RND followed the onset of RA in 87% of patients with an average (SD) latency time of approximately 10 (8.9) years. In 1 (1.8%) case the dermatitis preceded the appearance of joint symptoms, while in three (5.5%) cases it occurred concomitantly with them. Seropositive RA was the major associated form (76.5%). Clinically, asymptomatic papules (31%), nodules (15.1%) and/or plaques (13.5%) distributed bilaterally on extremities were most frequently described. Notably, females were more prone to develop a painful dermatitis (84.6%) compared to males. The vesicobullous (12.7%) and pustular (9.2%) clinical subtypes were the most demonstrative in contrast to the urticarial skin manifestations and the potential figurative/annular distribution of the lesions. Spontaneous resolution of RND was rare (5.5%). Systemic treatments, mainly represented by steroids and anti‐neutrophilic agents (dapsone, colchicine), were consistently required.
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spelling doaj-art-46b053e4c41c4970b6af435f7f6f09462024-12-02T13:08:37ZengWileyJEADV Clinical Practice2768-65662024-12-01351364138010.1002/jvc2.500Rheumatoid neutrophilic dermatitisBiagio Scotti0Cosimo Misciali1Yuri Merli2Federico Bardazzi3Diego Abbenante4Emi Dika5Bianca M. Piraccini6Dermatology Unit IRCCS Azienda Ospedaliero‐Universitaria di Bologna Bologna ItalyDermatology Unit IRCCS Azienda Ospedaliero‐Universitaria di Bologna Bologna ItalyDermatology Unit IRCCS Azienda Ospedaliero‐Universitaria di Bologna Bologna ItalyDermatology Unit IRCCS Azienda Ospedaliero‐Universitaria di Bologna Bologna ItalyDermatology Unit Santa Maria delle Croci Hospital, AUSL della Romagna Ravenna ItalyDermatology Unit IRCCS Azienda Ospedaliero‐Universitaria di Bologna Bologna ItalyDermatology Unit IRCCS Azienda Ospedaliero‐Universitaria di Bologna Bologna ItalyAbstract Rheumatoid neutrophilic dermatitis (RND) is a dermatological condition typically associated with rheumatoid arthritis (RA). The low prevalence of RND and the wide spectrum of its possible clinical appearances make the diagnosis challenging. Current literature is still lacking a comprehensive overview of this rare cutaneous disorder. The aim of this review is to summarize data from the existing literature on RND, focusing on its epidemiology, clinical manifestations, histopathology and treatment. Hence, a comprehensive literature search of case reports and series was made, starting from a Medline (via PubMed) and Scopus databases. We also included in the analysis one patient attending to our dermatology department and diagnosed with RND. Overall, 54 cases of RND were identified. The majority of patients were female (72.3%) with a median (IQR) age at the time of diagnosis of 58 (65‐45) years. RND followed the onset of RA in 87% of patients with an average (SD) latency time of approximately 10 (8.9) years. In 1 (1.8%) case the dermatitis preceded the appearance of joint symptoms, while in three (5.5%) cases it occurred concomitantly with them. Seropositive RA was the major associated form (76.5%). Clinically, asymptomatic papules (31%), nodules (15.1%) and/or plaques (13.5%) distributed bilaterally on extremities were most frequently described. Notably, females were more prone to develop a painful dermatitis (84.6%) compared to males. The vesicobullous (12.7%) and pustular (9.2%) clinical subtypes were the most demonstrative in contrast to the urticarial skin manifestations and the potential figurative/annular distribution of the lesions. Spontaneous resolution of RND was rare (5.5%). Systemic treatments, mainly represented by steroids and anti‐neutrophilic agents (dapsone, colchicine), were consistently required.https://doi.org/10.1002/jvc2.500cutaneous manifestationneutrophilneutrophilic dermatosisnodulerheumatoid arthritisrheumatoid neutrophilic dermatitis
spellingShingle Biagio Scotti
Cosimo Misciali
Yuri Merli
Federico Bardazzi
Diego Abbenante
Emi Dika
Bianca M. Piraccini
Rheumatoid neutrophilic dermatitis
JEADV Clinical Practice
cutaneous manifestation
neutrophil
neutrophilic dermatosis
nodule
rheumatoid arthritis
rheumatoid neutrophilic dermatitis
title Rheumatoid neutrophilic dermatitis
title_full Rheumatoid neutrophilic dermatitis
title_fullStr Rheumatoid neutrophilic dermatitis
title_full_unstemmed Rheumatoid neutrophilic dermatitis
title_short Rheumatoid neutrophilic dermatitis
title_sort rheumatoid neutrophilic dermatitis
topic cutaneous manifestation
neutrophil
neutrophilic dermatosis
nodule
rheumatoid arthritis
rheumatoid neutrophilic dermatitis
url https://doi.org/10.1002/jvc2.500
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AT yurimerli rheumatoidneutrophilicdermatitis
AT federicobardazzi rheumatoidneutrophilicdermatitis
AT diegoabbenante rheumatoidneutrophilicdermatitis
AT emidika rheumatoidneutrophilicdermatitis
AT biancampiraccini rheumatoidneutrophilicdermatitis