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Palisaded Neutrophilic and Granulomatous Dermatitis in Association with Subcutaneous Nodular and Systemic Sarcoidosis
Zrinjka Paštar
Jaka Radoš
Ivan Pavić
Suzana Kovačević
Anamarija Vukasović
Višnja Milavec-Puretić
Jasna Lipozenčić
Abstract
Palisaded neutrophilic granulomatous dermatitis (PNGD)
is a rare entity that has been clearly defined neither clinically nor histopathologically.
PNGD has been associated with some immune-mediated
disorders such as rheumatoid arthritis, systemic lupus erythematosus,
systemic vasculitis, Behçet’s disease, as well as with lymphoproliferative
conditions, bacterial endocarditis, sarcoidosis, and various drugs.
We present a 44-year-old Caucasian woman with roundish erythematous-
livid plaque and erythematous papules on the left calf that were
present for three months. Histopathology of plaque lesion showed palisading
neutrophilic and granulomatous dermatitis. Subsequently, she
developed a firm and tender nodule on the right calf. Histopathology
of the nodule showed typical naked sarcoid granulomas in the dermis
and subcutis. Additionally, the patient developed non-tender subcutaneous
nodules on the cheeks, submandibular region and left breast
with normal overlying skin, which were histopathologically diagnosed
as sarcoid granuloma. Red eyes and lower visual acuity on the right eye
were diagnosed as anterior uveitis. Therefore, systemic sarcoidosis was
established. This is a case of PNGD described in an adult patient with sarcoidosis
with cutaneous, breast, eye and lung involvement established
by clinical, radiographic, laboratory, and histopathologic criteria.
Keywords
palisaded neutrophilic granulomatous dermatitis; sarcoidosis
Hrčak ID:
116009
URI
Publication date:
13.1.2014.
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