Neutrophilic dermatoses

Summarizing term for an etiopathogenetically and clinically heterogeneous group of diseases characterized by varying degrees of systemic symptoms that are often febrile, reactive and frequently arthritic. The associated skin changes are defined histopathologically by neutrophilic diffuse dermatitis without evidence of vasculitis (exclusion criterion). On the one hand,"acute febrile neutrophilic dermatosis (Sweet syndrome)" is to be regarded as the prototype of this group of diseases. On the other hand, autoinflammatory (non-bacterial) pustuloses belong to this group of diseases.

In the following, "neutrophilic" dermatoses are listed in alphabetical order, whereby the classification into "in the broader and narrower sense" must be considered provisional. "Neutrophilic" dermatoses are often associated with reactive arthritis (see also dermatitis-arthritis syndromes) or are characterized by a primary arthritic constellation.

Neutrophilic dermatoses (in the narrower sense):

• Acute neutrophilic dermatosis (Sweet syndrome)
• Dermatitis, rheumatoid, neutrophilic
• Neutrophilic figured erythema in children
• Dermatitis, interstitial, granulomatous with arthritis
• Dermatosis, acute febrile neutrophilic (Sweet syndrome)
• Hidradenitis, neutrophilic, eccrine
• Erythema anulare rheumaticum
• Impetigo herpetiformis
• Psoriasis pustulosa generalisata
• Pustulosis, subcorneal (subcorneal pustular dermatosis)
• Neutrophilic dermatosis of the back of the hand
• Pyoderma gangraenosum
• Melanosis neonatal transient pustular
• Wegener's granulomatosis
• See also under Autoinflammatory syndromes (monogenic) skin changes

Neutrophilic dermatoses (in the broader sense):

• Acne fulminans
• Arthroosteitis, pustular
• Acropustulosis, infantile
• Anticonvulsant hypersensitivity syndrome
• Behçet, M.
• Erythema necroticans migrans
• Erythema elevatum diutinum
• Impetigo herpetiformis
• Small vessel vasculitis(leukocytoclastic vasculitis)
• Dermatitis herpetiformis
• Linear IgA dermatosis
• Bacterid Andrews, pustular (pustulosis palmo-plantaris)
• Reiter's syndrome
• SAPHO syndrome

• Intestinal-associated dermatosis-arthritis syndrome

The pathogenesis of this clinically very different group of diseases is not yet clear; however, it is probably not uniform but polyetiological - autoimmunological, vasculitic, infectious-allergic.

The skin symptoms vary considerably from clinical picture to clinical picture. They range from vesiculo-pustular to papular or plaque-like lesions. The polymorphism of the clinical symptoms in one and the same patient is characteristic.

1. Cool E (2010) Reactive neutrophilic dermatoses. Act Dermatol 36: 165-170
2. Callen JP (2002) Neutrophilic dermatoses. Dermatol Clin 20: 409-419