Abstract:
Neutrophilic dermatoses (NDs) constitute a group of diseases characterized by sterile neutrophilic infiltrations. Many NDs usually present with infiltrated erythematous plaques, nodules, urticarial plaques, or pustules. Lesions may show variability, and atypical presentations may develop among NDs. Annular lesions have been reported in many NDs and may lead to diagnostic problems. Clinical features and histopathologic findings such as localization of the neutrophilic infiltrate, existence of other cell types, and absence of true vasculitis may be helpful to distinguish NDs. Some of these NDs are associated with infections, inflammatory diseases, and malignancies. In most NDs, systemic steroids and dapsone are very effective and usually first choices. Colchicine, antimicrobials such as doxycycline, tetracycline, and sulfapyridine, and other immunosuppressants such as cyclosporin, methotrexate, and mycophenolate mofetil have been used successfully in treating many NDs. Tumor necrosis factor α inhibitors have also been used successfully in treating many NDs. Janus kinase inhibitors are effective in CANDLE (chronic atypical neutrophilic dermatosis with lipodystrophy and elevated temperature) syndrome, anakinra in neutrophilic urticarial dermatosis, and intravenous immunoglobulin in resistant pyoderma gangrenosum. We discuss the diagnosis and management of NDs that may present with annular lesions.
摘要:
中性粒细胞性皮肤病(ND)是一组以无菌中性粒细胞浸润为特征的疾病。许多ND通常存在浸润性红斑,结节,荨麻疹斑块,或者脓疱.病变可能表现出变异性,非典型表现可能在ND中发展。在许多ND中已经报道了环形病变,并且可能导致诊断问题。临床特征和组织病理学发现,如嗜中性粒细胞浸润的定位,其他细胞类型的存在,和没有真正的血管炎可能有助于区分ND。其中一些与感染有关,炎症性疾病,和恶性肿瘤。在大多数NDS中,全身性类固醇和氨苯砜是非常有效的,通常是首选。秋水仙碱,抗菌药物,如多西环素,四环素,还有磺胺吡啶,和其他免疫抑制剂,比如环孢菌素,甲氨蝶呤,霉酚酸酯和霉酚酸酯已成功用于治疗许多ND。TNF-α抑制剂也已成功用于许多ND。JAK激酶抑制剂对CANDLE综合征有效,anakinra在中性粒细胞性荨麻疹皮肤病中,耐药坏疽性脓皮病的静脉注射免疫球蛋白。我们将讨论可能存在环形病变的ND的诊断和处理。