Skin nontumor
Dermal non-granulomatous granulocyte-rich reaction patterns
Neutrophilic dermatosis associated with GI disease


Topic Completed: 1 July 2011

Minor changes: 16 July 2020

Copyright: 2002-2020, PathologyOutlines.com, Inc.

PubMed Search: Neutrophilic dermatosis associated with GI disease

Mowafak Hamodat, M.B.Ch.B., M.Sc.
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Cite this page: Hamodat M. Neutrophilic dermatosis associated with GI disease. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/skinnontumorneutrophilicderm.html. Accessed October 21st, 2020.
Definition / general
  • Occurs in 14 - 44% of patients with Crohn's disease
  • Includes pyoderma gangrenosum, erythema nodosum and so called metastatic Crohn's disease / nonnecrotizing sarcoid-like granulomatous dermatitis (Hum Pathol 2003;34:1185)
  • Above are all associated with vascular injury, typically with prominent extravascular neutrophilic or histiocytic dermal infiltrate
  • No microbes found in skin lesions
Treatment
  • Immunosuppressive therapy
Microscopic (histologic) description
  • Variable dermal edema and neutrophilic dermatosis
  • Perivascular and interstitial neutrophilic infiltrate
  • Variable numbers of lymphocytes and histiocytes
  • Abundant karyorrhexis, resembling Sweet disease
  • Also leukocytoclastic vasculitis and pustular vasculitis in some cases
  • Inflammation often limited to dermis but may involve subcutaneous fat, resulting in erythema nodosum or erythema nodosum like panniculitis
Differential diagnosis
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