Skin nontumor
Neutrophilic and eosinophilic dermatoses
Neutrophilic dermatosis associated with gastrointestinal and hepatobiliary disease
Last author update: 1 July 2011
Last staff update: 8 February 2024
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PubMed Search: Neutrophilic dermatosis associated with GI disease
Table of Contents
Definition / general | Treatment | Microscopic (histologic) description | Differential diagnosisCite this page: Hamodat M. Neutrophilic dermatosis associated with gastrointestinal and hepatobiliary disease. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/skinnontumorneutrophilicderm.html. Accessed April 25th, 2024.
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
- Sweet disease
- Pyoderma gangrenosum
- Rheumatoid neutrophilic dermatitis
