Abstract
We report a case of rheumatoid neutrophilic dermatitis in a patient with severe rheumatoid arthritis. A 65-year-old female had rheumatoid arthritis for 20 years. She had been treated with systemic corticosteroid treatment with 20-30 mg/day dose of prednisolon. She noticed reddish papules on the dorsal pedis 2 years ago and has been treated with DDS and potassium iodide. Two month ago clinical exacerbation occurred. Severely painful lesions which took appearance like annular or semi-annular pustules and dark-brown-colored plaques were formed on the bilateral hands, feet, knees, elbows and buttock. She visited us and complained severe pain at the lesions and walking difficulty. So, she was immediately administrated. A skin biopsy from a lesion on the knee showed subepidermal blisters filled with neutruphils, lymphocytes, erythrocytes. A dense diffuse infiltrate of neutrophilis involved the entire dermis. There was no evidence of vasculitis. Treatment with 20mg dose of etretinate was effective in treating the cutaneous eruptions.
