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Skin-nontumor / Clinical Dermatology

Other dermatoses

Neutrophilic dermatosis associated with GI disease


Reviewer: Mowafak Hamodat, MB.CH.B, MSc., FRCPC, Eastern Health, St. Johns, Canada (see Reviewers page)
Revised: 16 December 2014, last major update July 2011
Copyright: (c) 2002-2014, PathologyOutlines.com, Inc.

General
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● Occurs in 14-44% of patients with Crohn's disease
● Includes pyoderma gangrenosum, erythema nodosum and so-called metastatic Crohn's disease / non-necrotizing 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
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● Immunosuppressive therapy

Micro
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● Variable dermal edema and neutrophilic dermatosis
● Perivascular and interstitial neutrophilic infiltrate
● Variable numbers of lymphocytes and histiocytes
● Abundant karyorrhexis, resembling Sweet’s 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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Sweet's disease
Pyoderma gangrenosum
Rheumatoid neutrophilic dermatitis

End of Skin-nontumor / Clinical Dermatology > Other dermatoses > Neutrophilic dermatosis associated with GI disease


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