关键词: 类风湿性嗜中性皮炎, 类风湿关节炎, 真皮中性粒细胞浸润

Abstract: A case of Rheumatoid neutrophilic dermatitis is reported and related literature is reviewed. A 60-year-old woman presented with multiple erythematous plaques and nodules on extremities with pain for more than one year, aggravating for 1 week with vesicles or pustules. She had rheumatoid arthritis with positive rheumatoid factor for 3 years. Three skin biopsies were taken from a blister, plaque and nodule. Histological examination of three times revealed different pathological manifestations of epidermis, dense and diffuse infiltration of mainly neutrophils and rarely lymphocytes in the upper and mid-dermis, with nuclear dust and vascular endothelial swelling, extravasation of erythrocytes were noted, but vasculitis was absent. A direct immunofluorescence revealed no deposits of immunoglobulin or complement. The diagnosis of Rheumatoid neutrophilic dermatitis was made. Based on the case and related literature, the pathogenesis, clinical and pathological features, and treatment of the disease are comprehensively analyzed in this paper.

Key words: rheumatoid neutrophilic dermatitis, rheumatoid arthritis, dermal neutrophilic infiltration