Access Dermatology

Summary

The term neutrophilic dermatoses (ND) encompasses a group of diseases characterized by the presence of a noninfectious inflammatory infiltrate of mature polymorphonuclear leukocytes in the skin. The key features of ND include: i) the possible development of overlap syndromes between several ND; ii) the possible association with extracutaneous neutrophilic infiltrates; iii) the frequent association with some systemic diseases; and iv) absence of a recognized infectious mechanism. Three common clinical characteristics of ND support the absence of an infectious mechanism: i) negative skin and blood cultures; ii) absence of contagiousness; iii) absence of effect of antibiotics on the course of ND. However, the first differential diagnoses of ND are bacterial infections. The mechanism of the distinctive sterile inflammatory infiltrate of skin and other tissues by normal polymorphonuclear leukocytes remains unclear. The polymorphonuclear leukocytes are likely attracted to tissues by excessive inflammatory cytokines and growth factors, but the primum movens of their overproduction remains to be found. In line with the nonidentification of the primum movens, current therapeutic options are symptomatic and flares likely occur upon treatment withdrawal. We present herein an overview of the main neutrophilic dermatoses, classified according to their clinical and histological characteristics.