Rheumatoid Neutrophilic Dermatitis

Rheumatoid neutrophilic dermatitis (RND) is an infrequent cutaneous manifestation of rheumatoid arthritis (RA). This condition is seen in patients who are both positive and negative for a circulating rheumatoid factor. Histologically, it presents with a neutrophilic dermatosis, characterized by a heavy dermal infiltrate of neutrophils with variable degrees of leukocytoclasis but no vasculitis. We describe the case of a young female with seronegative RA who had concomitant lesions of RND over both elbows. Her lesions appeared as nodules, but RND has been reported as papules and plaques, sometimes with an urticarialike appearance or ulcerations. They are often symmetric. The possibility of RND should be considered in the differential of unusual skin lesions in all patients with RA, as the presentation is quite varied.