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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">A 92-year-old man with no medical history of interest was seen at our dermatology department for rapidly progressive lesions that appeared on the hands in the absence of any trauma&#46; The lesions began as 2 violaceous papules on the back of the right hand and the dorsum of the third finger of the same hand&#44; and in less than 2 weeks developed into 2 edematous plaques of approximately 7 cm and 3&#160;cm in diameter&#44; respectively&#44; with central ulceration&#44; a violaceous border&#44; and a friable base&#46; One week after the appearance of these lesions a new hard&#44; nonulcerated&#44; friable painful nodule appeared on the back of the left hand &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">Culture and a skin punch biopsy were performed and empirical intravenous antibiotic treatment was initiated while awaiting the results of the microbiological studies&#46; The culture was negative and the biopsy showed a dense neutrophilic infiltrate beneath a moderately hyperplasic epithelium&#46; Based on these findings the patient was diagnosed with neutrophilic dermatosis of the dorsal hands and was treated with oral prednisone &#40;0&#46;5&#160;mg&#47;kg&#47;d&#41;&#46; The lesions improved considerably within 2 weeks of beginning treatment&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">To rule out other associated processes&#44; the patient underwent a full laboratory work-up including a blood smear and an autoimmunity study&#44; computed tomography of the thorax&#44; abdomen&#44; and pelvis&#44; and a colonoscopy&#44; none of which revealed any pathological findings of interest&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">Neutrophilic dermatosis of the dorsal hands is an inflammatory disease related to Sweet syndrome&#44; and can be associated with other processes such as tumors &#40;mainly hematological&#41;&#44; autoimmune diseases&#44; infections&#44; and inflammatory bowel disease&#46; Skin biopsy is essential for diagnosis and culture is useful&#44; as this condition is frequently confused with an infectious disease&#46; The first line of treatment consists of systemic corticosteroids&#44; although in refractory cases other treatments such as dapsone have been administered&#44; with good response&#46;</p></span>"
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Images in Dermatology
Neutrophilic Dermatosis on the Dorsal Hands
Dermatosis neutrofílica del dorso de las manos
L. Quintana Castanedo
Autor para correspondencia
luciaquintana.e@gmail.com

Corresponding author.
, C. Chiloeches Fernández, E. Sendagorta Cudós
Servicio de Dermatología, Hospital Universitario La Paz, Madrid, Spain
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    "titulo" => "Neutrophilic Dermatosis on the Dorsal Hands"
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        "titulo" => "Dermatosis neutrof&#237;lica del dorso de las manos"
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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">A 92-year-old man with no medical history of interest was seen at our dermatology department for rapidly progressive lesions that appeared on the hands in the absence of any trauma&#46; The lesions began as 2 violaceous papules on the back of the right hand and the dorsum of the third finger of the same hand&#44; and in less than 2 weeks developed into 2 edematous plaques of approximately 7 cm and 3&#160;cm in diameter&#44; respectively&#44; with central ulceration&#44; a violaceous border&#44; and a friable base&#46; One week after the appearance of these lesions a new hard&#44; nonulcerated&#44; friable painful nodule appeared on the back of the left hand &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">Culture and a skin punch biopsy were performed and empirical intravenous antibiotic treatment was initiated while awaiting the results of the microbiological studies&#46; The culture was negative and the biopsy showed a dense neutrophilic infiltrate beneath a moderately hyperplasic epithelium&#46; Based on these findings the patient was diagnosed with neutrophilic dermatosis of the dorsal hands and was treated with oral prednisone &#40;0&#46;5&#160;mg&#47;kg&#47;d&#41;&#46; The lesions improved considerably within 2 weeks of beginning treatment&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">To rule out other associated processes&#44; the patient underwent a full laboratory work-up including a blood smear and an autoimmunity study&#44; computed tomography of the thorax&#44; abdomen&#44; and pelvis&#44; and a colonoscopy&#44; none of which revealed any pathological findings of interest&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">Neutrophilic dermatosis of the dorsal hands is an inflammatory disease related to Sweet syndrome&#44; and can be associated with other processes such as tumors &#40;mainly hematological&#41;&#44; autoimmune diseases&#44; infections&#44; and inflammatory bowel disease&#46; Skin biopsy is essential for diagnosis and culture is useful&#44; as this condition is frequently confused with an infectious disease&#46; The first line of treatment consists of systemic corticosteroids&#44; although in refractory cases other treatments such as dapsone have been administered&#44; with good response&#46;</p></span>"
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ISSN: 15782190
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