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Neutrophils on histology:
| • | Subcorneal pustular dermatosis (SPD) |
| • | leukocytoclastic vasculitis |
| • | dermatitis herpetiformis |
| • | palisaded neutrophilic granulomatosis dermatosis |
| • | neutrophilic eccrine hidradenitis |
| • | all contain neutrophils as the predominate inflammatory cell in at least some stage of their evolution |
| • | some or all follow certain stimuli: acute URI, IBD, hematologic malignancy |
| • | respond to corticosteroid and potassium iodide |
| • | (I might might also put LCV into this category) |
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Excess exposure to antigens (recurrent infections) or situations in which high levels of antibody occur (e.g. paraproteinemias) are likely to result in immune complexes…
| • | subcorneal pustular dermatosis (SPD) |
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Summary:
PG – associated with a monoclonal gammopathy (majority being IgA)
SPD – associated with a monoclonal gammopathy (majority being IgA)
EED – occasionally associated with an IgA monoclonal gammopathy (or IgG)
(ulcerative colitis reported in all three, however IgA monoclonal gammopathy seems to be a more frequent association in all three)
Drugs to treat neutrophilic dermatoses:
| • | Dapsone (especially DH and SPD) |
Oral Aphthae ddx:
| • | lupus (not neuts, but immune complexes?) |
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