A 52-year-old female patient presented with erythema,papules and pruritus on extremities for six months,with blisters for one week.Dermatologic examination showed ring-shaped edematous erythema lesions with clear boundaries on the trunk,buttocks,and limbs.Along the edges of the erythematous areas,there were thick-walled blisters ranging in size from rice grains to soybeans,arranged in a ring formation.The center of the erythema showed necrotic erosions with a brown scab,some of which are adherent and some detached.There was no significant exudation noted.Histopathological examination of the skin rash of the right hip revealed excessive keratosis in the epidermis,hyperplasia and hypertrophy of the spinous layer,and a significant presence of neutrophils observed between collagen bundles in the superficial dermis,around blood vessels,and appendages.No vascular fibrinoid changes were observed.The patients was diagnosed as rheumatoid neutrophilic dermatitis.Treatment included methylprednisolone 40 mg once daily,along with symptomatic care including gastroprotective measures,and supplementation with potassium and calcium.External treatment involved halomethasone cream and sodium fusidate cream.
NETL
NSTL
万方数据
