(BMJ)—A 77-yo man presented w/ a dorsal L-hand ulcer 10 days after reaching into a bush. He thought he had a cat bite. The ulcer worsened despite oral abx, IV abx, surgical debridement, and skin graft. Within days, bluish ulcerative nodules developed at graft margins. What is the dx?
Sporotrichosis
Dermatophilosis
Mycobacterium scrofulaceum
Squamous cell carcinoma
Neutrophilic dermatosis
You are correct. Neutrophilic dermatosis was diagnosed clinically and resolved rapidly w/ oral steroids. A rare idiopathic reactive inflammatory condition, neutrophilic dermatosis mimics infection but does not respond to abx or debridement. Some cases resolve spontaneously, although many persist. About 15% are associated with hematological malignancy.