Nötrofilik Dermatozlar — Atlas

Fig. 25.2 Sweet syndrome. A Scattered edematous pink papules and plaques on the chest. B The edema can be quite marked as seen in these lesions on the upper back. B, Courtesy Kalman Watsky, MD.

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Fig. 25.3 Sweet syndrome. A The periocular lesion demonstrates how some lesions can mimic cellulitis (pseudocellulitis). This patient also had neutrophilic esophageal ulcerations and subsequently developed colon cancer. B The plaques can have a pseudomammillated appearance due to the associated edema. C Hemorrhagic crusts may develop within the papules and plaques and in patients with acute leukemia and/or neutropenia, infectious etiologies are often the initial clinical diagnosis. C, Courtesy Kalman Watsky, MD.

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Fig. 25.4 Sweet syndrome – ocular involvement. Obvious erythema and hemorrhage involving the sclera and conjunctiva. Courtesy Kalman Watsky, MD.

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Fig. 25.7 Neutrophilic dermatosis of the dorsal hands. A Clinically and histologically, there is overlap with Sweet syndrome and bullous pyoderma gangrenosum. B More extensive necrotizing disease can be confused with an infectious process such as necrotizing cellulitis or necrotizing fasciitis.

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Fig. 25.9 Variants of pyoderma gangrenosum. A Pyostomatitis vegetans in a patient with ulcerative colitis. B Vegetative form following trauma to the skin. Courtesy Samuel L. Moschella, MD.

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Fig. 25.10 Pyoderma gangrenosum (PG) – clinical presentations. A, B Typical (classic) form in which the ulcer has an undermined and overhanging violet– gray edge as well as a surrounding violaceous border. C Grouped sterile pustular nodules. D Central ulceration surrounded by inflammatory papules and pustules. E Deeper ulcer with vegetative and pustular base. F Centrally, there is healing with cribriform (sievelike) scarring.

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$Fig. 25.11 Peristomal and postsurgical pyoderma gangrenosum (PG). A Several ulcers surround an ileostomy in a patient who had a total proctocolectomy performed because of refractory chronic ulcerative colitis. B Multiple ulcerations of the breasts following breast reduction. Because the original diagnosis postoperatively was soft tissue infection, multiple debridements had been performed and systemic antibiotics administered.$

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$Fig. 25.11 Peristomal and postsurgical pyoderma gangrenosum (PG). A Several ulcers surround an ileostomy in a patient who had a total proctocolectomy performed because of refractory chronic ulcerative colitis. B Multiple ulcerations of the breasts following breast reduction. Because the original diagnosis postoperatively was soft tissue infection, multiple debridements had been performed and systemic antibiotics administered.$

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Fig. 25.12 The earliest clinical lesion in pyoderma gangrenosum is a pustule with an inflammatory base. This patient had Crohn disease.

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Fig. 25.13 Pyoderma gangrenosum in a patient with PAPA syndrome. Individuals with this monogenic autoinflammatory disorder have pyogenic sterile arthritis, pyoderma gangrenosum and acne. Courtesy Maria Chanco Turner, MD.

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Fig. 25.14 Pyoderma gangrenosum. In expanding untreated lesions, a diffuse infiltrate of neutrophils (inset) is present at the edge of an ulceration. Courtesy Lorenzo Cerroni, MD.

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Fig. 25.15 Behçet disease – mucocutaneous lesions. A, B Oral aphthosis involving the tongue and lip; the ulcerations can be deep. These ulcers may be diagnosed as infectious (e. g. due to herpes simplex virus) or neoplastic rather than inflammatory. C Aphthae of the vulva and inguinal region. D Pathergy – a papulopustule appeared at the site of insertion of an intravenous catheter.

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Fig. 25.16 Behçet disease – systemic involvement. Iritis and cutaneous pustular vasculitis. Courtesy Samuel L. Moschella, MD.

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Fig. 25.17 Bowel-associated dermatosis–arthritis syndrome. A, B Papules and papulopustules can be erythematous or violaceous and purpuric. The number of lesions varies from a few to many.

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