Rheumatoid arthritis and pseudo-vesicular skin plaques: Rheumatoid neutrophilic dermatosis

A 54 year-old woman with a 3-year history of rheumatoid arthritis (ra) consulted us because of weight loss,fever and skin eruption. on physical examination,erythematous plaques with a pseudo-vesicular appearance were seen on the back of both shoulders. histological examination was consistent with rheumatoid neutrophilic dermatosis (rnd). after 3 days of prednisone treatment,the skin eruption resolved. rnd is a rare cutaneous manifestation of seropositive ra,characterized by asymptomatic,symmetrical erythematous plaques with a pseudo-vesicular appearance. histology characteristically reveals a dense,neutrophilic infiltrate with leucocitoclasis but without other signs of vasculitis. lesions may resolve spontaneously or with ra treatment. this case illustrates an uncommon skin manifestation of active rheumatoid arthritis. © 2016 by anais brasileiros de dermatologia.