[Pyoderma gangrenosum, subcorneal IgA pustulosis and recurrent neutrophilic pleural and pulmonary diseases in a patient with IgA gammopathy].

INTRODUCTION

The term "neutrophilic dermatosis" is normally used to cover a number of dermatoses characterized by their response to corticotherapy or to drugs effective on the neutrophilic polynuclear. Neutrophilic dermatosis was frequently associated with hematologic disease. We study the case of a neutrophilic dermatosis accompanied by a pulmonary involvement and then review the literature on the reported cases of neutrophilic dermatosis with extra-cutaneous localisations.

CASE STUDY: A woman aged 54 displayed a pyoderma gangrenosum successively followed by a pustular dermatosis (related to subcorneal pustular dermatosis of Sneddon-Wilkinson) and by a pulmonary involvement not caused by any underlying infection. The laboratory results revealed a benign IgA gammaglobulin. The use of corticotherapy and a relay by dapsone led to the gradual disappearance of the cutaneous and pulmonary lesions.

DISCUSSION: Pulmonary involvement have been observed in the Sweet syndrome and in the pyoderma gangrenosum. The neutrophilic lung is diagnosed once a tumorous or infectious cause has been eliminated and on the basis of the response to the cortisone treatment.

CONCLUSION

The link between pulmonary involvement and neutrophilic dermatosis is sometimes mentioned but is in fact often difficult to confirm. The positive reaction to corticosteroids could be a diagnostic test.