PUSTULAR VASCULITIS OF THE HANDS

Background: Several patients were observed with a peculiar cutaneous eruption limited to the dorsa of the hands and fingers. Clinically the lesions had some resemblance to those seen in Sweet's syndrome, but biopsy specimens showed severe leukocytoclastic vasculitis. Objective: Our purpose was to characterize this eruption clinically and histologically and compare it with previously described diseases. Methods: Six patients observed since 1977 are described. Skin biopsy specimens were obtained. Results: In six women (age, 41 to 79 years) a symmetric eruption of papules and plaques limited to the dorsa of the radial sides of the hands and first three digits developed. The lesions resembled those of Sweet's syndrome and were associated with fever, sterile culture, blood neutrophil leukocytosis, nonresponse to antibiotic therapy, and rapid response to prednisone. Biopsy specimens showed a severe leukocytoclastic vasculitis. Conclusion: These patients appear to have a distinct entity that we have termed pustular vasculitis of the hands.