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Case Reports
. 2016 Sep-Oct;91(5):639-641.
doi: 10.1590/abd1806-4841.20164919.

Acrokeratosis verruciformis of Hopf - Case report

Tatiana Cristina Pedro Cordeiro de Andrade  1 , Gardênia Viana da Silva  1 , Tatiane Meira Pinho Silva  1 , Ana Cecília Versiani Duarte Pinto  1 , Adauto José Ferreira Nunes  1 , Antônio Carlos Ceribelli Martelli  1
Affiliations
Case Reports

Acrokeratosis verruciformis of Hopf - Case report

Tatiana Cristina Pedro Cordeiro de Andrade et al. An Bras Dermatol. 2016 Sep-Oct.

Abstract

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 three 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.

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Conflict of interest statement

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Figures

Figure 1
Figure 1
Multiple flat-topped brownish verrucous plaques on the dorsum and palms of the hands associated with nail dystrophy
Figure 2
Figure 2
Multiple flattopped brownish verrucous plaques on the dorsum of the feet and distal lower limbs associated with nail dystrophy
Figure 3
Figure 3
Histology. A - HE 20X: epithelial hyperplasia, hyperkeratosis and papillomatosis. B - HE 20X: epithelial hyperplasia, exuberant hyperkeratosis and papillomatosis. C - HE 200X: in detail, dermal papilla with hyperkeratosis presenting a church-spire pattern.
See this image and copyright information in PMC

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