Neutrophilic dermatosis of the dorsal hands (NDDH) is a localized variant of Sweet syndrome, a neutrophilic dermatosis commonly associated with underlying malignancy or systemic inflammatory disorders. NDDH can be mistaken for infection due to its rarity, clinical appearance, and common association with elevated inflammatory markers. A high index of suspicion for this diagnosis should be maintained with symmetrical hand lesions, as approximately 78% of patients with NDDH have bilateral disease. Patients respond rapidly to the initiation of systemic steroids; however, like with generalized cutaneous Sweet syndrome, diagnosis should prompt further work-up for underlying disease.
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