Drug-Induced Neutrophilic Dermatoses

Medications are substantial underlying contributors to the development of neutrophilic dermatoses. Many different classes of drugs have been shown to induce a variety of neutrophilic dermatoses, with the histopathologic presence of a dermal neutrophilic infiltrate remaining the unifying feature. Identifying a drug-induced neutrophilic dermatosis with certainty can be difficult, as many patients have underlying conditions that may independently contribute to the development of similar cutaneous findings. Diagnosis is therefore based upon the observation of a temporal relationship between drug initiation and appearance of the characteristic dermatosis, coupled with resolution of symptoms upon discontinuation of the drug. Drugs that have been reported to trigger five classic neutrophilic dermatoses are summarized in Table 20.1 and discussed in more detail below.