Neutrophilic dermatosis of the dorsum of the hands complicated by panniculitis revealing myelodysplastic syndrome

Neutrophilic dermatosis of the dorsum of the hands (NDDH) is a rare inflammatory condition that belongs to the spectrum of neutrophilic dermatoses and is frequently associated with systemic diseases, particularly hematologic malignancies. We report the case of an 80-year-old woman with NDDH revealing an underlying myelodysplastic syndrome, later complicated by neutrophilic panniculitis of the face. Cutaneous lesions of NDDH can often be misdiagnosed due to their variable and sometimes atypical presentation, leading to delays in appropriate management. The resemblance of NDDH lesions to infectious, inflammatory, or even vasculitic conditions can result in unnecessary treatments, including antibiotics or surgical interventions, without addressing the underlying cause. Given the frequent association between NDDH and hematologic disorders, clinicians should maintain a high level of suspicion and systematically perform appropriate biological investigations. Early recognition and accurate diagnosis are essential to avoid mismanagement and to ensure timely screening for potential systemic diseases, particularly myelodysplastic syndromes and other hematological malignancies.