# Surgical Excision of Palisaded Neutrophilic and Granulomatous Dermatitis of the Vulva: A Case Report

## TL;DR

This case report describes the first known instance of a rare skin condition called PNGD occurring on the vulva, treated with surgery in a patient with lupus.

## Contribution

The first reported case of palisaded neutrophilic and granulomatous dermatitis occurring in the vulva.

## Key findings

- PNGD was diagnosed histologically after surgical excision of the vulvar lesion.
- The patient had systemic lupus erythematosus, a known association with PNGD.
- Surgical excision and reconstruction improved disfigurement and symptoms.

## Abstract

Palisaded neutrophilic and granulomatous dermatitis (PNGD) is an inflammatory cutaneous disorder of unknown etiology that typically occurs in association with systemic disease. Rheumatoid arthritis and systemic lupus erythematosus are the most common associated diseases. PNGD manifests as skin-colored to erythematous papules and plaques, mainly on the extremities. However, to the best of our knowledge, no cases of PNGD in the vulva have been reported in foreign literature to date. Herein, we report the first case of a 31-year-old female with systemic lupus erythematosus disease who presented multiple plaques and a pigmented, rough, mamillated skin surface affecting the vulva, leading to disfigurement of the vulva and interfering with sexual intercourse due to severe pain, irritation, and frequent infection. Surgical excision of the whole lesion with reconstruction of the vulva was done in two sessions and histologically diagnosed as PNGD.