Introduction
RA is a common inflammatory synovial disorder characterized by symmetrical polyarthritis and associated with joint destruction (1, 2). RA has a broad spectrum clinical manifestation of various organs. Extra-articular findings and lesions due to skin involvement may also co-exist which include vasculitis, pyoderma gangrenosum, rheumatoid nodules and leg ulcers (3, 4). In addition to these findings, palmar erythema, urticaria, vitiligo, neutrophilic lobular panniculitis and RND may less commonly occur (5-7).
RND typically progresses in severe RA several years after the diagnosis of RA and manifests as symmetric erythematous and urticarial lesions over the extensor surfaces of the extremities (8). Dermatological involvement tends to occur in patients with more severe or active RA (9, 10). Here, we present a case of RND, a rare neutrophilic skin condition, in a seronegative RA Sudanese patient treated with cyclosporine.