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The herein report illustrates how a synovial tissue heavily infiltrated by neutrophils in the first weeks of arthritis, can evolve in few months to a synovial infiltration by lymphocytes with a characteristic pattern of rheumatoid arthritis (RA). This observation suggests a critical initial role of neutrophils in RA onset, which is eventually surpassed by the activation of the adaptive immune system. In addition, this patient, despite the absence of rheumatoid factors and anti-cyclic citrullinated peptide antibodies, progressed to a highly destructive and disabling disease, that was only controlled adequately with rituximab, due to the lack of response to methotrexate and serious adverse effects with TNF blockers therapy. [ABSTRACT FROM AUTHOR]

Background Sweet's syndrome is the most common neutrophilic dermatosis, but its pathophysiology is still largely unknown and different subgroups can be defined. Objectives To assess the clinical/laboratory factors in a series of patients with Sweet's syndrome and search for significant differences between defined subgroups. Methods A retrospective study of inpatient files with this diagnosis was made, and patients were included if they fulfilled the classical diagnostic criteria. Data were analyzed with the SPSS package, with a significance level of 5%. Results Forty-two patients fulfilled the inclusion criteria, with a median age of 50 years. Females comprised 88% of patients, and disease onset occurred in autumn or spring in over 70% of cases. A previous oropharyngeal infection was described by 38% of patients, and a previous or concomitantly diagnosed neoplasm by 10%. In contrast with the literature, the lower extremities were also involved in the majority of patients, and arthralgia was the most frequent extracutaneous manifestation. On bivariate analysis, in patients who reported a previous oropharyngeal infection, the lesions were significantly more frequent in autumn, and a shorter inpatient stay as well as a lower temperature on admission and lower prevalence of arthralgia were observed in the same group. Conclusions The subgroup of patients with a previous oropharyngeal infection had a less severe form of this syndrome. [ABSTRACT FROM AUTHOR]