Palisaded neutrophilic granulomatous dermatoses (PNGD) is a spectrum of histologic diagnosis featuring abnormal collagen deposition, palisaded histiocytes, and small granulomas in the absence of leukocytoclastic vasculitis1. It is thought to reflect immune complex deposition and is associated with rheumatoid arthritis, connective tissue diseases, hematologic disorders, infections, and medications such as tumor necrosis factor-α inhibitors2 (Figure …