Neutrophilic dermatosis of the dorsal hands (NDDH) was originally described as pustular vasculitis (PV) of the hands. Recent debate focuses on categorizing this disorder in the family of neutrophilic dermatoses (ND), as opposed to a primary vasculitis. We present a case of NDDH with clinical and histologic features consistent with ND, and discuss the major concerns for this disease's reclassification.