Neutrophilic dermatosis of the hands (NDH) is an uncommon inflammatory condition recognized as a localized variant of Sweet syndrome, seen in older adults with malignancy or systemic inflammatory disease. We present a rare case of NDH in a 23-year-old male in an unusual location, without the typical associated systemic illness or recent trauma. The patient presented with recurrent, painful erythematous nodules exclusively on the fingers and a violaceous bulla-like plaque on the volar surface of the left index finger. Laboratory tests showed leukocytosis with neutrophilia, elevated erythrocyte sedimentation rate, and normal C-reactive protein levels. Investigations for other underlying causes were unremarkable. Histopathologic examination was consistent with NDH. He was treated with dapsone 50 mg daily, with resolution in 3 weeks, and no recurrence was reported. This case expands the clinical spectrum of NDH. It highlights the importance of considering it in the differential diagnosis of painful hand lesions in younger patients, even in the absence of typical risk factors or systemic involvement.