A 7 year‐old male child presented with erythematous erosive plaques affecting the upper and lower eyelids of the left eye and extending to the cheek. Crustations over the right nostril were also evident. His general health status was normal. His medical history revealed that he was suffering from chronic myeloid leukemia for which he was receiving cyclic pulse therapy of cytarabine, doxorubicin and prednisone. It was noticed that the skin eruption was activated after each cycle and faded in 2–3 weeks to reappear after the next cycle but it never really cleared completely. The clinical differential diagnosis included herpes simplex, contact dermatitis, neutrophilic eccrine hidradenitis (NEH) and atypical fungal infection. The investigations included a complete blood count which showed a picture of improving leukemia with a total leucocytic count of 60 000/cc, RBCs count 3.7 × 106/cc, and platelet count of 110 000/cc. His hemoglobin was 9% The differential leucocytic count was as follows: basophils 0; eosinophils 4; blast cells 0; promyelocytes 0; myelocytes 10; juvenile cells 7; staff cells 14; segmented 45; lymphocytes 18 and monocytes 2. Cultures for fungi were negative, and serological examination for HIV, herpes simplex (IgG and IgM) cytomegalovirus and Epstein‐Barr virus antibodies were within normal ranges. Examination of a skin biopsy taken from the periorbital lesions revealed the presence of numerous islands of squamous cells extending from the epidermis into the upper‐ and mid‐dermis. Some of the islands were typically present around sweat ducts. On higher magnification, the cells forming the islands and lining the ducts were found to have abundant eosinophilic cytoplasm and large pale nuclei with prominent nucleoli. Some of the cells were dyskeratotic and there were occasional mitotic figures. Sparse lymphoid cell infiltrate was found surrounding some of the squamous cell islands. Based on the findings of squamous metaplasia of the cells lining the sweat ducts as well as the resemblance of some islands to squamous cell carcinoma, the diagnosis of eccrine syringosquamous metaplasia was made. Apart from the use of topical antibiotic creams, the patient received no therapy for his condition. Spontaneous improvement occured within 18 days after initial presentation but it recurred after the next cycle of chemotherapy.