Infectious Eccrine Hidradenitis in a Patient Undergoing Hemodialysis

Moreno, Abelardo

doi:10.1001/archderm.1985.01660090020005

Cited by 38 publications

(14 citation statements)

References 4 publications

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“…Other associations were later recognized, in addition to chemotherapeutic drugs, including infectious diseases (HIV and Serratia marcescens ), drugs (granulocyte colony‐stimulating factor and acetaminophen), and haemodialysis; NEH has also been reported in a healthy patient 5,8–14 . Our patient did not have an underlying malignancy, she was not exposed to chemotherapeutic drugs, and her HIV serology was negative.…”

Section: Discussionmentioning

confidence: 61%

“…Severe epithelial alterations in the eccrine ducts and coils, in combination with the neutrophilic infiltrate, is one of the most specific markers of NEH. Nevertheless, NEH does not exclusively manifest with epithelial alterations, especially when NEH is secondary to factors other than chemotherapeutic drugs, as in our patient 8,9 . Therefore we propose the diagnosis NEH, rather than SS, as a descriptive designation for the lesions in our patient.…”

Section: Discussionmentioning

confidence: 73%

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Chronic pruritic neutrophilic eccrine hidradenitis in a patient with Behcet's disease

Nijsten¹,

Meuleman²,

Lambert³

2002

Br J Dermatol

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Neutrophilic eccrine hidradenitis (NEH) is a rare distinct entity that usually presents as asymptomatic erythematous papules that disappear spontaneously in 1-3 weeks. However, its appearance may be polymorphic, pruritic, recurrent or even chronic as is described in this case. The histological combination of neutrophilic infiltration in and necrosis of the eccrine secretory gland epithelium is highly characteristic for NEH. It typically occurs in patients receiving chemotherapeutic drugs for malignancies, but other associations have also been reported. To our knowledge, we report the first case of NEH in a patient with Behçet's disease (BD). Cutaneous manifestations of BD, an inflammatory systemic disorder of unknown origin, include neutrophilic dermatoses such as Sweet's syndrome and pyoderma gangrenosum, although these are unusual in BD. NEH could be another neutrophilic dermatosis related to BD. This observation suggests that NEH is not strictly related to chemotherapeutic drugs and malignancies. It appears to be a reactive dermatosis associated with other factors as well, including BD. Treatment was successful with dapsone 100 mg daily.

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Section: Discussionmentioning

confidence: 61%

Section: Discussionmentioning

confidence: 73%

Chronic pruritic neutrophilic eccrine hidradenitis in a patient with Behcet's disease

Nijsten¹,

Meuleman²,

Lambert³

2002

Br J Dermatol

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“…Neutrophilic hidradenitis was a rare finding in lesions of RMSF, seen in one fatal case. Changes of neutrophilic hidradenitis have been reported in skin lesions of patients with primary staphylococcal and Serratia infection of sweat glands in undernourished infants (9), immunecompromised hemodiaiysis patients (10), in skin lesions developed in patients with acute myelogenous leukemia (AML) following cytarabine induction chemotherapy (11), with granulocytopenia induced by high-dose chemotherapy for AML (12), in Hodgkin's disease with multiple chemotherapy, and in testicular carcinoma treated with vincristine, bleomycin and cis-platinum (13). The microscopic differential diagnosis of RMSF should include the aforementioned diseases and chemotherapy-related lesions that are usually easily excluded by history.…”

Section: Discussionmentioning

confidence: 99%

Cutaneous histopathology of Rocky Mountain spotted fever

et al. 1997

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The dermatologic diagnosis of Rocky Mountain spotted fever (RMSF) is often presumptive; the clinical presentation includes skin rash and febrile illness with or without a clear history of tick bite. The characteristic cutaneous manifestations include a generalized skin eruption with purpuric, blanching or non-blanching macules and papules usually involving the extremities. Although skin biopsies are often performed to confirm the diagnosis, the spectrum of cutaneous histopathology in RMSF has not been well described. We studied a series of 26 cases of RMSF, of which 10 were surgical specimens and 16 were autopsies. The microscopic changes were correlated with the duration of illness. The main histopathologic feature was lymphohistiocytic capillaritis and venulitis with extravasation of erythrocytes, edema, predominantly perivascular and some interstitial infiltrate. Leukocytoclastic vasculitis (LCV) with neutrophilic infiltrate and nuclear dust was seen in 11 of 15 (73%) specimens from involved skin. These lesions with LCV also showed notable epidermal change including basal layer vacuolar degeneration with mild dermoepidermal interface lymphocytic exocytosis. Six lesions with LCV displayed focal fibrin thrombi and capillary wall necrosis. Apoptotic keratinocytes were noted in 3 lesions with LCV. Subepidermal blister was observed in the skin lesion of an autopsied patient with LCV changes. Another lesion of a fatal case with LCV also contained features of acute neutrophilic eccrine hidradenitis. Focal small nerve twig inflammation was noted in a third autopsy case with LCV. Plasma cells were seen in 6 of 34 specimens (18%); and eosinophils were observed in 3 (9%). The subcutaneous fat contained a mild perivascular inflammation and one case revealed focal lobular neutrophilic inflammation. Immunohistologic (IH) staining using polyclonal rabbit anti-Rickettsia rickettsii demonstrated positive staining of the organisms in the affected endothelial cells in all 12 cases tested. The cutaneous histopathology of RMSF is caused by endothelial damage by the rickettsial organisms which elicit an initial lymphohistiocytic small vessel vasculitis with progression to LCV. The vasculitis in RMSF is, therefore, considered to be a form of septic vasculitis.

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“…Since then, similar dermatologic observations have been described in association with the use of various drugs and chemotherapeutic agents, [6][7][8] cancer, 9 and infections. 10,11 The urticarial-like erythematous plaques and/or nodules of NEH develop on the trunk, the proximal aspect of the extremities (involvement of the hands and wrist was recorded only in a few patients), or the face, whereas exclusive involvement of the plantar skin has not been observed. Most lesions have resolved spontaneously over the course of several days.…”

Section: Commentmentioning

confidence: 99%

Idiopathic Recurrent Palmoplantar Hidradenitis in Children

Simon¹,

Cremer²,

Driesch³

1998

Arch Dermatol

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Background: Idiopathic recurrent palmoplantar hidradenitis (IRPH) is characterized by tender erythematous plaques and nodules on the soles and, less often, the palms of young patients. To date, 10 cases of IRPH have been documented in the literature.Observations: We describe 22 pediatric patients with characteristic cutaneous and histologic findings of IRPH. Their mean age was 6 years (age range, 1.5-15 years). The onset of the disease clustered in 2 peaks, in autumn and spring. All patients had complete resolution of their lesions within 3 weeks, in 16 cases without any treat-

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Infectious Eccrine Hidradenitis in a Patient Undergoing Hemodialysis

Cited by 38 publications

References 4 publications

Chronic pruritic neutrophilic eccrine hidradenitis in a patient with Behcet's disease

Chronic pruritic neutrophilic eccrine hidradenitis in a patient with Behcet's disease

Cutaneous histopathology of Rocky Mountain spotted fever

Idiopathic Recurrent Palmoplantar Hidradenitis in Children

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