Neutrophilic eccrine hidradenitis: A new culprit-carbamazepine

Abstract

Neutrophilic eccrine hidradenitis (NEH) is a distinctive dermatosis occurring in patients with malignancy or undergoing chemotherapy. This disorder is characterized by a neutrophilic infiltrate around the eccrine glands and secretory coils, and is associated with necrosis. It must be distinguished from infections, drug eruptions, malignancies or other forms of skin diseases. As it is a self-limiting condition, establishing the diagnosis will avoid unnecessary investigations and treatment. Here we report a case of NEH in a 40-year-old woman suspected to be due to carbamazepine.

Chemotherapy Associated Neutrophilic Eccrine Hidradenitis, an Unusual Case with Eccrine Squamous Syringometaplasia

“…Approximately 90% of the cases of NEH were reported in oncology patients, 70% following their first cycle of chemotherapy [2,4]. A tentative link has been made with chemotherapeutic agents, most notably cytarabine [5]. However, identifying the specific causative agent in cases of NEH is often futile as combination chemotherapy is regularly prescribed [2].…”

“…Cytarabine is commonly implicated in NEH, however, the pathophysiology is unknown [5]. NEH secondary to vasculitis due to the toxic effects of cytarabine has been argued [6].…”

“…ESS can give the appearance of squamous cell carcinoma [9]. NEH and ESS can be grouped under the term 'toxic erythema of chemotherapy'; both conditions are associated with cytarabine [5,8].…”

“…NEH recurrence has been reported [4]. Treatment is symptomatic; analgesia and corticosteroids can be prescribed [5]. The use of dapsone as a preventative measure prior to chemotherapy may prevent recurrence [10].…”

Urticarial Syndromes

“…No speciic treatment is required as it is usually self-limiting. However, systemic corticosteroid treatment has been reported to shorten the duration of the lesions and the fever [5,44].…”