Recurrent Palmoplantar Hidradenitis with Exclusive Palmar Involvement and an Association with Trauma and Exposure to Aluminum Dust

Abstract

Recurrent palmoplantar hidradenitis is a benign, self-limited inflammatory skin condition that has been reported to occur on the soles and palms of otherwise healthy children and young adults. Patients with the disease present with tender, erythematous and edematous plaques and nodules on the palmoplantar skin. We describe a child who had recurrent palmoplantar hidradenitis that occurred after trauma and exposure to aluminum dust and manifested as lesions localized to only the palmar surfaces. This case is presented to add exclusive palmar involvement to the diagnostic spectrum of recurrent palmoplantar hidradenitis and to review the proposed pathogenesis of the disease.

Diseases of cutaneous appendages

“…[1553][1554][1555] It was originally described in children presenting with tender, erythematous plantar nodules (idiopathic plantar hidradenitis); 1553 patients with palmoplantar involvement and exclusive palmar involvement have since been reported. 1554,1558,1560 It has been suggested that plantar hidradenitis might be induced by exposure to a wet and cold milieu. 1554,1558,1560 It has been suggested that plantar hidradenitis might be induced by exposure to a wet and cold milieu.…”

“…1554,1558,1560 It has been suggested that plantar hidradenitis might be induced by exposure to a wet and cold milieu. 1558 Certainly there is a seasonality in its occurrence, 1556 with a predilection for summer months. 1558 Certainly there is a seasonality in its occurrence, 1556 with a predilection for summer months.…”

Neutrophilic Dermatoses in Children

“…Children with idiopathic palmoplantar hidradenitis develop tender erythematous plaques and nodules on the palms or, less commonly, the soles with acute onset, often after cold exposure, local trauma, physical activity, or prolonged wetness ⁄ sweating (68)(69)(70)(71)(72)(73)(74)(75)(76). No associated medication or underlying disease can be identified and patients are afebrile.…”

“…In a minority of patients, lesions recur. Younger children may be predisposed because of the immaturity of their eccrine glands (68)(69)(70)(71)(72)(73)(74)(75)(76). Several series described seasonality to cases, with peaks in the spring, summer, or autumn.…”

“…Neutrophilic eccrine hidradenitis (NEH) is a self‐limited eruption of urticaria‐like edematous erythematous papules, and plaques (66,67). Neutrophilic eccrine hidradenitis occurs in a classical malignancy‐associated variant (66,67), an idiopathic palmoplantar pediatric variant (68–76) and a pseudomonas‐associated variant (77). In the classical variant, lesions are tender, abrupt in onset, affect the face, arms, palms, and soles (66,67) in the last two to four weeks but frequently recur.…”