Neutrophilic Eccrine Hidradenitis
Cary Chisholm, MD
Key Facts
Etiology/Pathogenesis
Usually associated with induction chemotherapy
Has been reported in other patients with malignancies, HIV, Behçet disease, and bacterial infections
Clinical Issues
Multiple plaques &/or nodules, usually on trunk
Erythema, ± pruritus, may mimic cellulitis
Resolves within a few weeks
Microscopic Pathology
Dense neutrophilic infiltrate localized to eccrine glandular apparatus
Subsequent necrosis and prominent vacuolar change along basement membrane surrounding eccrine glands
Reactive changes: Cellular atypia, squamous metaplasia, edema, mucin deposition
Usually no overlying epidermal involvement
 Erythematous bullae appeared clinically over the dorsal fingers of this patient on chemotherapy. Biopsy showed neutrophilic eccrine hidradenitis. |
 Neutrophils can be seen infiltrating into  and in between  these eccrine glands. (Courtesy S. Billings, MD.) |
TERMINOLOGY
Abbreviations
Neutrophilic eccrine hidradenitis (NEH)
Synonyms
Toxic erythema of chemotherapy
Definitions
Neutrophilic infiltration and destruction of eccrine glands
ETIOLOGY/PATHOGENESIS
Infectious Agents
Generally not attributed to chemotherapy
Patients with malignancies, HIV, and Behçet disease
Infectious agents like Serratia marcescens, Nocardia asteroides, Streptococcus species, Staphylococcus species, Enterobacter species, Pseudomonas species
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