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Neutrophilic eccrine hidradenitis in Adult
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Neutrophilic eccrine hidradenitis in Adult

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Contributors: Vivian Wong MD, PhD, Susan Burgin MD
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Synopsis

Neutrophilic eccrine hidradenitis is a disorder characterized by toxic injury to eccrine coils resulting in erythematous or purpuric lesions on the trunk, limbs, neck, face, scalp, and/or ears. The disorder is most frequently associated with chemotherapy, but may be associated with other etiologies:
  • Predisposing medications, including cytarabine, mitoxantrone, bleomycin, and other chemotherapy agents, but not limited to this class. Other triggers include acetaminophen, carbamazepine, and granulocyte colony-stimulating factor (G-CSF); this reaction typically occurs 8-10 days after initiation of the drug.
  • A paraneoplastic phenomenon, as it has been reported with myeloproliferative and lymphoproliferative malignancy as well as solid organ malignancies (such as osteosarcoma, testicular carcinoma, metastatic breast cancer, and Wilms tumor) without preceding chemotherapy.
  • Human immunodeficiency virus (HIV) and Behçet disease.
  • Rarely, with bacterial infection (Serratia, Staphylococcus, Enterobacter, and Nocardia).
Patients may present with fever, neutropenia, lesion pruritus, and pain and tenderness. Lesions are usually self-limited and rarely will recur with subsequent drug exposure.

Codes

ICD10CM:
L74.8 – Other eccrine sweat disorders

SNOMEDCT:
238754005 – Neutrophilic eccrine hidradenitis

Look For

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

Best Tests

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Management Pearls

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Therapy

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Drug Reaction Data

Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.

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References

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Last Reviewed: 08/06/2018
Last Updated: 09/12/2018
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Neutrophilic eccrine hidradenitis in Adult
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Neutrophilic eccrine hidradenitis : Tender skin lesion, Widespread, Smooth nodules
Clinical image of Neutrophilic eccrine hidradenitis
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