Neutrophilic eccrine hidradenitis heralding acute myelogenous lekemia: An etiologic dilemma.
- Author:
Giselle Marie S. TIOLECO
;
Suzette B. SAGUN
;
Georgina C. PASTORFIDE
- Publication Type:Case report
- MeSH: Human; Male; Middle Aged; Amebiasis; Anti-bacterial Agents; Biopsy; Bone Marrow; Diarrhea; Dysentery, Amebic; Eccrine Glands; Giardiasis; Hidradenitis; Leukemia, Myeloid, Acute; Neutrophils; Typhoid Fever
- From: Journal of the Philippine Dermatological Society 2014;23(1):50-53
- CountryPhilippines
-
Abstract:
Neutrophilic eccrine hidradenitis (NEH) is a rare neutrophilic dermatosis most commonly reported among patients undergoing chemotherapy for acute myeologenous leukemia (AML). Its clinical findings are non-specific, usually seen as erythematous papules, nodules and plaques on the extremeties, trunk and face. Here, we are presented with a 51-year-old male with one-week history of atypical annular plaques on the extremities. Based on bone marrow biopsy, a diagnosis of acute myelogenous leukemia was established. The presence of diarrhea prior to skin findings was attributed to typhoid fever, giardiasis and amoebiasis for which antibiotics were given. Skin biopsy showed aggregates of neutrophils around eccrine glands, consistent with NEH. Spontaneous resolution was noted after 3 weeks. To our knowledge, there are only five other reported cases on NEH heralding the onset of a malignancy and unassociated with chemotherapeutic drug intake. In this scenario, the following culprits are suspected: as a reactive manifestation from antibiotic intake, as a part and parcel of an infectious process or a paraneoplastic phenomenon from acute myelogenous leukemia.