Belot Véronique, Perrinaud Adeline, Corven Cloé, de Muret Anne, Lorette Gérard, Machet Laurent
Service de dermatologie, centre hospitalier Universitaire, Tours (37).
Presse Med. 2006 Oct;35(10 Pt 1):1475-8. doi: 10.1016/s0755-4982(06)74837-0.
Neutrophilic eccrine hidradenitis (NEH) is a rare disease belonging to the group of neutrophilic dermatoses. It has a characteristic histopathologic pattern, with necrosis of the eccrine glands and a local neutrophilic infiltrate. It occurs mostly in patients receiving chemotherapy for acute myeloblastic leukemia or, less frequently, another malignancy. Its occurrence in healthy patients is rare.
We report the case of a 56-year-old woman with no remarkable medical history who developed an erythematous papular facial eruption. Skin biopsy showed typical features of neutrophilic eccrine hidradenitis including neutrophilic infiltrate. No cause was found. The patient was successfully treated with colchicine.
This case is particular because NEH was not associated with malignant hematologic disease, solid cancer, chemotherapy, fever or any other disease, after a follow-up of 22 months. Such idiopathic NEH has been reported only rarely in adults. The second particularity is the length of the eruption, which required colchicine treatment. Clinical improvement occurred within 1 month. Because hematologic malignancies can in some cases be preceded by neutrophilic dermatitis, clinical follow-up is recommended in adults.
嗜中性小汗腺汗管炎（NEH）是一种罕见疾病，属于嗜中性皮肤病范畴。它具有特征性的组织病理学模式，表现为小汗腺坏死和局部嗜中性粒细胞浸润。该病主要发生于接受急性髓细胞性白血病化疗的患者，较少见于其他恶性肿瘤患者。在健康患者中罕见。
我们报告一例56岁女性患者，既往无显著病史，出现面部红斑丘疹性皮疹。皮肤活检显示嗜中性小汗腺汗管炎的典型特征，包括嗜中性粒细胞浸润。未发现病因。患者接受秋水仙碱治疗后成功治愈。
该病例特殊之处在于，经过22个月的随访，NEH与恶性血液病、实体癌、化疗、发热或任何其他疾病均无关联。这种特发性NEH在成人中仅有极少病例报道。第二个特殊之处在于皮疹持续时间，需要秋水仙碱治疗。临床症状在1个月内改善。由于在某些情况下血液系统恶性肿瘤之前可能出现嗜中性皮肤病，因此建议对成人进行临床随访。
