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Related Experiment Videos

Neutrophilic eccrine hidradenitis simulating orbital cellulitis

D S Bardenstein1, J Haluschak, S Gerson

  • 1Department of Ophthalmology, Case Western Reserve University, Cleveland, Ohio.

Archives of Ophthalmology (Chicago, Ill. : 1960)
|November 1, 1994
PubMed
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Neutrophilic eccrine hidradenitis can cause periocular swelling and hemorrhage in chemotherapy patients. This rare condition, often mistaken for infection, requires consideration in cancer patients with similar symptoms.

Area of Science:

  • Dermatology
  • Oncology
  • Ophthalmology

Background:

  • Orbital swelling in cancer patients often indicates neoplastic or infectious causes.
  • Diagnosis is challenging with concurrent fever and neutropenia.
  • Chemotherapy for acute myelogenous leukemia can present complex clinical scenarios.

Observation:

  • A 30-year-old male undergoing chemotherapy experienced fever and periorbital swelling.
  • Findings suggested passive swelling and hemorrhage rather than typical orbital cellulitis.
  • Skin biopsy revealed neutrophilic inflammation and eccrine gland necrosis without infection.

Findings:

  • Neutrophilic eccrine hidradenitis (NEH) was diagnosed based on skin biopsy.
  • NEH is an inflammatory condition primarily affecting eccrine glands.

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  • This entity is most prevalent in patients undergoing induction chemotherapy.
  • Implications:

    • NEH should be included in the differential diagnosis for periocular swelling and hemorrhage in cancer patients on chemotherapy.
    • This case highlights an unusual presentation of NEH with periocular involvement.
    • Accurate diagnosis is crucial to avoid misclassification as infectious or neoplastic processes.