Infectious eccrine hidradenitis: a report of 3 cases and a review of the literature

Neutrophilic eccrine hidradenitis (NEH) is a nonspecific clinicopathological reaction pattern, classified as a neutrophilic dermatosis, that usually develops in patients receiving chemotherapy for a hematologic malignancy. More rarely, it has been reported in association with infectious agents such as Serratia and Enterobacter species, Staphylococcus aureus, and human immunodeficiency virus. We describe 3 cases of infectious eccrine hidradenitis secondary to infection with Nocardia species, Mycobacterium chelonae, and S aureus. Histological findings revealed a dense infiltrate with perivascular and periductal neutrophils in the dermis. In the eccrine glands, there was vacuolar degeneration and necrosis of the epithelial cells. Our cases support the assertion that NEH is a characteristic cutaneous response to nonspecific stimuli. Clinical and histopathological findings of infectious and noninfectious NEH are generally indistinguishable and when NEH is suspected, the possibility of an infectious association must be investigated by skin tissue culture. In this article we also discuss differential diagnoses and review the literature.