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The Cutting Edge: Challenges in Medical and Surgical Therapies |

Successful Treatment of Recurrent Idiopathic Plantar Eccrine Hidradenitis With Colchicine

Helene Sophie Scheer, MD; Jivko Kamarashev, MD; Lisa Weibel, MD
Arch Dermatol. 2012;148(12):1357-1359. doi:10.1001/archdermatol.2012.2221.
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Idiopathic palmoplantar eccrine hidradenitis (IPPH) is a distinct clinical entity in otherwise healthy children with sudden appearance of tender, erythematous nodules on the soles or palms. Therapy usually consists of bed rest for a few days and nonsteroidal anti-inflammatory drugs (NSAIDs). However, a proportion of patients experiences recurrent episodes of IPPH, causing significant pain and limiting their daily activities. The pathogenesis of IPPH is not completely understood; however, the histologic feature consists of an inflammatory infiltrate of neutrophils and lymphocytes. Colchicine is effectively used for the treatment of classical neutrophilic skin disorders. To our knowledge, this is the first report of recurrent IPPH successfully treated with colchicine in a child.

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Figure 1. A 7-year-old boy with painful red nodules on both soles. A, Multiple erythematous tender nodules without epidermal changes on the sole. B, The patient's feet showing complete recovery 3 days after initiation of treatment with colchicine.

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Figure 2. A, Perivascular and perisudoral inflammatory infiltrate consisting of lymphocytes and neutrophils (hematoxylin-eosin, original magnification ×200). B, Neutrophils are highlighted in red within the inflammatory infiltrate (chloracetate, original magnification ×400).




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