(BMJ)—A 23-mo girl presented w/ fever, vomiting, and diarrhea x3 days and a rash on her hands. Exam: palms warm, red, itchy w/ papules and patches. Soles and dorsal surfaces of hands spared. Labs: CBC, CRP normal; PCR negative for parvovirus, Epstein-Barr virus, and cytomegalovirus. Stool exam positive for adenovirus type HAdV-C1. What is the dx?
Pseudomonas aeruginosa infxn
Neutrophilic eccrine hidradenitis
Hand-foot-and-mouth dz
Kawasaki dz
Papular-purpuric gloves and socks syndrome
You are correct. The palmar eruption was clinically consistent w/ neutrophilic eccrine hidradenitis (NEH). In NEH, an aggregation of neutrophils occurs around the eccrine glands, which can be concentrated on the palms. NEH can be triggered by infxns and can cause erythematous papules, nodules, plaques, pustules, purpura, and urticaria. It can also be seen in pts undergoing chemotherapy for malignancies. Within 3wk, this pt’s rash resolved uneventfully w/o tx.

Arch Dis Child 2017;0:1–2. doi:10.1136/archdischild-2016-312107.

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