title: Neutrophilic eccrine hidradenitis in two patients treated with BRAF inhibitors: a new cutaneous adverse event.
abstract: Neutrophilic eccrine hidradenitis (NEH) is a rare neutrophilic dermatosis, first described in patients undergoing chemotherapy for a malignant haemopathy. It has polymorphous clinical features and the association of both clinical and histological features is necessary to make a diagnosis. We report the first two cases of NEH in patients treated with a BRAF inhibitor (BRAFi), either dabrafenib or vemurafenib, for a stage IV metastatic melanoma. Disseminated erythematous plaques associated with fever and polyarthralgia occurred early after the initiation of treatment and were badly tolerated. Histological analyses confirmed the diagnosis of NEH. Symptoms disappeared a few days after the cessation of treatment and introduction of topical steroids. The replacement of one BRAFi with another is a therapeutic alternative as it is not necessarily associated with a relapse of NEH. NEH can be added to the spectrum of neutrophilic dermatoses induced by BRAFis. It occurs earlier (3-4 days) than previously described drug-induced NEH (9-12 days) and may be an earlier stage of eccrine squamous syringometaplasia, which has already been reported in the context of BRAFi-treated patients.
authors.affiliation: Department of Dermatology, Assistance Publique Hôpitaux de Paris, Cochin Hospital, 27 rue du Faubourg Saint-Jacques, 75014, Paris, France.|Faculty of Medicine, Université Paris Descartes, 12 rue de l'École de Médecine, 75006, Paris, France.
authors.forename: F
authors.initials: F
authors.lastname: Herms
authors.affiliation: Department of Dermatology, Assistance Publique Hôpitaux de Paris, Cochin Hospital, 27 rue du Faubourg Saint-Jacques, 75014, Paris, France.|Faculty of Medicine, Université Paris Descartes, 12 rue de l'École de Médecine, 75006, Paris, France.
authors.forename: N
authors.initials: N
authors.lastname: Franck
authors.affiliation: Department of Dermatology, Assistance Publique Hôpitaux de Paris, Cochin Hospital, 27 rue du Faubourg Saint-Jacques, 75014, Paris, France.|Faculty of Medicine, Université Paris Descartes, 12 rue de l'École de Médecine, 75006, Paris, France.
authors.forename: N
authors.initials: N
authors.lastname: Kramkimel
authors.affiliation: Department of Dermatology, Assistance Publique Hôpitaux de Paris, Cochin Hospital, 27 rue du Faubourg Saint-Jacques, 75014, Paris, France.|Faculty of Medicine, Université Paris Descartes, 12 rue de l'École de Médecine, 75006, Paris, France.
authors.forename: F
authors.initials: F
authors.lastname: Fichel
authors.affiliation: Department of Dermatology, Assistance Publique Hôpitaux de Paris, Cochin Hospital, 27 rue du Faubourg Saint-Jacques, 75014, Paris, France.|Faculty of Medicine, Université Paris Descartes, 12 rue de l'École de Médecine, 75006, Paris, France.
authors.forename: L
authors.initials: L
authors.lastname: Delaval
authors.affiliation: Faculty of Medicine, Université Paris Descartes, 12 rue de l'École de Médecine, 75006, Paris, France.|Department of Pathology, Assistance Publique Hôpitaux de Paris, Cochin Hospital, 27 rue du Faubourg Saint-Jacques, 75014, Paris, France.
authors.forename: S
authors.initials: S
authors.lastname: Laurent-Roussel
authors.affiliation: Faculty of Medicine, Université Paris Descartes, 12 rue de l'École de Médecine, 75006, Paris, France.|Department of Pathology, Assistance Publique Hôpitaux de Paris, Cochin Hospital, 27 rue du Faubourg Saint-Jacques, 75014, Paris, France.
authors.forename: A
authors.initials: A
authors.lastname: Carlotti
authors.affiliation: Department of Dermatology, Assistance Publique Hôpitaux de Paris, Cochin Hospital, 27 rue du Faubourg Saint-Jacques, 75014, Paris, France.|Faculty of Medicine, Université Paris Descartes, 12 rue de l'École de Médecine, 75006, Paris, France.
authors.forename: M-F
authors.initials: MF
authors.lastname: Avril
mesh_terms: D000328:Adult; D000970:Antineoplastic Agents / Q000009:adverse effects*; D003875:Drug Eruptions / Q000209:etiology*; D005260:Female; D016575:Hidradenitis / Q000139:chemically induced*; D006801:Humans; D007093:Imidazoles / Q000009:adverse effects*; D007211:Indoles / Q000009:adverse effects*; D008297:Male; D008545:Melanoma / Q000188:drug therapy; D010091:Oximes / Q000009:adverse effects*; D012878:Skin Neoplasms / Q000188:drug therapy; D013449:Sulfonamides / Q000009:adverse effects*; D000077484:Vemurafenib; D055815:Young Adult
chemical_list: D000970:Antineoplastic Agents; D007093:Imidazoles; D007211:Indoles; D010091:Oximes; D013449:Sulfonamides; D000077484:Vemurafenib; C561627:dabrafenib