Eccrine Squamous Syringometaplasia Mimicking Acute Cutaneous GVHD in a Pediatric HSCT Recipient: Case Report and Brief Review of the Indexed Literature.
Benedetta Galli, Cecilia Catapano, Iacopo Ghini et al.
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Case in brief
A 3-year-old boy with chronic granulomatous disease developed a diffuse erythematous eruption six weeks post-haploidentical hematopoietic stem cell transplantation, initially suggestive of acute cutaneous graft-versus-host disease (GVHD). Histopathological analysis revealed spongiotic dermatitis with eccrine duct squamous metaplasia, leading to a diagnosis of eccrine squamous syringometaplasia (ESS). The condition resolved with topical corticosteroids without altering systemic therapy.
Diagnostic / clinical pearl
Clinicians should be aware that eccrine squamous syringometaplasia can mimic acute cutaneous GVHD in transplant recipients, necessitating careful histopathological evaluation to avoid unnecessary immunosuppression.
Why it matters
This case highlights the importance of clinicopathologic correlation in distinguishing between ESS and GVHD, which can significantly impact management decisions in pediatric transplant patients.