Trichomycosis Axillaris

Author: Zeina Nehme Ghorayeb, MD; Chief Editor: Dirk M Elston, MD more...

Updated: Jan 12, 2012

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Background
Pathophysiology
Epidemiology
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Background

Trichomycosis axillaris is a relatively common superficial bacterial colonization of the axillary hair shafts. Granular concretions, which are yellow, black, or red, adhere to the hair shaft and clinically characterize trichomycosis axillaris.

Pathophysiology

Trichomycosis axillaris results from corynebacterial overgrowth on hair shafts in moist regions of the body and predominantly affects axillary hair, and to a lesser extent, pubic hair (trichomycosis pubis).^[1]Shelley and Shelley noted the coexistence of erythrasma, trichomycosis axillaris, and pitted keratolysis and termed it the corynebacterial triad.^[2]Rho and Kim reported the corynebacterial triad in 13% of 842 Korean soldiers.^[3]

Frequency

United States

No studies have assessed the frequency of trichomycosis axillaris in the United States.

International

In one study from the United Kingdom, trichomycosis axillaris was present in 27% of adult male students, and in the general population, 42% of male patients and 7% of female patients.

Mortality/Morbidity

Trichomycosis axillaris is a benign disease with no associated mortality or complications.

Race

No racial predilection is reported for trichomycosis axillaris.

Sex

Both sexes may be affected; however, trichomycosis axillaris appears to affect males more commonly, since most women shave their axillary hair.

Age

Trichomycosis axillaris can affect any age group from puberty through adulthood.

Proceed to Clinical Presentation

Contributor Information and Disclosures

Author

Zeina Nehme Ghorayeb, MD Lecturer, University of Balamand School of Medicine

Zeina Nehme Ghorayeb, MD is a member of the following medical societies: Alpha Omega Alpha

Disclosure: Nothing to disclose.

Coauthor(s)

Mona Matta-Muallem, MD Associate Professor, Department of Dermatology, American University of Beirut, Lebanon

Mona Matta-Muallem, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

Specialty Editor Board

Susan M Swetter, MD Director, Pigmented Lesion and Melanoma Program, Professor, Department of Dermatology, Stanford University Medical Center and Cancer Institute, Veterans Affairs Palo Alto Health Care System

Susan M Swetter, MD is a member of the following medical societies: American Academy of Dermatology, American Medical Association, American Society of Clinical Oncology, Eastern Cooperative Oncology Group, Pacific Dermatologic Association, Society for Investigative Dermatology, Society for Melanoma Research, and Women's Dermatologic Society

Disclosure: Nothing to disclose.

Richard P Vinson, MD Assistant Clinical Professor, Department of Dermatology, Texas Tech University Health Sciences Center, Paul L Foster School of Medicine; Consulting Staff, Mountain View Dermatology, PA

Richard P Vinson, MD is a member of the following medical societies: American Academy of Dermatology, Association of Military Dermatologists, Texas Dermatological Society, and Texas Medical Association

Disclosure: Nothing to disclose.

Jeffrey J Miller, MD Associate Professor of Dermatology, Pennsylvania State University College of Medicine; Staff Dermatologist, Pennsylvania State Milton S Hershey Medical Center

Jeffrey J Miller, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, Association of Professors of Dermatology, North American Hair Research Society, and Society for Investigative Dermatology

Disclosure: Nothing to disclose.

Joel M Gelfand, MD, MSCE Medical Director, Clinical Studies Unit, Assistant Professor, Department of Dermatology, Associate Scholar, Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania

Joel M Gelfand, MD, MSCE is a member of the following medical societies: Society for Investigative Dermatology

Disclosure: AMGEN Consulting fee Consulting; AMGEN Grant/research funds Investigator; Genentech Grant/research funds investigator; Centocor Consulting fee Consulting; Abbott Grant/research funds investigator; Abbott Consulting fee Consulting; Novartis investigator; Pfizer Grant/research funds investigator; Celgene Consulting fee DMC Chair; NIAMS and NHLBI Grant/research funds investigator

Chief Editor

Dirk M Elston, MD Director, Ackerman Academy of Dermatopathology, New York

Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

References

Freeman RG, McBride ME, Knox JM. Pathogenesis of trichomycosis axillaris. Arch Dermatol. Jul 1969;100(1):90-5. [Medline].
Shelley WB, Shelley ED. Coexistent erythrasma, trichomycosis axillaris, and pitted keratolysis: an overlooked corynebacterial triad?. J Am Acad Dermatol. Dec 1982;7(6):752-7. [Medline].
Rho NK, Kim BJ. A corynebacterial triad: Prevalence of erythrasma and trichomycosis axillaris in soldiers with pitted keratolysis. J Am Acad Dermatol. Feb 2008;58(2 Suppl):S57-8. [Medline].
Savin JA, Somerville A, Noble WC. The bacterial flora of trichomycosis axillaris. J Med Microbiol. May 1970;3(2):352-6. [Medline].
Shelley WB, Miller MA. Electron microscopy, histochemistry, and microbiology of bacterial adhesion in trichomycosis axillaris. J Am Acad Dermatol. Jun 1984;10(6):1005-14. [Medline].
Korting GW. Practical Dermatology of the Genital Region. Philadelphia, Pa: WB Saunders; 1980:59.
Levit F. Trichomycosis axillaris. J Am Acad Dermatol. May 1990;22(5 Pt 1):858-9. [Medline].
Levit F. Trichomycosis axillaris: a different view. J Am Acad Dermatol. Apr 1988;18(4 Pt 1):778-9. [Medline].
McBride ME, Duncan WC. Trichomycosis axillaris. Arch Dermatol. Mar 1972;105(3):459. [Medline].
Wilson C, Dawber R. Trichomycosis axillaris: a different view. J Am Acad Dermatol. Aug 1989;21(2 Pt 1):325-6. [Medline].

Yellow concretions are seen over axillary hairs.

Close-up view of axillary hairs.

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