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Trichomycosis Axillaris

  • Author: Nicholas V Nguyen, MD; Chief Editor: Dirk M Elston, MD  more...
 
Updated: Feb 02, 2015
 

Background

Trichomycosis axillaris is a relatively common superficial corynebacterial colonization of the axillary hair shafts characterized by the presence of adherent granular concretions and a benign clinical course. When the pubic hair is affected, the condition is referred to as trichomycosis pubis.[1] Shelley and Shelley noted the coexistence of erythrasma, trichomycosis axillaris, and pitted keratolysis and termed it the corynebacterial triad.[2]

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Pathophysiology

Corynebacteria are gram-positive rods and a major component of the cutaneous flora. A warm and moist local environment contributes to bacterial overgrowth. Hyperhidrosis and poor hygiene are risk factors for disease.

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Epidemiology

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. Rho and Kim reported the corynebacterial triad in 13% of 842 Korean soldiers.[3]

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.

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Contributor Information and Disclosures
Author

Nicholas V Nguyen, MD Director of Pediatric Dermatology, Akron Children's Hospital

Nicholas V Nguyen, MD is a member of the following medical societies: American Academy of Dermatology, American Academy of Pediatrics, Society for Pediatric Dermatology

Disclosure: Nothing to disclose.

Coauthor(s)

Tracy Funk, MD Fellow in Pediatric Dermatology, Department of Dermatology, The Children’s Hospital Colorado

Tracy Funk, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Academy of Pediatrics, Society for Pediatric Dermatology, Women's Dermatologic Society

Disclosure: Nothing to disclose.

Specialty Editor Board

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, Texas Medical Association, Association of Military Dermatologists, Texas Dermatological Society

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, Society for Investigative Dermatology, Association of Professors of Dermatology, North American Hair Research Society

Disclosure: Nothing to disclose.

Chief Editor

Dirk M Elston, MD Professor and Chairman, Department of Dermatology and Dermatologic Surgery, Medical University of South Carolina College of Medicine

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

Disclosure: Nothing to disclose.

Additional Contributors

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, Women's Dermatologic Society, American Society of Clinical Oncology, Society for Melanoma Research, Eastern Cooperative Oncology Group, American Medical Association, Pacific Dermatologic Association, Society for Investigative Dermatology

Disclosure: Nothing to disclose.

Acknowledgements

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. 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.

References
  1. Freeman RG, McBride ME, Knox JM. Pathogenesis of trichomycosis axillaris. Arch Dermatol. 1969 Jul. 100(1):90-5. [Medline].

  2. Shelley WB, Shelley ED. Coexistent erythrasma, trichomycosis axillaris, and pitted keratolysis: an overlooked corynebacterial triad?. J Am Acad Dermatol. 1982 Dec. 7(6):752-7. [Medline].

  3. Rho NK, Kim BJ. A corynebacterial triad: Prevalence of erythrasma and trichomycosis axillaris in soldiers with pitted keratolysis. J Am Acad Dermatol. 2008 Feb. 58(2 Suppl):S57-8. [Medline].

  4. Bonifaz A, Váquez-González D, Fierro L, Araiza J, Ponce RM. Trichomycosis (trichobacteriosis): clinical and microbiological experience with 56 cases. Int J Trichology. 2013 Jan. 5(1):12-6. [Medline]. [Full Text].

  5. Crissey JT, Rebell GC, Laskas JJ. Studies on the causative organism of trichomycosis axillaris. J Invest Dermatol. 1952 May. 19(3):187-97. [Medline].

  6. Savin JA, Somerville A, Noble WC. The bacterial flora of trichomycosis axillaris. J Med Microbiol. 1970 May. 3(2):352-6. [Medline].

  7. Kimura Y, Nakagawa K, Imanishi H, Ozawa T, Tsuruta D, Niki M, et al. Case of trichomycosis axillaris caused by Corynebacterium propinquum. J Dermatol. 2014 May. 41(5):467-9. [Medline].

  8. Shelley WB, Miller MA. Electron microscopy, histochemistry, and microbiology of bacterial adhesion in trichomycosis axillaris. J Am Acad Dermatol. 1984 Jun. 10(6):1005-14. [Medline].

 
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Yellow concretions are seen over axillary hairs.
Close-up view of axillary hairs.
 
 
 
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