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Fox-Fordyce Disease Workup

  • Author: Christopher R Gorman, MD; Chief Editor: William D James, MD  more...
Updated: Sep 23, 2015

Laboratory Studies

Histopathologic diagnosis of Fox-Fordyce disease may be very difficult with conventional sectioning. Stashower et al proposed transverse histologic sectioning as the most effective way to demonstrate diagnostic features.[8]

Diagnosis of Fox-Fordyce disease is usually made on clinical/historical grounds. Laboratory or even histopathologic tests are seldom necessary for clinicians familiar with this condition.



In 2002, Chae et al described axillary Fox-Fordyce disease treated with liposuction-assisted curettage.


Histologic Findings

The proposed apocrine origin of Fox-Fordyce disease was based on the finding of a keratin plug in the follicular infundibulum that occluded the apocrine acrosyringium. Reports also include a rupture of the apocrine duct and a resulting spongiotic inflammation. Plasma cells may be noted, and the deeper apocrine duct may be dilated with sialomucin. The dermis may show fibrosis and chronic inflammation. These latter findings depend on the condition's chronicity.

Transverse sectioning may allow for a more accurate diagnosis of Fox-Fordyce disease. Bormate et al contend that perifollicular xanthomatosis (foam cells) is a specific, relatively consistent, and distinct histologic feature in 7 cases.[9]  Perifollicular xanthomatosis may result in a histologic misdiagnosis of planar xanthoma due to sectioning error (author). Apocrine acini dilation may be another helpful nonspecific histologic finding.[10]

Contributor Information and Disclosures

Christopher R Gorman, MD Avenues Dermatology, Private Practice

Christopher R Gorman, MD is a member of the following medical societies: Alpha Omega Alpha

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.

Chief Editor

William D James, MD Paul R Gross Professor of Dermatology, Vice-Chairman, Residency Program Director, Department of Dermatology, University of Pennsylvania School of Medicine

William D James, MD is a member of the following medical societies: American Academy of Dermatology, Society for Investigative Dermatology

Disclosure: Nothing to disclose.


Mary Farley, MD Dermatologic Surgeon/Mohs Surgeon, Anne Arundel Surgery Center

Disclosure: Nothing to disclose.

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