Chromhidrosis Clinical Presentation

  • Author: June Kim, MD; Chief Editor: Dirk M Elston, MD   more...
 
Updated: May 11, 2012
 

History

History taking should include a detailed investigation of the patient's environment and lifestyle to exclude exogenous causes.

Quantities of apocrine sweat are less than those of eccrine sweat.

  • Usually, patients report axillary staining of their undershirt, staining of their bra,[6] or, less frequently, staining of the face or areola. Yellow is the most common color of axillary staining.
  • An aura of warmth or a prickly sensation prompted by emotional or physical stimuli may precede the onset of colored sweat.
  • Facial apocrine chromhidrosis is rarely described. It occurs most frequently on the cheeks and malar eminences. The secretion can often be expressed mechanically.
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Physical

On careful inspection, the following signs can often be observed in chromhidrosis:

  • An odorless yellow, green, blue, brown, or black and turbid secretion that can be manually expressed from apocrine-bearing skin
  • Staining that is accentuated in the follicular orifices and pores
  • Glistening, adherent, deeply colored flecks that appear as the secretions dry
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Causes

The increased numbers of lipofuscin pigments in the secretory apocrine cells are presumed to be the cause of apocrine chromhidrosis.

Several extrinsic causes of eccrine chromhidrosis and pseudochromhidrosis include chromogenic bacteria, especially Corynebacterium species, fungi, dyes, drugs, and chemical contactants.[7, 8, 9, 10]

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Contributor Information and Disclosures
Author

June Kim, MD  Mohs Surgery Fellow, Department of Dermatologic Surgery, Yale Medical Center

June Kim, MD, is a member of the following medical societies: American Academy of Dermatology, American College of Mohs Surgery, American Medical Association, American Society for Dermatologic Surgery, and Women's Dermatologic Society

Disclosure: Nothing to disclose.

Coauthor(s)

Wingfield Rehmus, MD, MPH  Dermatologist, BC Children's Hospital, Vancouver, British Columbia

Wingfield Rehmus, MD, MPH is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

Specialty Editor Board

Günter Burg, MD  Professor and Chairman Emeritus, Department of Dermatology, University of Zürich School of Medicine; Delegate of The Foundation for Modern Teaching and Learning in Medicine Faculty of Medicine, University of Zürich, Switzerland

Günter Burg, MD is a member of the following medical societies: American Academy of Dermatology, American Dermatological Association, International Society for Dermatologic Surgery, North American Clinical Dermatologic Society, and Pacific Dermatologic Association

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.

Glen H Crawford, MD  Assistant Clinical Professor, Department of Dermatology, University of Pennsylvania School of Medicine; Chief, Division of Dermatology, The Pennsylvania Hospital

Glen H Crawford, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Medical Association, Phi Beta Kappa, and Society of USAF Flight Surgeons

Disclosure: Nothing to disclose.

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.

Additional Contributors

The authors and editors of Medscape Reference gratefully acknowledge the contributions of previous authors, Shereen Timani, MD, and Nelly Rubeiz, MD, to the development and writing of this article.

References

  1. Barankin B, Alanen K, Ting PT, Sapijaszko MJ. Bilateral facial apocrine chromhidrosis. J Drugs Dermatol. Mar-Apr 2004;3(2):184-6. [Medline].

  2. Mali-Gerrits MM, van de Kerkhof PC, Mier PD, Happle R. Axillary apocrine chromhidrosis. Arch Dermatol. Apr 1988;124(4):494-6. [Medline].

  3. Griffith JR. Isolated areolar apocrine chromhidrosis. Pediatrics. Feb 2005;115(2):e239-41. [Medline].

  4. Saff DM, Owens R, Kahn TA. Apocrine chromhidrosis involving the areolae in a 15-year-old amateur figure skater. Pediatr Dermatol. Mar 1995;12(1):48-50. [Medline].

  5. Carman KB, Aydogdu SD, Sabuncu I, Yarar C, Yakut A, Oztelcan B. Infant with chromhidrosis. Pediatr Int. Apr 2011;53(2):283-4. [Medline].

  6. Polat M, Dikilitas M, Gozubuyukogullari A, Alli N. Apocrine chromhidrosis. Clin Exp Dermatol. Oct 2009;34(7):e373-4. [Medline].

  7. Singal A, Thami GP. Red pseudochromhidrosis of the neck. Clin Exp Dermatol. Sep 2004;29(5):548-9. [Medline].

  8. Thami GP, Kanwar AJ. Red facial pseudochromhidrosis. Br J Dermatol. Jun 2000;142(6):1219-20. [Medline].

  9. Yoshida R, Kobayashi S, Amagai M, Tanaka M. Brown palm pseudochromhidrosis. Contact Dermatitis. Apr 2002;46(4):237-8. [Medline].

  10. Hill S, Duffill M, Lamont D, Rademaker M, Yung A. Pseudochromhidrosis: blue discolouration of the head and neck. Australas J Dermatol. Nov 2007;48(4):239-41. [Medline].

  11. Allegue F, Hermo JA, Fachal C, Alfonsín N. Localized green pigmentation in a patient with hyperbilirubinemia. J Am Acad Dermatol. Jul 1996;35(1):108-9. [Medline].

  12. Kanzaki T, Tsuda J. Bile pigment deposition at sweat pores of patients with liver disease. J Am Acad Dermatol. Apr 1992;26(4):655-6. [Medline].

  13. Albers SE, Brozena SJ, Glass LF, Fenske NA. Alkaptonuria and ochronosis: case report and review. J Am Acad Dermatol. Oct 1992;27(4):609-14. [Medline].

  14. Cox NH, Popple AW, Large DM. Autofluorescence of clothing as an adjunct in the diagnosis of apocrine chromhidrosis. Arch Dermatol. Feb 1992;128(2):275-6. [Medline].

  15. Pérez-Tato B, Zamora-Martínez E, Sánchez-Albisua B, Pérez-González YC, Polimón-Olabarrieta I, Marinero-Escobedo S, et al. Facial and axillary apocrine chromhidrosis. Dermatol Online J. Mar 15 2012;18(3):13. [Medline].

  16. Beer K, Oakley H. Axillary chromhidrosis: report of a case, review of the literature and treatment considerations. J Cosmet Dermatol. Dec 2010;9(4):318-20. [Medline].

  17. Matarasso SL. Treatment of facial chromhidrosis with botulinum toxin type A. J Am Acad Dermatol. Jan 2005;52(1):89-91. [Medline].

  18. Wu JM, Mamelak AJ, Nussbaum R, McElgunn PS. Botulinum toxin a in the treatment of chromhidrosis. Dermatol Surg. Aug 2005;31(8 Pt 1):963-5. [Medline].

  19. Marks JG Jr. Treatment of apocrine chromhidrosis with topical capsaicin. J Am Acad Dermatol. Aug 1989;21(2 Pt 2):418-20. [Medline].

  20. Rumsfield JA, West DP. Topical capsaicin in dermatologic and peripheral pain disorders. DICP. Apr 1991;25(4):381-7. [Medline].

  21. Daoud MS, Dicken CH. Disorders of the apocrine sweat glands. In: Fitzpatrick's Dermatology in General Medicine. 6th ed. New York, NY: McGraw-Hill; 2003:708-9.

  22. Shelley WD, Hurley HJ Jr. Localized chromhidrosis: a survey. Arch Dermatol Syphilol. 1954;69:449-71.

 
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