Chromhidrosis Workup

Updated: May 14, 2018
  • Author: June Kim, MD; Chief Editor: Dirk M Elston, MD  more...
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Workup

Laboratory Studies

No significant laboratory abnormalities have been noted with apocrine chromhidrosis. The following test may help to rule out other causes:

  • Determination of complete blood cell counts to exclude bleeding diathesis

  • Tests of urinary homogentisic acid levels to exclude alkaptonuria

  • Fungal and bacteriologic cultures to exclude infectious causes of pseudochromhidrosis

  • Liver function tests and bilirubin levels to exclude hyperbilirubinemia

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Other Tests

Wood lamp examination of colored sweat may be positive. If no sweat is produced at the time of the test, manual expression or pharmacologic stimulation with intradermal epinephrine or oxytocin (Pitocin) can be used to stimulate sweat secretion.

Clothing fibers in contact with the secretions may also fluoresce yellow-green with standard UV microscopy. [22]

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Histologic Findings

The apocrine glands appear normal in size and morphology, but the number of glands varies. The increased number of yellow-brown lipofuscin granules is observed in the cytoplasm of secretory cells on routine hematoxylin-eosin staining. The granules are positive on periodic acid-Schiff stains and demonstrate autofluorescence under a UV excitation wavelength of 360-395 nm. Schmorl stains may also be weakly positive. [13]

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