Bromhidrosis Clinical Presentation

Updated: May 23, 2018
  • Author: Nathaniel Teegee, MD; Chief Editor: William D James, MD  more...
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Presentation

History

Patients present with particularly offensive body odor that most commonly originates from the axillary region. However, the condition may also occur as genital or plantar bromhidrosis. The odor has been described as pungent, rancid, musty, or sour in character.

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Physical Examination

Bromhidrosis is a metabolic and functional disease not typically associated with any anatomic disturbance. Therefore, results of physical examination of patients with axillary bromhidrosis are usually unremarkable. The skin appears normal, except when bromhidrosis is associated with concomitant skin conditions such as erythrasma, in which case a sharply marginated erythematous macular rash is seen, or trichomycosis axillaris, in which case concretions are visible on the hairs in the affected area.

In contrast, individuals with eccrine bromhidrosis caused by bacterial degradation of keratin may have maceration and a thick mat of moist keratin on examination. This finding is most common on the plantar and intertriginous surfaces.

Several case reports in children have described a nasal foreign body as a cause of generalized bromhidrosis. [17, 18, 19, 20, 21] Therefore, examiners should conduct thorough visualization and palpation of nasal passages in pediatric patients.

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