an unusual disorder that usually occurs in puberty, when apocrine secretory function is activated
as apocrine glands regress with age, a parallel regression of the disease is often seen
majority of cases report in the literature, are confined to the face or axillae but areolar chromhidrosis has been reported
Clinical features
sweat is a darker coloration like blue, yellow, green or black
lipofuscin is a yellow pigment that is not specific to apocrine glands. In apocrine chromhidrosis the lipofuscin is in higher concentration or in a higher state of oxidation than in normal secretions, adopting a darker coloration - reason for the development in only a few patients is unknown
treatment
consult expert advice
treatment modalities used in this condition include topical capsaicin, topical alumium hydroxide based preparations and botulinum toxin A
consider eccrine and pseudoeccrine chromohidrosis:
true eccrine chromhidrosis is a very rare condition, occurring through eccrine excretion of water-soluble agents like dyes and drugs
not associated with systemic disorders. Incidence is unknown, and there is paucity of reports on the etiology of eccrine chromhidrosis
tartrazine coating of bisacodyl is documented as the cause for true eccrine chromhidrosis resulting in yellow sweat (2)
pink sweat associated with food colourings
a case report described a 26-year-old female presented with marked pink staining of her uniform and lingerie (3)
extractions of clothing, skin surface samples, eccrine sebum, urine and a fast food product were spectrophotometrically analysed to identify the pink staining pigment. Three water-soluble colouring agents have been identified. An eccrine route of excretion probably produced chromhidrosis
pseudochromhidrosis is the result of colorless perspiration mixed with an external chromogen such as dyed clothing, colored chemicals, or microorganisms such as Piedraia or Cornynebacterium
red facial pseudochromatosis
a case report describes a 9-year-old girl with pseudochromhidrosis simulating apocrine chromhidrosis (4)
treatment with topical and systemic erythromycin resulted in complete clearance of the reddish discoloration of the face. No relapse or recurrence was observed over a 3-month period.
Notes:
eccrine glands (sometimes called merocrine glands) are the major sweat glands of the human body, found in virtually all skin
apocrine sweat glands are found only in certain locations of the body: the axillae (armpits), areola and nipples of the breast, ear canal, eyelids, wings of the nostril, perianal region, and some parts of the external genitalia
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