chromhidrosis

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Chromhidrosis

  • 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

Reference:

Last reviewed 11/2021