Fox-Fordyce Disease

Abstract

A 42-year-old woman presented to the Department of Dermatology & Venereology, Virgen de las Nieves Hospital, Granada, Spain, in May 2015 with a severe pruritic rash and hair loss in both axillary regions. Physical examination showed skin coloured papules and alopecia [ Figure 1A], which showed no fluorescence under a Wood's lamp. Dermoscopy revealed hair follicle-centred papules, Figure 1A-D: A 42-year-old woman with Fox-Fordyce disease with (A) skin coloured papules of 1-2 mm and moderate alopecia in the right axilla and (B) folliculocentric papules with a few traumatised terminal hairs and blackheads. Haematoxylin and eosin stains showed (C) inflammatory infiltrate of lymphocytes affecting the follicle at x10 magnification and (D) eccrine and apocrine sweat glands showing dilatation at x4 magnification.interesting medical image

Fox-Fordyce Disease: Dermoscopic Perspective

“…To the best of our knowledge, dermoscopy in FFD has been reported only once previously in a 42-year-old woman who showed multiple folliculocentric skin -yellowish papules with central hair and blackheads [7]. The follicular hyperkeratotic plugs on dermoscopy correspond to the dilated follicular infundibula with hyper-keratosis on histology [7]. Dermoscopy of Grahm-Little-Piccardi syndrome shows follicular hyperkeratosis and accentuation of follicular ostia [8].…”

“…Lichen nitidus shows a classic sunburst appearance on dermoscopy [5], while syringoma shows white dots corresponding to the eccrine duct openings [6]. To the best of our knowledge, dermoscopy in FFD has been reported only once previously in a 42-year-old woman who showed multiple folliculocentric skin -yellowish papules with central hair and blackheads [7]. The follicular hyperkeratotic plugs on dermoscopy correspond to the dilated follicular infundibula with hyper-keratosis on histology [7].…”

Axillary manifestations of dermatologic diseases: a focused review

“…Fox-Fordyce Disease (FFD), also known as apocrine miliaria, is an inflammatory skin condition postulated to occur when apocrine or apo-eccrine sweat ducts become occluded and inflamed (20)(21)(22). FFD presents as flesh-colored to reddish-brown pruritic domeshaped papules in apocrine gland-bearing regions such as the axillae, groin, areolae, and inframammary folds ( Fig.…”

“…On physical examination, the affected area is often thickened and darkened due to chronic itching and excoriation. Diagnosis of FFD is clinical; however, if a skin biopsy is performed it will characteristically show occlusion of the apocrine duct by a keratin plug in the follicular infundibulum (20,22,24,26).…”

Pathophysiology, clinical findings, and management of Fox‐Fordyce disease: A systematic review

“…Fox-Fordyce disease (FFD) is an uncommon chronic inflammatory eruption affecting apocrine sweat glands. 1,2 In 1902, apocrine miliaria was the initial term attributed to the disease by George Henry Fox and John Addison Fordyce. The term was suggested after the confirmation of inflammatory reaction plugging sweat glands and causing sweat retention.…”