Fox-Fordyce Disease
Michael W. Peterson, DO
Cary Chisholm, MD
Clay J. Cockerell, MD
Key Facts
Clinical Issues
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Age
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13-35 years old
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Gender
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90% female
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Apocrine distribution
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Primarily axilla, periareolar, and anogenital areas
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Monomorphic discrete flesh-colored papules
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Intense pruritus
Microscopic Pathology
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Keratotic plugging of infundibulum
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Follicular epidermal spongiosis and vesiculation
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Perifollicular and periductal inflammation
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Lymphocytes and occasionally eosinophils
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Inflammation does not usually involve sweat glands
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± rupture of associated apocrine gland
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Perifollicular foam cells are common
Fox-Fordyce disease is characterized by grouped papules in the groin and, pictured above, the axilla. (Courtesy N. Agim, MD.) |
There is a follicular plug  obstructing the follicle and eccrine duct ostium. There is a surrounding mild, perifollicular and periadnexal, lymphocytic infiltrate  . |
TERMINOLOGY
Synonyms
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Apocrine miliaria
Definitions
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Keratin plugging of apocrine glands resulting in sweat retention and rupture of superficial apocrine duct
ETIOLOGY/PATHOGENESIS
Unknown
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Multiple possible triggers
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Hormonal factors
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Emotional stimuli
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Physical stimuli
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Keratin Plugging of Apocrine Glands
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Causes sweat retention
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Ultimately distention and rupture of gland
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