Fox-Fordyce Disease
Michael W. Peterson, DO
Cary Chisholm, MD
Clay J. Cockerell, MD
Key Facts
Clinical Issues
Age
13-35 years old
Gender
90% female
Apocrine distribution
Primarily axilla, periareolar, and anogenital areas
Monomorphic discrete flesh-colored papules
Intense pruritus
Microscopic Pathology
Keratotic plugging of infundibulum
Follicular epidermal spongiosis and vesiculation
Perifollicular and periductal inflammation
Lymphocytes and occasionally eosinophils
Inflammation does not usually involve sweat glands
± rupture of associated apocrine gland
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
Apocrine miliaria
Definitions
Keratin plugging of apocrine glands resulting in sweat retention and rupture of superficial apocrine duct
ETIOLOGY/PATHOGENESIS
Unknown
Multiple possible triggers
Hormonal factors
Emotional stimuli
Physical stimuli
Keratin Plugging of Apocrine Glands
Causes sweat retention
Ultimately distention and rupture of gland
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