ABSTRACT
BACKGROUND: Fox-Fordyce (FFD), also known as apocrine military, is an uncommon chronic inflammation of the apocrine sweat glands. It is characterized by pruritic, papular eruptions in apocrine-gland-bearing regions. FFD was described a century ago, but the exact pathogenesis of the disease and the management are not well understood. AIMS: This paper provides a wide understanding of the pathophysiology, clinical findings, and management of Fox-Fordyce disease. Its aim is to help the physician to diagnose and manage this entity accordingly. METHODS: A research was done using PubMed database on 12 April 12, 2020, and in order to retrieve all case reports, case series, cohort studies, randomized, and nonrandomized clinical trials were included describing FFD among patients. RESULTS: A total of 43 articles and 68 patients were included in the study. The majority of patients were young females. The disease was bilateral in 90%, affected the axillae and to a lesser extent the pubic and the periareolar areas and rarely the thoracic area, the abdominal area, and the face. FFD followed a relapsing and remitting course, and an evident improvement in disease course was noted after menopause. CONCLUSION: The typical FFD patient is a post-pubertal female and pre-menopause, presenting with pruritic papules in apocrine-gland-bearing regions. FFD can be sporadic or occurs in family, and it can be asymptomatic in 1/(3-4) of patients and can be triggered by laser hair removal and hormonal changes. Further randomized clinical trials assessing different treatment of FFD are now warranted.
Subject(s)
Fox-Fordyce Disease , Hair Removal , Apocrine Glands , Axilla , Epidermis , Female , Fox-Fordyce Disease/diagnosis , Fox-Fordyce Disease/therapy , HumansABSTRACT
Fox-Fordyce disease (FFD), also known as apocrine miliaria, is a rare and chronic skin disease characterized by itching and skin-colored, light brown or yellowish papules. FFD typically affects postpubertal young women between 13 and 35 years. The etiology is not completely known, but a hormonal component is in discussion. Furthermore, exacerbating factors like laser hair removal and hyperhidrosis have been described. Treatment of FFD is quite challenging, as the reported modalities mostly show limited success.
Subject(s)
Fox-Fordyce Disease , Hyperhidrosis , Axilla , Female , Fox-Fordyce Disease/diagnosis , Fox-Fordyce Disease/therapy , Hair Removal , Humans , Hyperhidrosis/diagnosis , Hyperhidrosis/therapy , Skin , Young AdultABSTRACT
A switch from cell-mediated to humoral immunity (helper T 1 [Th1] to helper T 2 [Th2] shift) during gestation plays a key role in placental immune tolerance. As a result, skin diseases that are Th2 mediated often worsen, whereas skin diseases that are Th1 mediated often improve during gestation. Also, due to fluctuations in glandular activity, skin diseases involving sebaceous and eccrine glands may flare, whereas those involving apocrine glands may improve during pregnancy. Despite these trends, inflammatory and glandular skin diseases do not always follow the predicted pattern, and courses are often diverse. We review the gestational course of inflammatory skin diseases, such as atopic dermatitis (atopic eruption of pregnancy), psoriasis, impetigo herpetiformis, urticaria, erythema annulare centrifugum, pityriasis rosea, sarcoidosis, Sweet syndrome, and erythema nodosum, as well as glandular skin diseases, including acne vulgaris, acne rosacea, perioral dermatitis, hidradenitis suppurativa, Fox-Fordyce disease, hyperhidrosis, and miliaria. For each of these diseases, we discuss the pathogenesis, clinical presentation, and management with special consideration for maternal and fetal safety.
Subject(s)
Pregnancy Complications/diagnosis , Pregnancy Complications/therapy , Skin Diseases/diagnosis , Skin Diseases/therapy , Acne Vulgaris/drug therapy , Acne Vulgaris/etiology , Dermatitis, Atopic/diagnosis , Dermatitis, Atopic/drug therapy , Dermatitis, Perioral/etiology , Erythema Nodosum/diagnosis , Female , Fox-Fordyce Disease/therapy , Hidradenitis Suppurativa/therapy , Humans , Pityriasis Rosea/diagnosis , Pityriasis Rosea/etiology , Pregnancy , Pregnancy Complications/etiology , Psoriasis/complications , Psoriasis/therapy , Remission, Spontaneous , Rosacea/therapy , Sarcoidosis/complications , Sarcoidosis/drug therapy , Skin Diseases/etiology , Sweet Syndrome/diagnosis , Symptom Flare Up , Urticaria/drug therapySubject(s)
Fox-Fordyce Disease/diagnosis , Fox-Fordyce Disease/pathology , Axilla , Female , Fox-Fordyce Disease/therapy , Humans , Young AdultABSTRACT
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