Fox-Fordyce Disease

Key Points
Rare skin condition in which sweat become trapped in the hair follicle, mostly affecting women
Exact cause is unknown, though it is thought that hormones and alterations to the chemical makeup of sweat may play a part in its development
Consists of small papules, flesh or red colored, usually in the armpits but sometimes in the groin, at times causing inflammation and itching, which may be intense

Fox-Fordyce Disease is a rare skin condition in which sweat becomes trapped within hair follicles due to the formation of a plug in the follicle. Initially presents as small papules in the affected area, red to flesh colored and accompanied by intense itching due to the rupture of sweat ducts. Affected skin may become darker and thicker due to scratching. Sweating may be greatly reduced or disappear completely from the area. In some cases, no symptoms develop. The condition generally affects follicles in the underarms, although the pubic or nipple region may occasionally be involved.

While Fox-Fordyce Disease most commonly affects women between 13-35, it is rarely seen in men or children. While the exact cause of the formation of follicle plugs is unknown, it is suspected that changes in hormones and/or alteration of the chemical makeup of sweat may play a part in its development. Heat, humidity and stress may also be factors in its appearance.

Differential Diagnosis (Other conditions with similar appearance)

Acneiform Eruptions
Folliculitis
Milia
Miliaria

Diagnosis
Key Points
Diagnosis based on skin appearance and typical location, especially in a young adult female
Other tests may be performed to confirm diagnosis

Fox-Fordyce Disease is usually diagnosed based on the appearance of the affected skin. Health care professionals may performed other testing to confirm diagnosis and rule out similar appearing conditions.

Treatment
There is no cure for the condition
May resolve spontaneously during hormonal changes in some affected persons
Several treatments have shown varying degrees of effectiveness

There is no cure for Fox-Fordyce Disease. While some cases may resolve spontaneously during pregnancy or Menopause, the condition is often persistent over a period of years. While there is no cure, there are several treatments available, which have shown varying degrees of effectiveness. These treatments include the use of oral contraceptives, retinoid and steroid creams, topical medications containing Tacrolimus or Pimecrolimus, and oral or topical antibiotics. Additionally, Phototherapy, Dermabrasion and even excision may assist in alleviating the condition.