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Alhudaif A, Almazied MK, Khashoggi M, Alasgah E, Alhaddab A. Facial Apocrine Chromhidrosis: A Case Report. Cureus 2024; 16:e53401. [PMID: 38435167 PMCID: PMC10908344 DOI: 10.7759/cureus.53401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/31/2024] [Indexed: 03/05/2024] Open
Abstract
Apocrine chromhidrosis is a rare disease that is characterized by colored sweating. Here, we present a rare case that was successfully treated for this condition. A 32-year-old woman presented with dark blue discharge from her cheeks. She was diagnosed with apocrine chromhidrosis and was treated successfully with botulinum toxin type A.
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Kelly A, Gandhi R, Natkunarajah J. 'Your mascara is running'. Clin Exp Dermatol 2021; 47:639-641. [PMID: 34962316 DOI: 10.1111/ced.15015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 11/09/2021] [Accepted: 11/10/2021] [Indexed: 11/28/2022]
Abstract
Chromhidrosis is a rare disorder, which can have significant psychosocial consequences for patients, particularly when it affects the face, as it can be mistaken for scarring, dirt or erroneous make-up application. Chromhidrosis can be divided into apocrine, eccrine and pseudo subtypes. We present a case of apocrine chromhidrosis localized to the bilateral cheek area.
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Affiliation(s)
- A Kelly
- Department of Dermatology, Kingston Hospital, Kingston Hospital NHS Foundation Trust, Kingston upon Thames, Surrey, UK
| | - R Gandhi
- Department of Dermatology, Kingston Hospital, Kingston Hospital NHS Foundation Trust, Kingston upon Thames, Surrey, UK
| | - J Natkunarajah
- Department of Dermatology, Kingston Hospital, Kingston Hospital NHS Foundation Trust, Kingston upon Thames, Surrey, UK
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Affiliation(s)
- Jason E. Sammons
- Department of Clinical Medicine, Avalon University School of Medicine, Willemstad, CW, USA
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Semkova K, Gergovska M, Kazandjieva J, Tsankov N. Hyperhidrosis, bromhidrosis, and chromhidrosis: Fold (intertriginous) dermatoses. Clin Dermatol 2015; 33:483-91. [DOI: 10.1016/j.clindermatol.2015.04.013] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Childhood lupus with microangiopathic antiphospholipid syndrome and pulmonary hemorrhage. Indian Pediatr 2015; 52:333-4. [DOI: 10.1007/s13312-015-0634-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Gaffney DC, Cooper HL. Coloured sweat in two brothers: First report of familial chromhidrosis. Australas J Dermatol 2015; 57:e23-5. [DOI: 10.1111/ajd.12262] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2014] [Accepted: 09/10/2014] [Indexed: 11/26/2022]
Affiliation(s)
- Daniel C Gaffney
- Department of Dermatology; St. Mary's Hospital; Portsmouth Hospitals NHS Trust; Portsmouth UK
| | - Hywel L Cooper
- Department of Dermatology; St. Mary's Hospital; Portsmouth Hospitals NHS Trust; Portsmouth UK
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Boyd K, Shea SM, Patterson JW. The role of capsaicin in dermatology. PROGRESS IN DRUG RESEARCH. FORTSCHRITTE DER ARZNEIMITTELFORSCHUNG. PROGRES DES RECHERCHES PHARMACEUTIQUES 2014; 68:293-306. [PMID: 24941674 DOI: 10.1007/978-3-0348-0828-6_12] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Neurogenic pain and pruritus are the common chief complaints at dermatology office visits. Unfortunately, they are also notoriously difficult conditions to treat. Topical capsaicin used as a single therapy or as an adjuvant offers a low-risk option for patients who do not achieve control on other therapies. This chapter presents the evidence behind topical capsaicin use in dermatologic conditions characterized by neurogenic pain or pruritus, including postherpetic neuralgia, notalgia paresthetica, brachioradial pruritus, lichen simplex chronicus, prurigo nodularis, pruritus ani, pruritus of hemodialysis, aquagenic pruritus, apocrine chromhidrosis, lipodermatosclerosis, alopecia areata, and psoriasis. It presents the most common capsaicin formulations, dosages, and durations of treatment for each condition. Additionally, the chapter addresses various adverse effects and limitations in the use of topical capsaicin in dermatology.
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Diagnostic de chromhidrose apocrine et analyse spectrophotométrique de la sueur. Ann Dermatol Venereol 2012; 139:143-5. [DOI: 10.1016/j.annder.2011.10.409] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2011] [Revised: 07/31/2011] [Accepted: 10/17/2011] [Indexed: 11/22/2022]
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Wu JM, Mamelak AJ, Nussbaum R, McElgunn PSJ. Botulinum Toxin A in the Treatment of Chromhidrosis. Dermatol Surg 2006. [DOI: 10.1111/j.1524-4725.2005.31814] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Abstract
A case of isolated areolar apocrine chromhidrosis in an 11-year-old female is presented. This is the youngest case cited in Medline. The goal of this review is to increase awareness of apocrine chromhidrosis among primary care providers and to discuss treatment. Capsaicin cream 0.025% is a proven treatment that may reduce the potential psychological impact and embarrassment that patients experience.
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Affiliation(s)
- Joan R Griffith
- University of Kentucky, Department of Pediatrics, Division of General Pediatrics, Adolescent Medicine and Young Parents Program, Lexington, Kentucky, USA.
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Abstract
BACKGROUND Hyperhidrosis is an idiopathic condition of exaggerated sweat production by the eccrine glands that affects approximately 1% of the population. There are many viable therapeutic options and the use of botulinum toxin has become an important treatment option and received FDA approval for this disorder in July 2004. The other forms of aberrant sweating; bromhidrosis (malodorous) and chromhidrosis (pigmented) are much rarer and more recalcitrant to treatment. METHOD This is the first case report of dark-colored facial sweat in a young woman that was adequately controlled with botulinum toxin. CONCLUSION Chromhidrosis is an unusual clinical entity with an ill-defined glandular etiology. The successful response to botulinum toxin supports the eccrine gland as a source of the sweat production and, furthermore, that the administration of this toxin should be considered as a form of therapy.
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Ständer S, Moormann C, Schumacher M, Buddenkotte J, Artuc M, Shpacovitch V, Brzoska T, Lippert U, Henz BM, Luger TA, Metze D, Steinhoff M. Expression of vanilloid receptor subtype 1 in cutaneous sensory nerve fibers, mast cells, and epithelial cells of appendage structures. Exp Dermatol 2004; 13:129-39. [PMID: 14987252 DOI: 10.1111/j.0906-6705.2004.0178.x] [Citation(s) in RCA: 271] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The vanilloid receptor subtype 1 (VR1)/(TRPV1), binding capsaicin, is a non-selective cation channel that recently has been shown in human keratinocytes in vitro and in vivo. However, a description of VR1 localization in other cutaneous compartments in particular cutaneous nerve fibers is still lacking. We therefore investigated VR1 immunoreactivity as well as mRNA and protein expression in a series (n = 26) of normal (n = 7), diseased (n = 13) [prurigo nodularis (PN) (n = 10), generalized pruritus (n = 1), and mastocytosis (n = 2)], and capsaicin-treated human skin (n = 6). VR1 immunoreactivity could be observed in cutaneous sensory nerve fibers, mast cells, epidermal keratinocytes, dermal blood vessels, the inner root sheet and the infundibulum of hair follicles, differentiated sebocytes, sweat gland ducts, and the secretory portion of eccrine sweat glands. Upon reverse transcriptase-polymerase chain reaction and Western blot analysis, VR1 was detected in mast cells and keratinocytes from human skin. In pruritic skin of PN, VR1 expression was highly increased in epidermal keratinocytes and nerve fibers, which was normalized after capsaicin application. During capsaicin therapy, a reduction of neuropeptides (substance P, calcitonin gene-related peptide) was observed. After cessation of capsaicin therapy, neuropeptides re-accumulated in skin nerves. In conclusion, VR1 is widely distributed in the skin, suggesting a major role for this receptor, e.g. in nociception and neurogenic inflammation.
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Affiliation(s)
- Sonja Ständer
- Department of Dermatology, University of Münster, Muenster, Germany.
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Abstract
Neurons possessing C-fibers transmit nociceptive information into the central nervous system and participate in various reflex responses. These neurons carry receptors that bind capsaicin, recently identified as the vanilloid VR1 receptor. Excitation of these cells by capsaicin is followed by a lasting refractory state, termed desensitisation, in which the neurons fail to respond to a variety of noxious stimuli. Desensitisation to capsaicin has a clear therapeutic potential in relieving neuropathic pain and ameliorating urinary bladder overactivity, just to cite 2 important examples. Vanilloids may also be beneficial in the treatment of benign prostate hyperplasia (BPH). Since the majority of elderly patients have neuropathic pain co-existent with urinary incontinence and/or BPH, a drug that ameliorates pain and improves urinary symptoms at the same time promises to be of great clinical value in geriatric medicine. In fact, capsaicin has already been shown to have a role in the treatment of conditions that can arise in the elderly, including herpes zoster-related neuropathic pain, diabetic neuropathy, postmastectomy pain, uraemic itching associated with renal failure, and urinary incontinence. The potent VR1 agonist resiniferatoxin, now in phase II clinical trials, appears to be superior to capsaicin in terms of its tolerability profile. Recent discoveries enhance the therapeutic potential of vanilloids. The recognition that VR1 also functions as a principal receptor for protons and eicosanoids implies that VR1 antagonists may be of value in the treatment of inflammatory hyperalgesia and pain. Animal experimentation has already lent support to this assumption. The discovery of VR1-expressing cells in the brain as well as in non-neural tissues such as the kidney and urothelium places VR1 in a much broader perspective than peripheral pain perception, and is hoped to identify further, yet unsuspected, indications for vanilloid therapy. The realisation that VR1 and cannabinoid CB1 receptors have overlapping ligand recognition properties may also have far-reaching implications for vanilloid therapy. In fact, arvanil, a combined agonist of VR1 and CB1 receptors, has already proved to be a powerful analgesic drug in the mouse. From academic molecular biology laboratories to industrial drug discovery centres to the clinics, there is a steady flow of new data, forcing us to constantly revise the ways we are thinking about vanilloid receptor ligands and their hopes and realities for the future. This review covers the most promising current trends in vanilloid research with special emphasis on geriatric medicine.
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Affiliation(s)
- A Szallasi
- Department of Pathology and Immunology, Washington University School of Medicine, St Louis, Missouri, USA.
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Abstract
Apocrine chromhidrosis is a rare disease frequently localized to the face or axillae, and rarely has been reported to occur around the breasts. We report a 15-year-old amateur figure skater who displayed localized chromhidrosis around her areolae. The most common precipitating event was exercise. She was treated topically with capsaicin cream 0.025% with a subsequent decrease in symptomatology.
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Affiliation(s)
- D M Saff
- Department of Dermatology, Cleveland Clinic Foundation, OH 44195-5032, USA
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Abstract
Topical capsaicin has been studied in a variety of conditions by uncontrolled and controlled trials. It is attractive because it is a simple, safe treatment. Although these studies suggest an analgesic effect, even placebo-controlled trials have been impossible to blind due to the burning sensation induced by the capsaicin. A high placebo response rate in the controlled trials is an interesting observation and may account for the apparent salutary effect reported in the studies lacking a control. A careful scrutiny of the results of these trials to date as well as clinical experience indicate at best a modest effect with the currently available preparations with many patients failing to find relief, finding the relief unsatisfactory, or being unable to tolerate the burning sensation. Occasional patients appear to have a very good result, and these unusual cases may not be reflected by clinical trials. Topical capsaicin is generally not satisfactory as a sole therapy for chronic painful conditions, although it may serve as an adjuvant to other approaches.
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Affiliation(s)
- C P Watson
- Department of Medicine, University of Toronto, Ontario, Canada
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Szallasi A, Blumberg PM. Mechanisms and therapeutic potential of vanilloids (capsaicin-like molecules). ADVANCES IN PHARMACOLOGY (SAN DIEGO, CALIF.) 1993; 24:123-55. [PMID: 8504062 DOI: 10.1016/s1054-3589(08)60936-9] [Citation(s) in RCA: 57] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Affiliation(s)
- A Szallasi
- Department of Pharmacology, Menarini Ricerche Sud, Pomezia, Roma, Italy
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Rumsfield JA, West DP. Topical capsaicin in dermatologic and peripheral pain disorders. DICP : THE ANNALS OF PHARMACOTHERAPY 1991; 25:381-7. [PMID: 1656616 DOI: 10.1177/106002809102500409] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Topical capsaicin has been introduced in the U.S. and Canada as a cream indicated for temporary relief of neuralgia following episodes of herpes zoster infections and in the treatment of diabetic neuropathy. Although capsaicin is clinically used as an external analgesic for temporary relief of neuralgia, it has also been widely used as a research tool to study peripheral pain. Capsaicin apparently works to release substance P from sensory nerve fibers and after repeated applications, depletes neurons of substance P. Clinical investigations of topical capsaicin include trials in chronic pain syndromes such as postherpetic neuralgia, postmastectomy neuroma, reflex sympathetic dystrophy syndrome, diabetic neuropathy, rheumatoid arthritis, psoriasis, hemodialysis-associated itching, and vulvar vestibulitis. In addition, therapeutic benefits of capsaicin cream on apocrine chromhidrosis have been described. Further clinical studies are warranted in several of these conditions to establish the efficacy of topical capsaicin. Serious or unexpected adverse reactions from clinical use have not been reported to date. Considering the paucity of safe and effective treatments for the conditions mentioned above, capsaicin cream appears to warrant further clinical investigations to establish its efficacy in a variety of chronic pain syndromes.
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Affiliation(s)
- J A Rumsfield
- Department of Pharmacy Practice, Colleges of Pharmacy, University of Illinois, Chicago 60612
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Coskey RJ. Dermatologic therapy: 1989. J Am Acad Dermatol 1990; 23:280-7. [PMID: 2212125 DOI: 10.1016/s0190-9622(08)81238-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Affiliation(s)
- R J Coskey
- Dermatology Department, Wayne State University School of Medicine, Detroit, Michigan
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