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Fox–Fordyce disease is a chronic blockage of the
sweat gland Sweat glands, also known as sudoriferous or sudoriparous glands, , are small tubular structures of the skin that produce sweat. Sweat glands are a type of exocrine gland, which are glands that produce and secrete substances onto an epithelial sur ...
ducts with a secondary, non-
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l inflammatory response to the
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s.Freedberg, et al. (2003). ''Fitzpatrick's Dermatology in General Medicine''. (6th ed.). McGraw-Hill. p. 709. . The inflammation is often accompanied by intense itching. In general, the disease often causes skin to darken near the affected area and raised bumps or papules to appear. In addition, hair follicles can become damaged which cause hair loss.
Hidradenitis Hidradenitis is any disease in which the histologic abnormality is primarily an inflammatory infiltrate around the eccrine glands.James, William; Berger, Timothy; Elston, Dirk (2005). ''Andrews' Diseases of the Skin: Clinical Dermatology''. (10th ...
is very similar, but tends to have a secondary bacterial infection so that pus-draining sinuses are formed. It is a very devastating
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disease that does not have universally curative treatments.


Signs and symptoms

Symptoms may appear suddenly following any condition of heat, humidity, or friction. The apocrine glands (sweat glands) are the site of the Fox–Fordyce disease. Sudden appearance of raised bumps (papules) near the apocrine glands is characteristic of the disease. Papules are mostly skin colored, dome shaped, and itchy. Papules can be found at the sweat glands in addition to periareolar, inframammary and pubic areas. Hair follicles can become damaged as well and can result in hair loss in the affected area.


Causes

Exact cause of Fox-Fordyce is currently unknown. Studies have not been able to confirm if apocrine gland duct obstruction is required for development. It is speculated that gland duct rupture causes inflammation. Inflammatory response includes white blood cells.


Diagnosis

Clinical evaluation along with identification of typical symptoms such as the eruption of papules on the apocrine glands along with a patient history report is used to diagnose the disease. Surgical removal along with a microscopic evaluation by a dermatopathologist is the most reliable form of diagnosis.


Treatment

With only a small number of case reports, treatment can be difficult and focuses primarily on axillary disease and specific symptoms. First line treatment includes topical and intralesional glucocorticoids. Specific therapies include estrogen hormones and steroid creams. Use of tretinoin reduced pruritic and axillary papules in one study. However, irritation limited drug use to short term only. Clindamycin mixed with pimecrolimus cream and benzoyl peroxide was also effective. Clindamycin is used to inhibit bacterial growth and is used when treating staphylococcal and streptococcal infections.


Epidemiology

It most commonly affects women aged 13–35 years, approximately puberty through their prime. Some reports show affected women to men at 9:1. Rare cases have been shown to affect post-menopausal women, children, and men. Incident report is currently unknown. Although rare, men and children have been shown to be affected. Heat, humidity, stress, and exercise have been shown to worsen symptoms. Rate of incidence is currently unknown. Fox-Fordyce has also been shown to be severe during menstruation and spontaneously disappear during pregnancy.


Eponym

It is named for George Henry Fox and
John Addison Fordyce John Addison Fordyce (born 16 February 1858 in Guernsey County, Ohio, died on 4 June 1925 in New York City) was an American dermatologist, whose name is associated with Fordyce's spot (also known as Fordyce's disease or Fordyce's lesion), Angioke ...
.


See also

*
List of cutaneous conditions Many skin conditions affect the human integumentary system—the organ system covering the entire surface of the body and composed of skin, hair, nails, and related muscle and glands. The major function of this system is as a barrier against t ...


References


Further reading

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External links

{{DEFAULTSORT:Fox-Fordyce disease Conditions of the skin appendages