Red facial pseudochromhidrosis

[Brown facial pseudochromhidrosis in a child: A bacterial disease?]

INTRODUCTION

Pseudochromhidrosis denotes the production of colourless sweat that acquires colour after coming into contact with exogenous factors such as dyes in clothing, chemicals or chromogenic microorganisms.

PATIENTS AND METHODS

A 9-year-old girl presented with progressive brown pigmentation predominantly on the nose, forehead, perioral region and cheeks. It was easily removable by rubbing with a moist compress, leaving normal-coloured skin as well as brown pigment on the compress. The same pigmentation recurred within 2h. The patient was not using cosmetics. Bacteriological culture of samples taken by rubbing the skin in affected areas on the face was positive for commensal bacteria of the skin (Actinomyces viscosus, Staphylococcus epidermidis, Cutibacterium acnes and Streptococcus sanguinis). Antibiotic therapy achieved total resolution of symptoms.

CONCLUSION

Bacteria constitute the most frequent aetiology of pseudochromhidrosis. Where such a cutaneous condition exists, even in the absence of positive bacteriological testing, antibiotic therapy would seem to be indicated as a therapeutic test. Biopsy does not appear to be essential as a first-line approach where a bacterial cause is suspected, but it may be proposed in the event of resistance to antibiotics.

Yellow pseudochromhidrosis in a young female

Chromhidrosis is a rare disorder in which there is pigmentation of sweat in a variety of colors. It can be classified into apocrine, pseudoeccrine, and true eccrine chromhidrosis. Pseudochromhidrosis is a condition in which the excreted sweat is colorless, but later acquires color due to contact with chromogenic chemicals. Systemic and topical antibiotics are the mainstay of treatment. Although it does not constitute a major health issue, it causes psychological stress and social embarrassment. A 20-year-old female presented to us with yellow-colored sweat and discoloration of clothes since 1 month. Routine laboratory investigations were normal. Skin scrapings were negative for fungus and bacteria. Skin biopsy was also normal. She was labelled as a case of pseudochromhidrosis, and oral and topical antibiotics were prescribed, to which she responded well.

Isolated areolar apocrine chromhidrosis

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.