About fox fordyce disease

What is fox fordyce disease?

Fox-Fordyce disease is a rare skin disorder that primarily affects women. The disorder is characterized by intense itching especially in the underarm area, the pubic area and around the nipples. In Fox-Fordyce disease abnormalities affecting the apocrine sweat glands causes inflammation, and enlargement of the glands and the characteristic intense itching. Skin near an affected area may become darkened and dry and multiple, small, raised bumps (papules) may develop. Hair follicles in the affected area can become secondarily damaged, resulting in hair loss. The exact cause of Fox-Fordyce disease is unknown.

What are the symptoms for fox fordyce disease?

Underarm itching symptom was found in the fox fordyce disease condition

The symptoms of Fox-Fordyce disease may appear suddenly usually following conditions of heat, humidity or friction. The disease is characterized by an eruption of multiple, small, raised Bumps on the skin near the apocrine glands.

The apocrine glands are specialized sweat glands that play a pheromonic role in animals; a similar role has been postulated in humans. Pheromones are chemicals secreted by animals that influence social or sexual behavior of other animals of that species. Apocrine glands respond to sex and stress stimuli. Apocrine glands become extremely active during puberty. Most apocrine glands are found in the armpits or the groin. They may also be found by the nipples, external ear canal, eyelids, and around the bellybutton.

The Papules are usually skin-colored, but may be yellowish or reddish in color. They are usually dome-shaped and smooth. Affected areas usually have many small papules. Papules are most often found in the armpits (axillae). The affected areas are often extremely Itchy (pruritus) and Sweating in these areas may also be absent (anhidrosis). Itching may be mild or may be severe enough to disturb sleep. Hairs within follicles in the affected area may fall out.

What are the causes for fox fordyce disease?

The exact cause of Fox-Fordyce disease is unknown. Researchers have speculated that obstruction of the apocrine gland ducts is necessary for the development of Fox-Fordyce disease, but studies have not been able to definitely confirm this theory. Researchers speculate that blocked ducts rupture causing inflammation where the duct comes close to the hair follicle. The inflammatory reaction around hair follicles includes specialized leukocytes (white blood cells) that engulf extruded secretory debris.

Researchers have also speculated that additional factors such as hormonal or genetic ones may play a role in the development of Fox-Fordyce disease. However, research into the cause(s) of Fox-Fordyce disease has not yielded any definitive answers as yet. More research is necessary to determine the exact cause of Fox-Fordyce disease.

What are the treatments for fox fordyce disease?

The treatment of Fox-Fordyce disease is directed toward the specific symptoms that are apparent in each individual. Consultation with a dermatologist is recommended. Specific therapies that have been used include estrogen hormones, oral retinoids, steroid creams, and topical antibiotics. No therapy is universally effective in all patients.

Estrogen hormones, usually given as part of estrogen-based oral contraceptives, have been most effective in treating women with Fox-Fordyce disease. Less effective therapies include oral retinoids (such as tretinoin), corticosteroid creams and topical antibiotics (such as clindamycin) have been beneficial in some cases while ineffective in others. Some of these therapies may be associated with irritation, limiting their ability to be used a long-term therapy.

Some women with Fox-Fordyce disease see a significant improvement or resolution of the disease during pregnancy.

What are the risk factors for fox fordyce disease?

Fox-Fordyce disease occurs primarily in women between 13 and 35 years of age. However, in rare cases, it can affect men and children and women who are post-menopausal. Some reports place the ration of affected women to men at 9:1. The incidence of Fox-Fordyce disease is unknown. Heat, humidity, stress and exercise have been noted as exacerbating factors. In addition, Fox-Fordyce disease may be more severe during menstruation and tends to disappear (spontaneously resolve) during pregnancy. Fox-Fordyce disease was first described in the medical literature in 1902.

Is there a cure/medications for fox fordyce disease?

A skin condition that occurs in sweat-producing areas is known as Fox Fordyce Disease. It is a rare condition that mainly occurs in women between the age of 13 to 35 years. Areas affected by the disease have itchy bumps produced around the hair follicles of the underarm, nipples, and other pubic regions.

The ratio of women to men with the disease is more due to sweat accumulation and bacterial production. It is due to many factors like skin absorbing all the sweat directly without hair protection and resulting in bacterial production.

Identification of the cause and symptoms of the disease is based in the following ways:

  • Eruptions on Apocrine gland areas (Pubic and Underarms)
  • Detailed Patient History
  • Biopsy (microscopic evaluation of surgically removed tissue)

Diagnosis results in the following findings:

  • Spongiosis
  • Corneal plug
  • Vesicles
  • Dilations
  • Mucin Deposits

Showing the symptoms and diagnosis to dermatologists can help in moving towards the right direction of curing the disease. They will suggest the following options to stop the disease from reoccurrence.

  • Oral Antibiotics
  • Medications for Clindamycin Solution
  • Topical Steroids or Retinoids
  • Antiandrogenic Hormonal Therapy

The first therapies include the above methods with Benzol peroxide and contraceptives to control the rashes from spreading.

  • Ultraviolet Radiation Therapy
  • Electrocoagulation
  • Copper Vapor
  • CO2 Laser
  • Liposuction
  • Curettage
  • Surgical Excision
  • Botulinum toxin
  • Microwave

Above are the second-line methods to be applied in severe cases of fox Fordyce disease.

Itchy Bumps around Underarms,Pubic Area and Around the Nipples,Disturbs Sleep,Dark Skin,Thick Skin,Absent sweating in affected areas
Small Reddish Papules due to Heat,Humidity,Friction,Stress,Dry Skin,Scratchy Skin
Topical Retinoids,Steroids,Oral Antibiotics,Clindamycin Solution,Calcineurin Inhibitors,Oral Contraceptives

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