Facial and axillary apocrine chromhidrosis

Dermatol Online J. 2012 Mar 15;18(3):13.


Apocrine chromhidrosis is a rare, chronic, idiopathic disorder, characterized by the excretion of pigmented sweat. A 26-year-old woman presented with a 3-year history of dark blue secretions on bilateral malar cheeks. On examination, upon pressure on the cheeks, a dark blue fluid was expressed, which appeared to arise primarily from the follicle. The patient had not appreciated it, but on examination of her axillae, a very subtle blue coloring was observed. Histopathologic examination revealed apocrine glands in the deep reticular dermis. Bluish cytoplasmic granules were observed in the apocrine epithelium lining, which correspond to lipofuscin granules. The diagnosis of apocrine cromhidrosis was made. We began treatment with 20 percent aluminum chloride hexahydrate solution and capsaicin cream with poor tolerance. Finally, we treated with botulinum toxin type A with a successful response. We report a case of facial and axillary apocrine cromhidrosis with good response to botulinum toxin type A.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Aluminum Chloride
  • Aluminum Compounds / therapeutic use
  • Apocrine Glands / pathology*
  • Botulinum Toxins, Type A / therapeutic use
  • Capsaicin / therapeutic use
  • Cheek / pathology
  • Chlorides / therapeutic use
  • Dermatologic Agents / therapeutic use
  • Female
  • Humans
  • Lipofuscin / analysis
  • Pigmentation Disorders / diagnosis*
  • Pigmentation Disorders / drug therapy
  • Pigmentation Disorders / pathology
  • Sweat / drug effects
  • Sweat Gland Diseases / diagnosis*
  • Sweat Gland Diseases / drug therapy
  • Sweat Gland Diseases / pathology
  • Treatment Outcome


  • Aluminum Compounds
  • Chlorides
  • Dermatologic Agents
  • Lipofuscin
  • Aluminum Chloride
  • Botulinum Toxins, Type A
  • Capsaicin