| fox-fordyce disease (FFD) is an uncommon chronic follicular based dermatosis with distinctive clinical characteristics consisting of pruritic papules confined to apocrine gland-bearing skin. Histologic confirmation of this entity is often time-consuming and difficult with conventional histologic sectioning. We describe a case of FFD occurring in a 26-year-old woman, in which we used transverse histologic sectioning to easily demonstrate the histopathologic features of this condition. With conventional sectioning of a punch biopsy specimen of an affected area, more than 23 serial sections were required to locate a follicle with pathognomonic features of the disease. In contrast, only one transverse section of a biopsy specimen was required to confirm the diagnosis. We propose that transverse histologic sectioning of biopsy specimens of patients suspected of having FFD more effectively demonstrates the diagnostic features. ( info) |
2/9. Fordyce nodules in a buccal membrane graft to the ocular surface. PURPOSE: To present a case of epibulbar Fordyce nodules, with a referral diagnosis of primary tumor. methods: Case report. RESULTS: A 38-year-old woman was referred for ocular oncology consultation because of a conjunctival lesion in the right eye. She had had a buccal mucous graft to treat recurrent pterygium 18 years earlier. The lesion consisted of multiple small, yellow granules over a pink, thickened mucosa from the 12 to 3 o'clock meridians. Excisional biopsy revealed multiple subepithelial sebaceous glands consistent with Fordyce nodules. CONCLUSIONS: Fordyce nodules are a possible late benign complication of buccal mucous grafts. ( info) |
3/9. Apoeccrine sweat duct obstruction as a cause for fox-fordyce disease. The pathogenesis of fox-fordyce disease has been reported to be hyperkeratosis and obstruction of the upper hair follicle, where the duct of the apocrine sweat gland opens. We report a case of fox-fordyce disease with full clinical manifestation. It appeared to be caused by the obstruction of intraepidermal apoeccrine sweat ducts by apoeccrine secretory cells detached and released from the secretory epithelium. A 24-year-old woman visited our clinic with intensely pruritic papules on axillae, mammary areolae, and pubic areas. Histopathologic examination revealed an obstruction of the sweat duct in the epidermis, which opened directly to the skin surface. The closing substance of the duct was an aggregate of epithelial cells, probably derived from the secretory portion. In the dermis, the secretory cells of apocrinelike sweat glands had been detaching from the secretory epithelia. These findings suggest that fox-fordyce disease can occur by the mechanism in which apoeccrine secretory cells obstruct sweat ducts. ( info) |
| We report a 66-year-old woman with a 3-year history of intensely pruritic follicular papules in the axillar, pubic and inguinal areas. Previous treatment with topical fusidic acid and gentamicin sulfate was ineffective. The clinical and histological examination was consistent with fox-fordyce disease. Application of clindamycin in an alcoholic propylene glycol solution led to the clearing of the lesions within 1 month. Nine months later, the treatment was stopped, and no recurrence was observed. ( info) |
| A 40-year-old woman presented with a 2-year history of intermittently pruritic pale yellow follicular papules localized to both axillae associated with decreased axillary hair growth and sweating. skin biopsies revealed an expanded perifollicular adventitial sheath packed with xanthoma cells. There was scant lymphocytic inflammation around the follicles. Vacuolated keratinocytes were present within the infundibular region of the follicles. serum lipid levels and serum protein electrophoresis were both normal. The features in our case overlap those described recently as a xanthomatous variant of fox-fordyce disease. However, in our patient the pruritus was not intense, the lesions were confined to the axillae, and the histopathological features of fox-fordyce disease were not confirmed. We prefer to classify our case as an axillary perifollicular xanthomatosis. It is possible that axillary perifollicular xanthomatosis is the follicular counterpart of the epidermal-based verruciform xanthomas, as both are normolipaemic and are limited to the adventitial tissue close to keratinocytes that may be the source of lipid. The finding of vacuolated keratinocytes in the infundibular region in our case may support this mechanism. ( info) |
6/9. Ectopic epibulbar Fordyce nodules in a buccal mucous membrane graft. A 70-year-old man underwent oral mucous membrane grafts to the right eye for presumed trachoma at the ages 26 and 32 years. A superior limbic mass within the site of the graft was found in 1983; the mass was composed of mature sebaceous glands compatible with the lesions called Fordyce nodules when located in the buccal mucosa. Recession of the levator aponeurosis and partial excision of the mass restored the upper eyelid's normal position, and visual acuity in this eye improved from 20/300 to 20/40. ( info) |
7/9. Angiokeratomas in Fabry's disease and Fordyce's disease: successful treatment with copper vapour laser. Two patients with multiple angiokeratomas on genitalia and thighs, one with Fabry's disease and one with Fordyce's disease, were treated with copper vapour laser light of 578 nm wavelength. The result was desirable, with destruction and disappearance of the lesions and minimal scarring and posttreatment hyper- or hypopigmentation. ( info) |
8/9. fox-fordyce disease in a male patient--response to oral retinoid treatment. fox-fordyce disease (apocrine milaria) is predominantly observed in women. A male patient with typical features of this disorder is described. Oral treatment with isotretinoin resulted in temporary relief. ( info) |
9/9. fox-fordyce disease in two prepubertal girls: histopathologic demonstration of eccrine sweat gland involvement. This report presents two prepubertal girls with fox-fordyce disease. The pruritic papules extensively affected the areas where apocrine glands are distributed (axillae, periareolar and intermammary zones, pubes, infraumbilical midline), and also extended to the neck and face near the external angle of the eyes in one child. Analyses of several biopsy specimens showed that the main lesion was a spongiotic vesicle containing inflammatory cells and keratinocytes affecting the hair infundibula and acrosyringia, together, with hyperkeratosis of both adnexa. The cause of the disease remains elusive, but the microscopic findings may explain the good results obtained with keratolytic agents. ( info) |