Dermoscopic,skin confocal laser scanning microscopic and histopathological features of Fox-Fordyce disease:A report of three cases
Objective To investigate the dermoscopic,skin confocal laser scanning micro-scopic(CLSM)and histopathological features of Fox-Fordyce disease and to deepen the under-standing of this disease.Methods Clinical,dermoscopic,skin CLSM and histopathological data of 3 patients with FFD were retrospectively analysed.Results All 3 patients were females,with mean age of 37 years and mean disease duration of 8.3 years(2 years to 20 years).Skin lesions were isolated firm pruritic follicular papules,sized 1～4 mm in diameter,in skin color,brown or yellowish,accompanied by hair thinning,on the large sweat gland-rich sites,including armpits in 2 cases,and both armpits and periumbilical area in one case.Dermoscopic features included flesh-to light brown-colored follicle-centered amorphous area with loss of dermatoglyphics and some hyperkeratotic plugs.Skin CLSM showed hyperkeratosis,parakeratosis,irregular thickening of the epidermis,dilated follicular orifices,follicular plugs,intercellular spongiotic edema in the follicu-lar infundibulum,and scattered perivascular infiltration of inflammatory cells in the dermis.His-topathological changes included irregular thickening of the epidermis,mild hyperkeratosis and par-akeratosis,follicular plugs,intercellular edema in the follicular infundibulum,infiltration of in-flammatory cells and foam cells around the follicular infundibulum,mild dilatation of the sweat ducts,and sweat retention.All patients did not respond well to oral antihistamines,topical retino-ic acid cream,and topical medium-strength glucocorticoid cream.Conclusions FFD is rare.Al-though a diagnosis can be made based on the special involved sites and characteristics of skin le-sions in combination with dermoscopic,skin CLSM,and histopathological features,the treatment is still a challenge.
Fox-Fordyce diseasedermoscopic featuresskin CLSM featureshistopatho-logical features
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