- Jami L Miller, MD
Jami L Miller, MD
- Assistant Professor of Medicine
- Vanderbilt University
Sweat-related body odor manifests in essentially all individuals at some point during life. Excessively foul-smelling sweat is considered pathologic and termed bromhidrosis, a term derived from the Greek "bromos" (stench) and "hidros" (sweat). Synonyms of bromhidrosis include "bromidrosis," "osmidrosis," and "ozochrotia."
The degree of odor considered "excessive" and sufficient for a diagnosis of bromhidrosis is not definitive. Bromhidrosis is generally diagnosed when noticeable body odor has a negative effect on an individual's self-view, social interactions, or quality of life.
Bromhidrosis is divided into apocrine bromhidrosis and eccrine bromhidrosis. The most common site for apocrine bromhidrosis is the axilla. Eccrine bromhidrosis most often affects the feet.
The clinical features, diagnosis, and management of bromhidrosis will be reviewed here. Hyperhidrosis (excessive sweating) is reviewed separately. (See "Primary focal hyperhidrosis".)
Bromhidrosis is subdivided into apocrine and eccrine variants based upon the type of sweat gland involved. Apocrine glands develop after puberty and are most densely distributed in the axillae, anogenital areas, and breasts. The primary role of apocrine glands appears to be the secretion of pheromones. Eccrine glands are widely distributed all over the body, with the exception of the external auditory canal, lips, clitoris, labia minora, and glans penis. Eccrine glands are primarily responsible for thermoregulation.
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- Apocrine bromhidrosis
- Eccrine bromhidrosis
- CLINICAL PRESENTATION
- ASSOCIATED DISORDERS
- History and physical examination
- Laboratory testing
- DIFFERENTIAL DIAGNOSIS
- Localized bromhidrosis
- - General approach
- - Refractory localized bromhidrosis
- Generalized bromhidrosis
- SUMMARY AND RECOMMENDATIONS