- Jami L Miller, MD
Jami L Miller, MD
- Assistant Professor of Medicine
- Vanderbilt University
In the normal state, sweat is colorless. The term "chromhidrosis," derived from the Greek "chroma" (colored) and "hidros" (sweat), describes the occurrence of colored sweat.
True chromhidrosis is a rare condition characterized by the secretion of colored sweat from apocrine or eccrine sweat glands. In pseudochromhidrosis, a more common disorder, sweat becomes colored after secretion from the sweat gland. Pseudochromhidrosis results from contact between sweat and dyes, chemicals, or chromogenic bacteria on the skin.
The clinical features, diagnosis, and management of chromhidrosis and pseudochromhidrosis will be reviewed here. Other sweat disorders, including hyperhidrosis (excessive sweat) and bromhidrosis (malodorous sweat), are reviewed separately. (See "Primary focal hyperhidrosis" and "Bromhidrosis".)
In chromhidrosis, sweat glands secrete colored sweat onto the surface of the skin.
Etiology — Chromhidrosis may involve apocrine glands or eccrine glands. Apocrine glands develop after puberty and are most densely distributed in the axillae, anogenital areas, and areolae. Eccrine glands are primarily responsible for thermoregulation and are widely distributed over the body, with the highest concentration on the palms and soles. Apoeccrine glands are an intermediate type of sweat gland that exhibit features of both apocrine and eccrine glands. Whether apoeccrine glands are involved in chromhidrosis is unclear.
- Barankin B, Alanen K, Ting PT, Sapijaszko MJ. Bilateral facial apocrine chromhidrosis. J Drugs Dermatol 2004; 3:184.
- Griffith JR. Isolated areolar apocrine chromhidrosis. Pediatrics 2005; 115:e239.
- Cawley EP, Hsu YT, Sturgill BC, Harman LE Jr. Lipofuscin ("wear and tear pigment") in human sweat glands. J Invest Dermatol 1973; 61:105.
- Krishnaram AS, Bharathi S, Krishnan S. An interesting case of bisacodyl (dulcolax)-induced chromhidrosis. Indian J Dermatol Venereol Leprol 2012; 78:756.
- Chang YC, Anderson N, Soeprono F. Bilateral facial pigmentation. Dermatol Online J 2007; 13:16.
- Kim Y, Suh HS, Cha HJ, et al. A case of generalized argyria after ingestion of colloidal silver solution. Am J Ind Med 2009; 52:246.
- HURLEY HJ, WITKOWSKI J. Dye clearance and eccrine sweat secretion in human skin. J Invest Dermatol 1961; 36:259.
- So JK, Romero L. Eccrine chromhidrosis secondary to hyperbilirubinemia. Dermatol Online J 2014; 21.
- Park JG, Prose NS, Garza R. Eccrine Chromhidrosis in an Adolescent with Sickle Cell Disease. Pediatr Dermatol 2017.
- Yöntem A, Kör D, Hızlı-Karabacak B, et al. Blue-colored sweating: four infants with apocrine chromhidrosis. Turk J Pediatr 2015; 57:290.
- Semkova K, Gergovska M, Kazandjieva J, Tsankov N. Hyperhidrosis, bromhidrosis, and chromhidrosis: Fold (intertriginous) dermatoses. Clin Dermatol 2015; 33:483.
- Yoshida R, Kobayashi S, Amagai M, Tanaka M. Brown palm pseudochromhidrosis. Contact Dermatitis 2002; 46:237.
- Thami GP, Kanwar AJ. Red facial pseudochromhidrosis. Br J Dermatol 2000; 142:1219.
- Tempark T, Wittayakornrerk S, Jirasukprasert L, et al. Pseudochromhidrosis: report and review of literature. Int J Dermatol 2017; 56:496.
- Manonukul J, Wisuthsarewong W, Chantorn R, et al. Hematidrosis: a pathologic process or stigmata. A case report with comprehensive histopathologic and immunoperoxidase studies. Am J Dermatopathol 2008; 30:135.
- Marks JG Jr. Treatment of apocrine chromhidrosis with topical capsaicin. J Am Acad Dermatol 1989; 21:418.
- Gandhi V, Vij A, Bhattacharya SN. Apocrine chromhidrosis localized to the areola in an Indian female treated with topical capsaicin. Indian J Dermatol Venereol Leprol 2006; 72:382.
- Beer K, Oakley H. Axillary chromhidrosis: report of a case, review of the literature and treatment considerations. J Cosmet Dermatol 2010; 9:318.
- Pérez Tato B, Zamora Martínez E, Sánchez Albisua B, et al. Facial and axillary apocrine chromhidrosis. Dermatol Online J 2012; 18:13.
- Wu JM, Mamelak AJ, Nussbaum R, McElgunn PS. Botulinum toxin a in the treatment of chromhidrosis. Dermatol Surg 2005; 31:963.