Fox-Fordyce disease: response to adapalene 0.1%

Abstract

Abstract:The Fox-Fordyce disease is a rare inflammatory dermatosis that affects mainly young women and is characterized by multiple follicular papules, skin color or brownish, very itchy, localized in areas rich in apocrine glands. Histopathology shows focal spongiosis of the upper infundibulum with fibrosis and perifollicular lymphohistiocytic infiltrate. The diagnosis is based on clinical and histopathological examination. Many treatment options have been described; however none of them is excellent. We chose the topic adapalene 0.1% and a satisfactory improvement of the signs and symptoms of the disease was observed. Keywords: Apocrine glands; Fox-Fordyce disease; Retinoids; Treatment outcome Resumo: A doença de Fox-Fordyce é uma dermatose inflamatória rara que afeta predominantemente mulheres jovens e caracteriza-se por múltiplas pápulas foliculares cor da pele ou acastanhadas, muito pruriginosas, localizadas nas áreas ricas em glândulas apócrinas. A histopatologia demonstra espongiose focal da porção superior do infundíbulo, com fibrose perifolicular e infiltrado linfohistiocítico. O diagnóstico é baseado na clínica e no exame histopatológico. Muitas opções de tratamento já foram descritas, porém nenhuma delas é excelente. Optamos pelo adapaleno 0,1% tópico e foi observada melhora satisfatória dos sinais e sintomas da doença. Palavras-chave: Doença de Fox-Fordyce; Glândulas apócrinas; Resultado de tratamento; Retinóides Fox-Fordyce disease, also known as apocrine miliria, is a rare inflammatory dermatosis, characterized by multiple follicular papules, skin color or brownish, located in areas rich in apocrine glands, like armpits, periareolar areas, and pubic area, accompanied by itch.

Recent Advances Regarding the Therapeutic Potential of Adapalene

“…Fox–Fordyce disease is an inflammatory dermatosis characterized by follicular papules, brownish skin color and is localized most often at armpits. An improvement in manifestations of Fox–Fordyce disease has been recorded when 0.1% ADP gel was topical applied [ 74 ]. The role of ADP was also shown in the treatment of pityriasis versicolor, a fungal infection of the stratum corneum [ 85 , 86 ].…”

Clinical Effects of Topical Tacrolimus on Fox-Fordyce Disease

“…Oral contraceptives and oral isotretinoin treatment are also tried in the treatment. Phototherapy, electrocauterisation, excision-liposuction and curettage, and fractional carbon dioxide laser are also among the treatment options [ 8 – 11 ].…”

Fox-Fordyce Disease

“…The underlying aetiology of FF remains unclear, although a history of trauma caused by laser hair removal or hormonal factors may be triggers. [1][2][3][4] The pathophysiology consists of the obstruction of the apocrine gland duct due to the insertion of a keratin plug in the hair follicle wall. This causes secretion retention with consequent rupture of the glandular structure and secondary inflammation of the dermis.…”

“…3,4 The diagnosis of FF disease is based on characteristic clinical features, as well as non-specific histopathological features. [1][2][3][4][5] The histopathological…”