Clinical Effects of Topical Tacrolimus on Fox-Fordyce Disease

Abstract

Fox-Fordyce Disease (FFD) is a rare, chronic, pruritic, inflammatory disorder of apocrine glands. It is characterized by dome-shaped, firm, discrete, skin-colored, and monomorphic perifollicular papules. The most common sites of involvement are axillae and anogenital and periareolar regions which are rich in apocrine sweat glands. Treatment is difficult. Topical, intralesional steroids, topical tretinoin, adapalene, clindamycin, benzoyl peroxide, oral contraceptives, isotretinoin, phototherapy, electrocauterisation, excision-liposuction and curettage, and fractional carbon dioxide laser are among the treatment options. In the literature, there are articles reporting beneficial effects of pimecrolimus in FFD. Nevertheless, there have not been any reports about the use of tacrolimus in FFD. We report two patients diagnosed with FFD by clinical and histopathologic examination and discussed therapeutic effects of topical tacrolimus on FFD in the light of literature.

Treatment of pruritus with botulinum toxin in a pediatric patient with Fox‐Fordyce disease

“…First-line treatments include topical corticosteroids, and case reports have described success with topical calcineurin inhibitors, tretinoin, clindamycin, oral contraceptives, pulse dye laser, surgical excision, and phototherapy. [1][2][3] A case report of refractory FFD in an adult patient showed successful treatment with BTX-A injections, with sustained resolution of pruritus. 4 However, there is no literature on the applicability of this treatment to the pediatric population.…”

Axillary Fox-Fordyce Disease Induced By Laser Hair Removal

“…It is characterized by numerous pruritic skin-coloured, domeshaped, follicular papules localized on gland-bearing areas (axillae, areola, umbilicus and ano-genital area). Histopathological features include dilation of the follicular infundibulum with plugging, dyskeratosis of the infundibular epithelium and follicular hyperkeratosis; there is an associated periductal lymphohistiocytic in- noids and clindamycin [7]; they usually act on symptom with no significant efficacy on skin lesions. New procedural therapies, such as plastical surgery, fractionated microneedle radiofrequency, fractional carbon dioxide laser, pulsed dye laser [8], may be proposed to remove the cutaneous lesions, but there is lack of evidence regarding their usefulness.…”

Effective treatment of Fox–Fordyce disease with pulsed dye laser

“…Fox–Fordyce disease is usually difficult to treat. Several topical and systemic agents have been reported to be effective by mainly their anti‐inflammatory effects with variable outcomes, including topical steroids, calcineurin inhibitors, retinoids, phototherapy, and clindamycin . Oral contraceptives is another treatment option, but none of these therapeutics provide a long‐term effect recently.…”