Fox-Fordyce Disease Following Axillary Laser Hair Removal

Abstract

Background: Fox-Fordyce disease (FFD) is a relatively rare entity with a typical clinical presentation. Numerous studies have described unifying histopathological features of FFD, which together suggest a defect in the follicular infundibulum resulting in follicular dilation with keratin plugging, subsequent apocrine duct obstruction, and apocrine gland dilation, with eventual extravasation of the apocrine secretions as the primary histopathogenic events in the evolution of the disease. Observations: We describe a case of FFD that developed in a 41-year-old woman 3 months after completing a series of axillary laser hair removal treatments, and we detail the clinical and histopathological changes typical for FFD. Conclusion: Because defective infundibular maturation has been suggested to play a central role in the evolution of FFD, the close temporal relationship of laser hair therapy with the development of FFD suggests a causal role, which we continue to explore.

Axillary Fox-Fordyce-like disease induced by laser hair removal therapy

“…A recent report indicated laser hair removal as a novel cause of FFD. 1 We report an unusual case of ''Fox-Fordyce-like'' disease with intensely pruritic papules on the axillae developing after laser hair removal therapy.…”

“…1,2 The pathophysiology is explained by infundibular plugging causing obstruction and subsequent dilatation of the apocrine duct, which may lead to formation of a retention vesicle, spewed secretions to adjacent tissue, or ductal rupture. 1,3,4 Intense pruritus is suggested to be the result of spewed sweat and accompanying inflammation. 3 Associated findings include hypohidrosis caused by follicular plugging and hypotrichosis.…”

“…2 Recently, a case of axillary FFD was reported developing 3 months after laser hair removal treatment of 14 months' duration. 1 The authors suggested that the laser therapy induced damage to follicular infundibulum, resulting in altered maturation of keratinocytes which led to keratin plugging causing the common pathologic features in FFD. 1 They concluded that this ''final common pathway'' was independent from the causative factor.…”

“…1 The authors suggested that the laser therapy induced damage to follicular infundibulum, resulting in altered maturation of keratinocytes which led to keratin plugging causing the common pathologic features in FFD. 1 They concluded that this ''final common pathway'' was independent from the causative factor. To our knowledge, our patient is the second reported case within the spectrum of FFD developing after laser hair removal therapy.…”

Fox–Fordyce Disease: An under‐diagnosed adverse event of laser hair removal?

“…Fox–Fordyce Disease (FFD) is a rare chronic inflammatory skin disease of the apocrine glands, mainly affecting post‐pubertal women . It involves apocrine gland‐bearing areas including the axilla, areola, anogenital area and umbilicus . It is characterized by multiple, skin‐coloured to yellowish, perifollicular, usually pruritic, uniform papular skin lesions with associated hypotrichosis and hyperkeratosis .…”