Fox-Fordyce Disease: Successful Treatment with Topical Clindamycin in Alcoholic Propylene Glycol Solution

Abstract

We report a 66-year-old woman with a 3-year history of intensely pruritic follicular papules in the axillar, pubic and inguinal areas. Previous treatment with topical fusidic acid and gentamicin sulfate was ineffective. The clinical and histological examination was consistent with Fox-Fordyce disease. Application of clindamycin in an alcoholic propylene glycol solution led to the clearing of the lesions within 1 month. Nine months later, the treatment was stopped, and no recurrence was observed.

Pimecrolimus is effective in Fox–Fordyce disease

“…The treatment of the disease has been unsatisfactory so far. Several methods, including topical, systemic, and intralesional corticosteroids, ultraviolet (UV) light, oral contraceptives, topical clindamycin, plastic surgery, topical tretinoin, isotretinoin, and topical 5% benzoylperoxide in combination with loratadine, have been used with varying success in this refractory disease 2,4–7 …”

Axillary Fox-Fordyce Disease Treated With Liposuction-Assisted Curettage

“…Numerous treatments have appeared in the literature, including hot quartz UV lamp, 3 oral isotretinoin, 4 topical tretinoin cream, 5,6 and topical clindamycin solution. 7,8 Our patient could not tolerate local irritation from topical tretinoin cream or clindamycin solution.…”

Fox-Fordyce Disease (Apocrine Miliaria)

“…14 Feldmann and Miller described two patients who had a complete response to topical clindamycin in an alcohol solution. 15,16 The efficacy of this approach may be due to the propylene glycol vehicle, a keratolytic agent, rather than to clindamycin itself. 15 More recently, Pock et al published a series of three patients all who had a significant response to pimecrolimus 1% cream (a topical calcineurin inhibitor).…”

“…15,16 The efficacy of this approach may be due to the propylene glycol vehicle, a keratolytic agent, rather than to clindamycin itself. 15 More recently, Pock et al published a series of three patients all who had a significant response to pimecrolimus 1% cream (a topical calcineurin inhibitor). 17 Oral antihistamines are often added as an adjunctive therapy to relieve pruritus.…”