Beer Gertrude M, Baumüller Stephan, Zech Nicolas, Wyss Pius, Strasser Doris, Varga Zsuzsanna, Seifert Burkhardt, Hafner Jürg, Mihic-Probst Daniela
Division for Plastic, Hand, and Reconstructive Surgery, Department of Surgery, Institute of Clinical Pathology, University Hospital Zurich, Zurich, Switzerland.
Plast Reconstr Surg. 2006 May;117(6):2043-9. doi: 10.1097/01.prs.0000210681.90799.b1.
The classic concept of axillary glands differentiates between eccrine glands, producing abundant clear, nonodorous sweat; and apocrine glands, excreting small amounts of turbid, odorous milky sweat. A third type of sweat glands, the "apoeccrine" glands, were recently identified. To define the different types of sweat glands and their location and number, the authors carried out a prospective histologic study on adult human axillary skin, including various immunohistochemical markers.
Forty-three consecutive Caucasian, subjectively normhidrotic patients, who underwent a surgical procedure in the axilla unrelated to the axillary glands, were included in the study. For verification of normhidrosis, the gravimetric test was carried out by measuring the amount of sweat secretion per minute. Then, a 1 x 1-cm measuring piece of skin and subcutaneous tissue was excised in the apex of the axilla, divided into three samples--altogether, 129 samples--and processed for histologic examination.
In the dermis, the authors found only very few eccrine (average, 0.3 gland/cm in only 12 percent of all patients) and apocrine glands (average, 0.1 gland/cm in only 4.7 percent of patients), and no apoeccrine glands in any patient. In the subcutaneous tissue, the mean number of glands per centimeter squared was 10 for the eccrine glands, nine for the apocrine glands, and six for the apoeccrine glands.
In the authors' Caucasian subjects, all or most of the sweat glands were found in the subcutaneous tissue near the border to the dermis and not in the dermis. For extremely hyperfunctioning sweat glands, the authors recommend less radical surgical methods, with the preservation of skin, based on the knowledge that most glands are localized in the subcutaneous tissue.
腋窝腺体的经典概念区分了两种腺体，即分泌大量清澈、无味汗液的外分泌腺，以及分泌少量浑浊、有气味的乳状汗液的顶泌汗腺。最近发现了第三种汗腺，即“顶浆分泌性外分泌腺”。为了明确不同类型汗腺的特征、位置及数量，作者对成人腋窝皮肤进行了一项前瞻性组织学研究，包括使用各种免疫组化标记物。
本研究纳入了43例连续的白种人患者，这些患者主观上出汗正常，且接受了与腋窝腺体无关的腋窝手术。为验证出汗正常，通过测量每分钟汗液分泌量进行重量测试。然后，在腋窝顶部切除一块1×1厘米的皮肤及皮下组织，分成三个样本，共129个样本，进行组织学检查。
在真皮层，作者仅发现极少数外分泌腺（平均每平方厘米0.3个腺体，仅占所有患者的12%）和顶泌汗腺（平均每平方厘米0.1个腺体，仅占患者的4.7%），所有患者均未发现顶浆分泌性外分泌腺。在皮下组织中，每平方厘米外分泌腺的平均数量为10个，顶泌汗腺为9个，顶浆分泌性外分泌腺为6个。
在作者研究的白种人受试者中，所有或大多数汗腺位于靠近真皮层边界的皮下组织，而非真皮层。鉴于大多数腺体位于皮下组织，对于汗腺功能极度亢进的患者，作者建议采用更保守的手术方法，保留皮肤。
