Larquey M, Micaëlo M, Courdavault L, Longuet P, Mahé E
Service de dermatologie, hôpital Victor-Dupouy, 69, rue du Lieutenant-Colonel Prudhon, 95100 Argenteuil, France.
Service de microbiologie, hôpital Victor-Dupouy, 69, rue du Lieutenant-Colonel Prudhon, 95100 Argenteuil, France.
Ann Dermatol Venereol. 2020 Oct;147(10):648-652. doi: 10.1016/j.annder.2020.04.011. Epub 2020 Jun 1.
Pseudochromhidrosis denotes the production of colourless sweat that acquires colour after coming into contact with exogenous factors such as dyes in clothing, chemicals or chromogenic microorganisms.
A 9-year-old girl presented with progressive brown pigmentation predominantly on the nose, forehead, perioral region and cheeks. It was easily removable by rubbing with a moist compress, leaving normal-coloured skin as well as brown pigment on the compress. The same pigmentation recurred within 2h. The patient was not using cosmetics. Bacteriological culture of samples taken by rubbing the skin in affected areas on the face was positive for commensal bacteria of the skin (Actinomyces viscosus, Staphylococcus epidermidis, Cutibacterium acnes and Streptococcus sanguinis). Antibiotic therapy achieved total resolution of symptoms.
Bacteria constitute the most frequent aetiology of pseudochromhidrosis. Where such a cutaneous condition exists, even in the absence of positive bacteriological testing, antibiotic therapy would seem to be indicated as a therapeutic test. Biopsy does not appear to be essential as a first-line approach where a bacterial cause is suspected, but it may be proposed in the event of resistance to antibiotics.
假性色汗症是指无色汗液在接触外源性因素(如衣物中的染料、化学物质或产色微生物)后变色。
一名9岁女孩主要在鼻、额、口周区域及脸颊出现进行性棕色色素沉着。用湿敷料擦拭后很容易去除,皮肤恢复正常颜色,而敷料上留下棕色色素。相同的色素沉着在2小时内复发。患者未使用化妆品。对面部受累区域皮肤进行擦拭取样的细菌培养显示,皮肤共生菌(粘性放线菌、表皮葡萄球菌、痤疮丙酸杆菌和血链球菌)呈阳性。抗生素治疗使症状完全缓解。
细菌是假性色汗症最常见的病因。对于存在这种皮肤状况的患者,即使细菌学检测为阴性,抗生素治疗似乎也可作为一种治疗性试验。在怀疑由细菌引起的情况下,活检似乎并非一线必要检查方法,但如果对抗生素耐药,则可考虑进行活检。