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Author: Dr Duncan Lyons, Resident Medical Officer, Gold Coast University Hospital, Gold Coast, Queensland, Australia. Medical Editor: Dr Helen Gordon, Auckland, New Zealand. DermNet Editor in Chief: Adjunct A/Prof Amanda Oakley, Dermatologist, Hamilton, New Zealand. Copy edited by Gus Mitchell. July 2020. Revised January 2021
Pseudochromhidrosis is the discolouration of normal colourless sweat by an exogenous agent on the skin surface.
Pseudochromhidrosis is rarely reported, affecting all age-groups, and may involve family members simultaneously.
In pseudochromhidrosis, the sweat can become discoloured by chromogenic bacteria and fungi including:
Examples of coloured chemicals or dyes on the skin surface causing pseudochromhidrosis include:
Pseudochromhidrosis can affect any body area, however face, neck and palms are the most commonly involved sites.
The colour of the sweat depends on the underlying chromogen or dye. The stain may be seen on the skin or clothing, and can be removed with a moistened wipe or alcohol swab.
Pseudochromhidrosis is usually asymptomatic but may cause embarrassment for the patient.
Pseudochromatosis is diagnosed by taking a thorough history and checking for any possible contact on the skin with chemicals, dyes, and coloured clothing. Check for possible risk factors for skin infection.
The diagnosis may be supported by:
Pseudochromhidrosis is easily treatable as it is due to an extrinsic cause.
Treatment is most commonly with antiseptic soap and/or antibiotics including topical clindamycin, topical and/or oral erythromycin for 1 to 2 weeks, even when culture-negative. Any predisposing cause for the infection, such as use of a topical steroid, should be ceased.
When an exogenous chemical or dye has been identified as the cause, avoidance quickly resolves the condition.
Pseudochromhidrosis resolves once the cause has been identified and removed or treated.
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