Print version ISSN 0365-0596
An. Bras. Dermatol. vol.87 no.2 Rio de Janeiro Mar./Apr. 2012
IMAGING IN TROPICAL DERMATOLOGY
Trichobacteriosis: case report and dermoscopic study*
Tricobacteriose: relato de caso e estudo dermatoscópico
Marcelo Massaki GuiotokuI; Paulo Müller RamosI; Hélio Amante MiotII; Silvio Alencar MarquesIII
IMD, Dermatologist - Faculdade de Medicina de Botucatu - Universidade Estadual Paulista "Julio de Mesquita Filho" (UNESP) - Botucatu (SP), Brazil
IIPhD, Assistant Professor - Faculdade de Medicina de Botucatu - Universidade Estadual Paulista "Julio de Mesquita Filho" (UNESP) - Botucatu (SP), Brazil
IIIPhD, Associate Professor - Faculdade de Medicina de Botucatu - Universidade Estadual Paulista "Julio de Mesquita Filho" (UNESP) - Botucatu (SP), Brazil
The authors report a case of axillary trichobacteriosis in a 16 year-old patient whose complaints were bromhidrosis and hyperhidrosis axillaris. Although it can be diagnosed clinically, dermoscopy may be useful in some cases and reveal remarkable academic images.
Keywords: Corynebacterium; Dermoscopy; Hyperhidrosis
Relata-se um caso de tricobacteriose axilar em paciente de 16 anos de idade cujas queixas eram de bromidrose e hiperidrose axilar. Embora a tricobacteriose possa ser diagnosticada clinicamente, a dermatoscopia pode ser útil em alguns casos e revelar imagens de extremo valor acadêmico.
Palavras-chave: Corynebacterium; Dermoscopia; Hiperidrose
A 16 year-old male was admitted to the outpatient department reporting excessive sweating in his axillae and unpleasant odor for one year. On physical examination, it was noticed that his axillary hair was surrounded by soft, waxy and yellowish concretions (Figure 1). Dermoscopy images were taken to get close-up details and to improve the diagnosis (Figures 2 and 3). Examination of some hair shafts at optical microscopy by adding 10% KOH solution supported the diagnosis of trichobacteriosis. The patient was treated by shaving the axillae and using topical erythromycin 2%. Chlorhexidine was prescribed to prevent relapses.
Trichobacteriosis, trichomycosis axillaris or trichomycosis palmellina belongs to the group of cutaneous corynebacteriosis as well as erythrasma and pitted keratolysis. 1 It is mostly caused by Coryne bacterium tenuis and is clinically characterized by yellowish, reddish or blackish sticky concretions surrounding the hair shaft of the axillary or pubic region. 1-5 Hyperhidrosis and improper hygiene are the main predisposing factors. Despite its symptomless condition, treatment may be based on cleansing methods. Sometimes topical antibiotics (erythromycin 2% or clyndamicin 1%) or benzoyl peroxide may be required. The differential diagnosis includes white piedra, black piedra and hair casts. 1-5
With the advent of the marketing of polarized dermatoscopes, dermoscopy has increased in popularity among dermatologists worldwide and dermoscopic features of a huge range of dermatoses have been described. 6-8
Although there is not much challenge in diagnosing trichobacteriosis, we believe that dermoscopy would be a time-saving and helpful tool in doubtful cases.
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Marcelo Massaki Guiotoku
Departamento de Dermatologia, s/n Faculdade de Medicina de Botucatu - UNESP
Campus Universitário de Rubião Jr
18618-970 Botucatu, SP
E-mail address: firstname.lastname@example.org
Received on 26.04.2011.
Approved by the Advisory Board and accepted for publication on 08.06.2011.
Conflict of interest: None
Financial funding: None
* Work conducted at the Departament of Dermatology - Faculdade de Medicina de Botucatu - Universidade Estadual Paulista "Julio de Mesquita Filho" (UNESP) - Botucatu (SP), Brazil.