This is a rare dermatological disorder named infectious pseudochromhidrosis. P. aeruginosa may produce multiple water-soluble pigments, most commonly pyocyanin (blue) and pyoverdine (dim muddy yellow with a green fluorescence) causing the distinguishing blue-green hue (36, 64, 65, 87). Talk to a dermatologist about treatment if seborrheic keratosis affects your appearance. JAMA Dermatol 2013; 149: 13391340. Chromhidrosis is a rare chronic condition that causes sweat to have a color possibly black, blue, green, yellow, or brown. Chromhidrosis is a harmless skin condition, but because colored sweat can be a symptom of something more serious, it's important to check in with your doctor or dermatologist for an official diagnosis. Apocrine glands develop in areas with many hair follicles, such as on the scalp, armpits and groin. Table II. Sweating also occurs, especially on your palms, when you're nervous. The blue discolouration appeared 23 weeks after his wifes. Arcas J, Ferrer T, Roche MC, Martnez-Bermejo A, Lpez-Martn V. Hypohidrosis related to the administration of topiramate to children. Anyone who has chromhidrosis and experiences any emotional distress should let a healthcare provider know. Hyperhidrosis. information submitted for this request. Dermatol Monatschr 1972; 158: 18. Yamada-Ankei T, Iwasaki H, Mori T. Production of copper coproporphyrin III by Bacillus cereus. It's common and affects people of all ages, races, and genders. J Clin Microbiol 1994; 32: 164169. Veysseyre F, Fourcade C, Lavigne JP, Sotto A. Bacillus cereus infection: 57 case patients and a literature review. Those substances might include water-soluble dyes, heavy metals (like copper), excess food coloring or flavoring, as well as certain medications (rifampin, an antibiotic; quinines, an antimalarial; and levodopa, a dopamine precursor used to manage Parkinson's). Lack of interest in activities you once enjoyed. These symptoms can include: There are a few possible causes of chromhidrosis, depending on the type. Takita Y, Ichimiya M, Yamaguchi M, Hamamoto Y, Muto M. A case of pseudochromhidrosis due to dihydroxyacetone. Ned Tijdschr Geneeskd 2005; 149: 583 (in Dutch). To diagnose this issue, a doctor performs a physical examination and asks about when and where the colored sweat appears. Canale-Parola E. A Red pigment produced by aerobic sporeforming bacteria. Symptoms include sores in the mouth and a rash on the hands and feet. The authors also suggested that topiramate reduces aquaporin-5 expression in the skin. Krishnaram AS, Bharathi S, Krishnan S. An interesting case of bisacodyl (dulcolax)-induced chromhidrosis. You'll soon start receiving the latest Mayo Clinic health information you requested in your inbox. Bilateral facial apocrine chromhidrosis. Correlation between pigment production and amino acid requirements in Bacillus subtilis. It could be removed with soap and water; however, it was more easily removed with alcohol wipes (Fig. ALP had also been above upper reference limit prior to the presentation of blue discolouration (with no known or suspected cause). Check out these best-sellers and special offers on books and newsletters from Mayo Clinic Press. Usually, chromhidrosis affects the apocrine glands, mainly on the face and underarms. The same authors also described resolution of both the blue skin discolouration and the Bacillus spp. Zahejsky J, Rovensky J. Pediatr Int 2011; 53: 283284. Both were penicillin resistant, motile, and produced haemolysis on blood agar. American Academy of Dermatology Association. J Clin Microbiol 1978; 8: 105107. IPCH is a rare dermatological disorder characterized by a change in sweat colour on normal skin due to microorganisms pigments. Fig. Here, learn about home care techniques and medical treatments that can reduce or stop the, Sweating in the area around the vagina is normal, but it can sometimes cause discomfort and irritation. Treatment approaches and outcomes associated with the use of abobotulinumtoxinA for the treatment of hyperhidrosis: A systematic review. triggered by topiramate (an antiepileptic drug) (38). overgrowth upon stopping ranitidine. 2. Apocrine glands open into the hair follicle, leading to the surface of the skin. pH measurements of sweat were considered normal (mean/minmax: 5.6/5.16.5). B. cereus is an occasional pathogen that can cause various infections mostly associated with its secreted toxins (5255). Effect of prothazin (promethazine hydrochloride) on sweat gland activity. Eccrine chromhidrosis is generalized discolouration that occurs secondary to ingestion of water-soluble drugs (2, 27, 28), dyes (2931), or due to breakdown products from eccrine glands (2, 3235). Role of melanin pigment in expression of Vibrio cholerae virulence factors. (51)). There seems to be no association between chromhidrosis and sex, geographic location, season, or weather, though it may be more likely to develop in people of African descent. People sweat due to heat, stress, and a range of other causes. Kaya TI, Delialioglu N, Yazici AC, Tursen U, Ikizoglu G. Medical pearl: blue underpants sign a diagnostic clue for Pseudomonas aeruginosa intertrigo of the groin. Two different isolates were cultured; a greyish culture and a greyish culture with a blue tint (Fig. Accessed June 29, 2022. Debra Sullivan, Ph.D., MSN, R.N., CNE, COI, Butt sweat: Why it happens and how to get rid of it, a general feeling of hopelessness, worthlessness, helplessness, guilt or pessimism, a persistent anxious, sad, or empty mood, a decrease in energy or increase in fatigue, a lack of interest in once enjoyable activities, trouble concentrating, making decisions, or remembering, stimuli such as anxiety, sexual arousal, or pain, certain medications, such as bisacodyl, a laxative, when it is coated in tartrazine, a yellow dye, applying a capsaicin cream once or twice a day, though this can cause a burning sensation. Kang S, et al., eds. Banerjee D, Mondal A, Gupta M, Guha AK, Ray L. Optimization of fermentation conditions for green pigment production from Bacillus cereus M116 (MTCC 5521) and its pharmacological application. Botulinum toxin a in the treatment of chromhidrosis. Her scalp, hair, anterior and dorsal trunk, palms, and feet were surprisingly dry. This hypothesis is strengthened by the observations found in some of the IPCH case reports. Sweating is the body's mechanism to cool itself. In other circumstances, health issues such as infection and liver problems may cause sweat to change color. Bronchitis itself isn't contagious, but some of its causes are. Chromhidrosis is a rare idiopathic disorder characterized by colored secretions most typically from the malar cheeks, axilla, or areolar regions. Mayo Clinic on Incontinence - Mayo Clinic Press, NEW The Essential Diabetes Book - Mayo Clinic Press, NEW Ending the Opioid Crisis - Mayo Clinic Press, FREE Mayo Clinic Diet Assessment - Mayo Clinic Press, Mayo Clinic Health Letter - FREE book - Mayo Clinic Press, Mayo Clinic Graduate School of Biomedical Sciences, Mayo Clinic School of Continuous Professional Development, Mayo Clinic School of Graduate Medical Education, Book: Mayo Clinic Family Health Book, 5th Edition, Health Products for Men and Women from Mayo Clinic Store, Newsletter: Mayo Clinic Health Letter Digital Edition. Mapara A TV, Khandelwal AK. Autofluorescence of clothing as an adjunct in the diagnosis of apocrine chromhidrosis. Clin Interv Aging 2015; 10: 265267. They can rule out more serious causes and recommend any necessary treatment. and Corynebacterium spp. The infected skin is red with pus-filled blisters that. Concerning the 4 bacteria described above, the pigments have been chemically extracted and characterized in 2 of them: Serratia marcescens and P. aeruginosa. Indian Dermatol Online J 2017; 8: 4244. There are three types of chromhidrosis: apocrine, eccrine, and pseudochromhidrosis. reported a novel Corynebacterium spp. Review of reported cases of chromhidrosis. Int J Dermatol 2017; 56: 496502. Chromhidrosis means discoloured sweat. Dermatol Online J 2012; 18: 13. Odanaka K, Iwatsuki M, Satho T, Watanabe M. Identification and characterization of a brilliant yellow pigment produced by Bordetella pertussis. 2007; 48: 239241. Your body has two types of sweat glands, apocrine and eccrine. Dermatology 1999; 199: 149152. to grow or to produce its pigment. Fig. Anyone who has chromhidrosis should speak with a healthcare provider if they start to experience symptoms of emotional distress, depression, or anxiety. Other possible reasons for the appearance of colored sweat include infection, blood in the sweat (hematohidrosis), excess bilirubin (an orange-yellow pigment formed in the liver), and/or poisoning. Some symptoms include: Emotional distress may cause physical symptoms, such as headaches and weight loss. In: Dermatology: An Illustrated Colour Text. A pigment called lipofuscin is commonly associated with chromhidrosis. Its impossible to prevent melasma. This is a pigment that is produced as a byproduct of the oxidization of lipids (fats) in some types of cells. Contact Dermatitis 2002; 46: 237238. Three different conditions can result in chromhidrosis (2): Apocrine chromhidrosis is an intrinsic condition limited to areas with apocrine glands (e.g. Apocrine chromhidrosis involving the areolae in a 15-year-old amateur figure skater. 1998-2023 Mayo Foundation for Medical Education and Research (MFMER). Park, H., & Glick, B. If we combine this information with your protected The blue toilet seat phenomenon is still somewhat of a mystery, but signs point to a condition called chromhidrosis. Several factors can increase sweating in the, Butt sweat can happen in various situations, such as while exercising. Table II sums up potential triggers of IPCH based on the literature review. Epilepsia 2003; 44: 974976. Skin Pharmacol Physiol 2006; 19: 296302. It is well known that the bacteria can colonize moist skin surfaces and can cause a greenish discolouration of skin, nails, clothes, and surgical dressings (48, 62, 64, 65). In pseudochromhidrosis, a far more common disorder, sweat becomes colored after secretion from the sweat gland. See below for methods for culture and identification of bacteria, and results. To provide you with the most relevant and helpful information, and understand which "For people with apocrine chromhidrosis, these secretions contain a greater concentration of highly oxidized lipofuscin granules, giving them a significantly darker green-brown to blue-black color.". The condition can be treated by addressing potential triggers and/or prescribing antibiotic/antiseptic therapies. A novel red pigment from marine Arthrobacter sp. Due to her reports of hypohidrosis, a sweat provocation test with following sweat pH measurements (Jenway pH meter, Model 3510, Cole-Parmer, Staffordshire, UK) were performed. Chromhidrosis is a rare condition characterized by the secretion of colored sweat. At the time of presentation, the patient was approximately 7 months pregnant with her first child. J Pak Med Assoc 2013; 63: 11921194. Most people will be contagious for up to 2 weeks. Whole genome characterization of Bacillus cereus associated with specific disease manifestations. Ann Intern Med 2010; 152: 198199. The ubiquitous bacteria have a predilection for starches and are rarely found in bacteriological skin cultures. The phenomenon might be thanks to chromhidrosis, a rare skin condition marked by the production of colored sweat (think: blue, green, yellow, red, brown or black). Hill S, Duffill M, Lamont D, Rademaker M, Yung A. Pseudochromhidrosis: blue discolouration of the head and neck. Depending on the cause of your child's pink eye, signs and symptoms usually improve within a few days to two weeks. are also found in the human microbiota and are, in general, innocuous (57, 58). The coloration may be barely noticeable and restricted to a few locations or more widespread. Good hygiene including hand-washing, avoiding close contact with . Hyperhidrosis. Weismann K, Poulsen AG, Moller AF, Kobayashi T. A man with a reddish stained wash cloth. 6 ThingsYou Sweat Can Tell You About Your Health. Publish modules to the "offcanvas" position. Marks JG, Jr. Chromhidrosis is a disorder of the sweat glands that manifests with colored sweat on the face, in the underarms, or on the areola of the breasts (the darker circle of skin around the nipples). Haematohidrosis. It may be associated with hyperhidrosis. This may be startling or alarming to anyone who isnt aware of the condition. If your bronchitis is caused by a virus, you can be contagious for a few days to a week. Tracking your daily activities for two to three weeks such as what you've eaten and any chemicals you've come into contact with leading up to your doctor's appointment can be helpful in determining your triggers and what the potential culprits might be. Initially, 2 blood samples were performed at her general physicians office with a 1-month interval. Sometimes an underlying condition may be found and treated. II. Mayo Clinic is a not-for-profit organization. Histologically, chromhidrosis is notable for glandular structures with decapitation secretion indicating ectopic apocrine glands in the dermis, and the pr Since bacteria are potential causative agents of pseudochromhidrosis; infectious pseudochromhidrosis (IPCH) is becoming an increasingly used term in literature (1, 15). If you are a Mayo Clinic patient, this could Green staining of clothing: a signal for pseudomonal infection. . Afra S, Makhdoumi A, Matin MM, Feizy J. 1. It often begins with antiperspirants. Hines Dermatology Associates Inc., Attleboro, MA, Highly regarded dermatologist and dermatopathologist. To prevent overheating, the body promotes heat loss through evaporation. International Hyperhidrosis Society. Chromhidrosis can occur at nearly any age, but it usually becomes noticeable after puberty, when the apocrine glands begin secreting fluid.The International Hyperhidrosis Society (IHS) note that information about this condition is scarce because it is so rare. Sweat is your bodys natural response to regulate temperature. Clinicals pearls in dermatology 2017. Though chromhidrosis is benign, it may lead to emotional or psychological distress. Australas J Dermatol. Case reports of infectious pseudochromhidrosis and causative microorganisms. [A woman with blue sweat]. It's. information and will only use or disclose that information as set forth in our notice of Mayo Clinic. Pink eye is commonly caused by viruses or bacteria. Its wise to see a doctor about colored sweat. reviewed pigment production in Corynebacterium spp., and reported that carotenoid production is one of many important virulence factors (59). The goal of treatment for chromhidrosis is to reduce symptoms in order to also reduce any related psychosocial impacts or stigma. Referred Bacillus spp. Based on the literature review, bacteriological tests should be the first diagnostic step when dealing with coloured sweat and/or atypical skin discolouration. Last medically reviewed on June 30, 2020, A range of issues can cause excessively sweaty palms. These colors are due to a pigment produced in the sweat glands called lipofuscin. Semkova K, Gergovska M, Kazandjieva J, Tsankov N. Hyperhidrosis, bromhidrosis, and chromhidrosis: Fold (intertriginous) dermatoses. 2004-2023 Healthline Media UK Ltd, Brighton, UK, a Red Ventures Company. As you produce sweat, the body cools down. The childs swabs grew no microorganisms other than normal microflora. In: Fitzpatrick's Dermatology. You can use pain relievers to feel better. The infectiousness of this disorder has been exemplified in other studies (36, 44) as well as by the current case report. Williamson NR, Simonsen HT, Ahmed RA, Goldet G, Slater H, Woodley L, et al. Infect Immun 2018; 86; e0008618. . Bernard K. The genus corynebacterium and other medically relevant coryneform-like bacteria. Matarasso SL. Chromhidrosis is a serious skin disease that can significantly affect your quality of life. Glaser DA, et al. Retrospectively, her husband also recognized slight blue discolouration located on his right pectoral and deltoid region. This is a narrative review. This tentative diagnosis has been strengthened by complete remission after antibacterial treatment, combining systemic and topical erythromycin in all cases. Am J Dermatopathol 2014; 36: 853855. Skin scrapings for dermatophyte PCR identification were taken from the female and male patient. Bacillus cereus: 2 isolates; one with a blue tint and one without. We report here a case of blue infectious pseudochromhidrosis caused by the bacteria Bacillus cereus and a literature review. Heart failure: Could a low sodium diet sometimes do more harm than good? Under favourable conditions such pigments can result in coloured sweat and/or atypical skin discolouration in patients. Copper was normalized in this blood sample. All rights reserved. Insight of genus corynebacterium: ascertaining the role of pathogenic and non-pathogenic species. Dermoscopy of the discoloured areas revealed diffuse superficial pigmentation and an unmodified skin pattern (as postulated by Pistone et al. Pseudochromhidrosis results from contact between sweat and dyes, chemicals, or chromogenic bacteria on the skin. Production by Bacillis subtilis of brown sporulation-associated pigments. Whether promethazine is the sole trigger is currently unknown. Sports + Sweating Playbook V2: Running Cold Winter Workout Tips to Avoid Frostbite & Hypothermia SPORTS + SWEATING PLAYBOOK VOLUME 1: GEAR. Best food forward: Are algae the future of sustainable nutrition? Merritt K, Jacobs NJ. This process might involve your doctor testing skin scrapings, secretion smears and extraction samples from clothing. Glasset B, Herbin S, Granier SA, Cavali L, Lafeuille E, Gurin C, et al. Clinical Neuropharmacol 2008; 31: 339346. Kitamura S, Yanagi T, Imafuku K, Hata H, Shimizu H. Lipofuscin deposition causes the pigmentation of apocrine hidrocystoma. JAAD Case Rep 2017; 3: 273275. J Clin Diagn Res 2013; 7: 243246. Pseudochromhidrosis occurs when sweat interacts with certain substances, resulting in colored sweat. PloS One 2015; 10: e0125428. Chromhidrosis Necrobiosis lipoidica Contacting a doctor Summary The skin is the largest organ of the human body. Dermatol Surg 2005; 31: 963965. As such, some microorganisms invest heavily in pigment production, producing up to 30% of their dry weight as pigments (84). Symptoms usually appear within one to two days of exposure. If you experience sweating in an unusual hue, talk to your healthcare provider. Electrophysiological study in 2 children with transient hypohidrosis induced by topiramate. Pediatrics 2005; 115: e239241. Lipofuscin can be produced in the apocrine glands, and when it occurs in high enough . Ami T. Allscripts EPSi. Conditions that might cause it include: Mayo Clinic does not endorse companies or products. They're the glands that secrete a milky, odorless substance when you're stressed, and when that combines with bacteria on your skin, it causes body odor, according to the Mayo Clinic. Schmaler-Ripcke J, Sugareva V, Gebhardt P, Winkler R, Kniemeyer O, Heinekamp T, et al. 1). Singal A, Thami GP. Gawkrodger DJ, et al. It can occur weeks or years after infection with the TB bacteria. There is no medical cause for this type of hyperhidrosis. Normally, sweat is a clear, salty fluid, but for people with chromhidrosis, sweat may appear a vivid color such as: The shade of sweat can vary from person to person. Panagoulias GS, Basagiannis CS, Tentolouris N, Stavropoulou E, Karnesis L. Colored sweat caused by pseudochromhidrosis. Arch Dermatol 2005; 141: 795796. The condition is harmless, though, so pregnant people shouldn't worry about blue or purple toilet seats, although it's something you can certainly mention to your ob-gyn. Because it develops in the skin folds, inverse psoriasis can cause significant discomfort and distress. Red sweat. Carman KB, Aydogdu SD, Sabuncu I, Yarar C, Yakut A, Oztelcan B. Certain activities such as hot showers and friction against the skin increase the likelihood of discolored sweat in people with chromhidrosis. Magyarosy A, Ho JZ, Rapoport H, Dawson S, Hancock J, Keasling JD. McGraw Hill; 2019. https://accessmedicine.mhmedical.com. Treatment of facial chromhidrosis with botulinum toxin type A. J Am Acad Dermatol 2005; 52: 8991. Eccrine chromhidrosis may occur anywhere on the body, as eccrine glands are widely distributed, except in areas such as the lips. Primary focal hyperhidrosis. Full texts and reference lists were reviewed. For evaluation of abnormal colored sweat or any other skin problem, contact our, Current and prospective patients can also. Advertising revenue supports our not-for-profit mission. Pediatr Dermatol 1984; 2: 3840. Infectious Pseudochromhidrosis: A Case Report and Literature Review, Copyright Acta Dermato-Venereologica. 3. International Hyperhidrosis Societyhas received theGuideStar Exchange Seala leading symbol of transparency and accountability provided by GuideStar, the premier source of nonprofit information. Sweating is an important bodily function that keeps you cool during hot weather and tough workouts. The samples were cultivated aerobically, anaerobically, and for fungi. These infections usually go away on their own. This condition can further subdivide into apocrine chromhidrosis and eccrine chromhidrosis, and the treatment depends on type and cause. Nair PA, Kota RK, Surti NK, Diwan NG, Gandhi SS. J Bacteriol 1981; 147: 900913. The B. cereus strains are referred to as B. cereus in the following text. Noroviruses are highly contagious. Harada K, Morohoshi T, Ikeda T, Shimada S. A patient with pseudochromhidrosis presenting with pink nails. The best treatment depends on the type of chromhidrosis: Treatment for this type of chromhidrosis either aims to reduce the amount of sweat or to induce the sweat and empty the glands. The colour of S. marcescens IPCH is explained by its production of a red pigment, named prodigiosin, which gives the red/pink colour on the skin surface (46). The B. cereus found in the current case report colonizes human skin and the intestinal tract (54), yet infections in immunocompetent patients are rare (56). If medication is the cause of your colored sweat, it should return to normal after the medication is discontinued. J Am Acad Dermatol 1981; 4: 481482. An ashen hue was observed primarily on hands, feet, and neck (female patient), and right pectoral region (male patient). To date, none of the previous studies have specifically reported a blue pigmentation as a result of colonization with B. cereus. Only a few species, however, have been identified to produce carotenoid pigments (e.g. Pregnancy is another possible trigger. National Library of Medicines list You may opt-out of email communications at any time by clicking on International Hyperhidrosis Societyhas been awarded as a Top-Rated Nonprofit since 2012! If you're dealing with discolored sweat, schedule a visit with a dermatologist to get answers, rule out more serious conditions, and learn about treatment options. Haddix PL, Shanks RMQ. An on-site dermatopathology laboratory reduces the time spent waiting on a diagnosis. We link primary sources including studies, scientific references, and statistics within each article and also list them in the resources section at the bottom of our articles. Barnett TA, Valenzuela D, Riner S, Hageman JH. We report here a case of blue infectious pseudochromhidrosis caused by pigment-producing Bacillus cereus and the results of a literature review. Accessed June 29, 2022. Blalock TW, Crowson AN, Danford B. It's also important to talk to your doctor about any emotional distress you're experiencing in relation to your chromhidrosis, as feeling self-conscious about it is totally normal, Dr. King says: "Although it's a rare condition, you're not alone there are therapists and counseling available to help you out. Currently GARD is able to provide the following information for Chromhidrosis: Population Estimate: This section is currently in development. Chromhidrosis is a harmless condition. Because apocrine glands don't start functioning until puberty (when hormonal stimulation begins), this form of chromhidrosis is typically more prominent when a person is younger, with symptoms becoming less severe as they age (as apocrine secretion tapers off).
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