Patterns histopathologic of Fox-Fordyce disease.

Area of Science:

• Dermatopathology
• Histopathology
• Clinical Dermatology

Background:

• Fox-Fordyce disease is historically defined by intraepidermal sweat retention vesicles.
• The condition is often equated to apocrine miliaria, analogous to eccrine miliaria.
• Histopathological diagnosis has traditionally relied on a single characteristic feature.

Observation:

• This study reviews existing literature and presents new clinicopathological correlations from 8 biopsy specimens.
• Histopathological changes in Fox-Fordyce disease demonstrate significant variability.
• Foamy macrophages surround infundibula and apocrine ducts in observed cases.

Findings:

• Beyond typical dilation, hyperkeratosis, and spongiosis of infundibula, other findings include vacuolar alteration, dyskeratotic cells, and parakeratosis resembling cornoid lamellation.
• Clinically, patients consistently present with small, infundibulocentric papules, sometimes with central keratotic plugs and a yellowish hue.
• The observed histopathological variations are unified as manifestations of a single disease process.

Implications:

• The current understanding of Fox-Fordyce disease may be too narrowly defined.
• Recognizing the spectrum of histopathological findings is crucial for accurate diagnosis.
• This broader perspective refines the clinicopathological concept of Fox-Fordyce disease.