Fox-Fordyce Disease in Women: A Case Report Highlighting Laser-Based Interventions

Fox-Fordyce disease (FFD) is a rare, chronic skin disorder affecting apocrine sweat glands, predominantly in women. It manifests as pruritic, dome-shaped papules in areas such as the axillae and pubic region. Treatment remains challenging, with limited success from conventional therapies. We report two cases of Saudi women aged 27 and 28 years presenting with hyperpigmented axillary papules and mild pruritus, consistent with FFD. One patient had no comorbidities, while the other had a known history of sickle cell anemia. Both cases were managed with laser therapy (erbium:yttrium aluminum garnet (YAG) in case 1 and ablative CO₂ in case 2) using precise protocols and follow-up plans. Clinical images demonstrated visual improvement post treatment. Adjunctive topical therapy was administered to manage inflammation and prevent hyperpigmentation. The cases underscore the typical presentation of FFD and the potential efficacy of laser-based interventions, even in patients with complex medical histories. Notably, the presence of sickle cell anemia did not exacerbate FFD manifestations, supporting the current treatment modalities. While hormonal therapy was not employed, its relevance remains a subject for future exploration. Laser therapy offers a promising approach for managing refractory FFD. Further studies are warranted to evaluate long-term outcomes and explore hormone-modulating strategies tailored to FFD's pathophysiology.