A Case of the Blues: Pseudochromhidrosis in an Adolescent Following Injury

Pseudochromhidrosis is an underrecognized cause of unusual skin discoloration but is important to include in the differential diagnosis of skin discoloration. This case presents a 17-year-old female with intermittent bright blue discoloration of the right elbow and upper arm following prior orthopedic injuries, prompting extensive evaluation with normal imaging, cardiologic evaluation, and laboratory findings by multiple specialists. Bacterial culture suggested a chromogenic organism consistent with pseudochromhidrosis. Treatment with systemic erythromycin and topical clindamycin resulted in complete and sustained resolution. This case highlights the importance of early recognition of pseudochromhidrosis in preventing unnecessary diagnostic procedures and facilitating timely treatment.