Pseudochromhidrosis is a rare phenomenon in clinical practice, with only a handful of cases described in the literature so far [1] [2] [3]. The coloration of the skin seen in these individuals stems from the initial production of uncolored sweat that interacts with various substances present on the skin [1] [4] [5]. Changes in sweat color have been associated with bacterial pathogens (Corynebacterium sp., Malassezia furfur, Bacillus sp., Serratia marcescens), fungi, drugs, chemical products (topiramate, gold salts, emollients, and tanning creme have been confirmed as causes), and clothing dyes [1] [2] [3] [4] [5]. Irritant contact dermatitis and subsequent use of systemic corticosteroids (that were assumed to aggravate the symptoms) are also noted as possible etiology [1]. Up to this point, patients have presented with red, black, blue, brown, yellow, and pink color sweat and virtually any site in the body can be affected [1] [2] [3] [4] [5]. Reports documented isolated coloration of the face, palms, toe webs, and toenails [1] [5], whereas generalized changes have also been observed [1] [2] [3] [4]. Age is not a relevant factor in the appearance of pseudochromhidrosis, as this condition is encountered in children, young adults, and the elderly [1] [2] [3] [4] [5]. Except for perioral irritation seen in one patient that suffered from the red coloring of the face, accompanying signs or color changes of other fluids or tissues (saliva, urine, blood, feces, etc.) are absent [1] [2] [3] [4] [5]. Because of the extrinsic nature of pseudochromhidrosis, it is self-limiting and resolves after elimination of the underlying cause.

• Swelling

  A new emollient (containing urea, light liquid paraffin, white soft paraffin, and glycerol) was introduced 10 days back, and he started experiencing irritation, pain, and swelling of lips. [e-ijd.org]

• Cyanosis

  CYANOSIS The most common and most dangerous cause of blue skin is cyanosis — the lack of oxygen-rich blood. (The word itself means blue tint, from the Greek root, cyan, a blue-green color.) [millerscahs.weebly.com]

  This was not a condition like cyanosis, or low oxygen, that was causing the skin to turn blue. Whatever this young woman had, it was on the surface of her skin and not within the body tissue. [well.blogs.nytimes.com]

• Dermatitis

  […] herpetiformis Inflammatory Dermatitis and eczema Atopic dermatitis · Seborrhoeic dermatitis ( Dandruff, Cradle cap ) · Contact dermatitis ( Diaper rash, Urushiol-induced contact dermatitis ) · Erythroderma · Lichen simplex chronicus / Prurigo nodularis [wikidoc.org]

  Six months ago, he was diagnosed as a case of celiac disease with dermatitis herpetiformis and was under treatment elsewhere for the same (Figure 1). [tropicalgastro.com]

  Our final diagnosis was pseudochromhidrosis due to secondary infection after irritant contact dermatitis to lips. [e-ijd.org]

  Irritant contact dermatitis and subsequent use of systemic corticosteroids (that were assumed to aggravate the symptoms) are also noted as possible etiology. [symptoma.com]

  […] fungi [5] tomato powder and paprika Růžový pot Stains could be removed by prolonged soaking in water 6-month history of eating a tomato-flavored prepackaged food Urine sample and sweat matched analysis of the tomato powder and paprika in the snacks [6] dermatitis [medicinman.cz]

• Eruptions

  Erythema nodosum Other erythema : Erythema annulare centrifugum · Erythema marginatum · Necrolytic migratory erythema · Erythema toxicum Radiation -related disorders Sunburn · actinic rays ( Actinic keratosis, Actinic cheilitis ) · Polymorphous light eruption [wikidoc.org]

  These abilities aid clinicians in their approach to the patient with a cutaneous eruption both in developing a differential diagnosis and while communicating with other physicians. The classic dermatologic lesions are defined in Table 18–1. [accesspharmacy.mhmedical.com]

  Green palmoplantar vesicular eruption in a patient with hyperbilirubinemia. JAAD Case Rep. 2017 Jul. 3 (4):273-275. [Medline]. Park JG, Prose NS, Garza R. Eccrine Chromhidrosis in an Adolescent with Sickle Cell Disease. [emedicine.medscape.com]

  Allergic symptoms-such as-skin eruptions like urticaria, eczema and prurigo are seen and these symptoms may alternate with the attack of dyspnoea. Hay fever, hemicrania or migraine and even attacks of epilepsy may alternate in the same way. [homeopathyworldcommunity.ning.com]

  Green palmoplantar vesicular eruption in a patient with hyperbilirubinemia. JAAD Case Rep 2017; 3: 273–275. View article Google Scholar Triwongwaranat D, Kasemsarn P, Boonchai W. Green pigmentation on the palms and soles. [medicaljournals.se]

• Bromhidrosis

  Convert to ICD-10-CM : 705.89 converts approximately to: 2015/16 ICD-10-CM L74.8 Other eccrine sweat disorders Or: 2015/16 ICD-10-CM L75.0 Bromhidrosis Or: 2015/16 ICD-10-CM L75.1 Chromhidrosis Or: 2015/16 ICD-10-CM L75.8 Other apocrine sweat disorders [icd9data.com]

  (Syphilis) Localized bromhidrosis Most frequently axillae, groins and feet are involved. Other body parts may also be involved in localized bromhidrosis. [homeopathyworldcommunity.ning.com]

  Hyperhidrosis, bromhidrosis, and chromhidrosis: Fold (intertriginous) dermatoses. Clin Dermatol 2015; 33: 483–491. View article Google Scholar Tempark T, Wittayakornrerk S, Jirasukprasert L, Chatproedprai S, Wananukul S. [medicaljournals.se]

• Pruritus

  […] herpetiformis Inflammatory Dermatitis and eczema Atopic dermatitis · Seborrhoeic dermatitis ( Dandruff, Cradle cap ) · Contact dermatitis ( Diaper rash, Urushiol-induced contact dermatitis ) · Erythroderma · Lichen simplex chronicus / Prurigo nodularis · Itch ( Pruritus [wikidoc.org]

  The treatment is usually targeted toward reducing sweat secretion by topical capsaicin cream, which is inexpensive and effective if continued; however, it has side effects such as intolerable pain, pruritus, soreness, and itching. [idoj.in]

  She had started daily 25 mg promethazine due to pruritus 6 months earlier. Promethazine was stopped 1 month after presentation with no change in colour intensity. [medicaljournals.se]

• Anhidrosis

  (Psora/ Syphilis) Anhidrosis occurs due to sweat glands failure (Psora/ Syphilis). [homeopathyworldcommunity.ning.com]

  Her symptoms resemble acquired idiopathic anhidrosis; however, this was not investigated further. Fig. 1. Clinical photographs. (a) Blue discolouration on dorsal side of the hand primarily covering the joints. [medicaljournals.se]

• Suggestibility

  One explanation suggested is dye transfer from new maternity jeans, however we find this unlikely for a variety of reasons: This is late pregnancy and the jeans have been worn for some time without this effect. [chemistry.stackexchange.com]

  That suggested that it was something on the skin and not in the skin. Strong work, Dr. Feingold! [well.blogs.nytimes.com]

  "Some continue to suggest that it is factitious, or a product of malingering, especially in articles from the early 20th century." [techtimes.com]

  Some authors suggest a brief examination before a lengthy history because some of the classic skin diseases with obvious morphologies allow a “doorway diagnosis” to be established. [accesspharmacy.mhmedical.com]

• Red Urine

  Rifampin and red urine. JAMA 1977; 238: 1628. View article Google Scholar Krishnaram AS, Bharathi S, Krishnan S. An interesting case of bisacodyl (dulcolax)-induced chromhidrosis. Indian J Dermatol Venereol Leprol 2012; 78: 756–758. [medicaljournals.se]

Because of the rare occurrence of pseudochromhidrosis, clinicians will unlikely encounter this disorder. For this reason, the physician must conduct a thorough investigation in the presence of skin discoloration. Firstly, a detailed patient history is necessary to cover the recent use of pharmacological agents and changes in treatment for pre-existing disorders. Clothing marks are sometimes reported by patients, which may be a useful clue toward the diagnosis [1] [3] [4]. The physical examination is crucial for determining the exact area(s) of skin changes and follow-up laboratory studies need to be conducted. Exams like a complete blood count (CBC), basic biochemistry and urinalysis should be included in the initial workup [1]. The role of microbial agents in the development of pseudochromhidrosis necessitates the use of skin cultures (for both bacteria and fungi), with a goal of identifying the underlying cause [1] [3]. In some cases, however, a favorable response to antimicrobial therapy has been confirmed in the absence of a positive culture [3]. A skin biopsy can be used as a definitive diagnostic method, showing dilated apocrine acini with a colored secretion [1] [4].

• Malassezia Furfur

  The diagnosis was made on the basis of clinico-histological features and growth of Malassezia furfur, and Bacillus species, not Bacillus cereus, in the absence of lipofuscin. [ncbi.nlm.nih.gov]

  Changes in sweat color have been associated with bacterial pathogens (Corynebacterium sp., Malassezia furfur, Bacillus sp., Serratia marcescens), fungi, drugs, chemical products (topiramate, gold salts, emollients, and tanning creme have been confirmed [symptoma.com]

  furfur has been associated with blue sweat. [dermnetnz.org]

  furfur and Bacillus speciesare the agents involved in the blue pseudochromhidrosis. [idoj.in]

  Pityriacitrin – a potent UV filter produced by Malassezia furfur and its effect on human skin microflora. Mycoses 2006; 49: 388–392. View article Google Scholar Mayser P, Schafer U, Kramer HJ, Irlinger B, Steglich W. [medicaljournals.se]

This article provides a literature review of the various etiology, investigation, treatment, and prognosis. [ncbi.nlm.nih.gov]

Treatment options for chromhidrosis is limited. Capsaicin depletes the neurons of substance P and has been found to be beneficial in the treatment of these patients. The other options are topical clindamycin and topical aluminum chloride. [tropicalgastro.com]

Chapter 40 Keratolytic treatment of acne 352 Chapter 41 Cosmetics for men 365 Chapter 42 Ethnic cosmetics 379 Chapter 43 Ethnic variation in hair 386 Chapter 44 Ethnic differences in skin properties 395 Chapter 45 The menopause skin and cosmetology 405 [books.google.com]

Treatment of facial chromhidrosis with botulinum toxin type A. J Am Acad Dermatol 2005;52:89-91. [Figure 1], [Figure 2], [Figure 3], [Figure 4] [Table 1] [idoj.in]

This article provides a literature review of the various etiology, investigation, treatment, and prognosis. [ncbi.nlm.nih.gov]

What is the prognosis for pseudochromhidrosis? Pseudochromhidrosis resolves once the cause has been identified and removed or treated. [dermnetnz.org]

However, rare cases in infants have been reported. [10, 11] Prognosis Chromhidrosis persists throughout life, but slow regression of the disease is noted, as apocrine glands regress with time. [emedicine.medscape.com]

Pseudochromhidrosis needs to be differentiated from apocrine and eccrine chromhidrosis because it is important for the prognosis [Table 1]. [idoj.in]

NPR: Health & Science - Prognosis Negative Again for Medicare - Better Tests Needed to Control Tuberculosis - Why Kids Curse - Tool Reassesses Osteoporosis Risk - For Spring, an Attempt to Forgo Meat - Stopping Deaths From Incorrect Drug Doses - How to [emacromall.com]

This article provides a literature review of the various etiology, investigation, treatment, and prognosis. [ncbi.nlm.nih.gov]

Certain conditions have both an underlying etiology and multiple body system manifestations due to the underlying etiology. [icd10coded.com]

Irritant contact dermatitis and subsequent use of systemic corticosteroids (that were assumed to aggravate the symptoms) are also noted as possible etiology. [symptoma.com]

Etiology is unknown till date. Stress may be a precipitating factor. Record : found Abstract : not found Article : not found Red pseudochromhidrosis of the neck. [scienceopen.com]

Etiology The increased numbers of lipofuscin pigments in the secretory apocrine cells are presumed to be the cause of apocrine chromhidrosis. [emedicine.medscape.com]

Patient Population: Prevalence and Epidemiology Knee // Shoulder & Elbow // Hip // Spine // Foot & Ankle // Hand & Wrist Fragility Fractures: Diagnosis and Treatment Shoulder & Elbow The Characteristics of Surgeons Performing Total Shoulder Arthroplasty [mdedge.com]

(A review of epidemiologic data and relation to sports) Apted, JH. “Calcaneal petechiae (black heel)”. Australas J Dermatol. vol. 14. 1973. pp. 132-5. [dermatologyadvisor.com]

Several extrinsic causes of eccrine chromhidrosis and pseudochromhidrosis include chromogenic bacteria, especially Corynebacterium species, fungi, dyes, drugs, and chemical contactants. [5, 6, 7, 8, 9] Epidemiology Frequency Incidence statistics are not [emedicine.medscape.com]

Bacillus cereus, a serious cause of nosocomial infections: epidemiologic and genetic survey. PloS One 2018; 13: e0194346. View article Google Scholar Chang T, Rosch JW, Gu Z, Hakim H, Hewitt C, Gaur A, et al. [medicaljournals.se]

FDA.Gov - Provides information about infectious diseases, travel medicine and epidemiology. provides users with credible, reliable health information on data and statistics, diseases and conditions, emergencies and disasters, environmental health, healthy [emacromall.com]

The pathophysiology of apocrine chromhidrosis is unclear, but it is postulated that oxidized lipofuscin is the responsible pigment. Eccrine chromohidrosis is due to water-soluble pigments being excreted via the eccrine glands. [lifeinthefastlane.com]

Pathophysiology: An increased synthesis of tyrosine, heme, and melanin has been implicated in the pathogenesis of apocrine chromhidrosis. [medhelp.org]

Pathophysiology: Lipofuscin is a yellowish brown pigment that is normally found in the cytoplasm of relatively nondividing cells (eg, neurons). [wikidoc.org]

Pathophysiology Lipofuscin is a yellowish brown pigment that is normally found in the cytoplasm of relatively nondividing cells (eg, neurons). [dermaamin.com]

Although the presentations of apocrine and eccrine chromhidrosis are similar, the pathophysiology is quite different. [idoj.in]

Ear wax is thought to prevent foreign material from entering your ears, including insects. Chromhidrosis is apocrine in origin. [mybodylanguage.co.uk]

Medication The goals of pharmacotherapy for chromhidrosis are to reduce morbidity and to prevent complications. Counterirritants Counterirritants may be used to treat chromhidrosis. [dermaamin.com]

To prevent recurrence, we recommend properly fitting footwear with adequate arch support and cushion. The use of a heel gel cup or felt pad may also be helpful. [dermatologyadvisor.com]

Assessment of the effectiveness of application antiseptics in prevention of foot skin inflammation. N Dermatol Online. 2011;2:21-4. 6. Al Aboud K. The selection of the types of shoes and its impact on the skin of the feet. [odermatol.com]

1. Koley S, Mandal RK. Red and Black Pseudochromhidrosis. Indian J Dermatol. 2016;61(4):454-457.
2. Castela E, Thomas P, Bronsard V, Lacour JP, Ortonne JP, Passeron T. Blue pseudochromhidrosis secondary to topiramate treatment. Acta Derm Venereol. 2009;89:538–539.
3. Nair PA, Kota RKS, Surti NK, Diwan NG, Gandhi SS. Yellow pseudochromhidrosis in a young female. Indian Dermatol Online J. 2017;8(1):42-44.
4. Bilgin I, Kelekci KH, Catal S, Calli A. Late-onset apocrine chromhidrosis. Indian J Dermatol Venereol Leprol. 2014;80(6):579.
5. Harada K, Morohoshi T, Ikeda T, Shimada S. A patient with pseudochromhidrosis presenting with pink nails. J Am Acad Dermatol. 2012;67(2):e74-75.