Summary about Disease
Trichomycosis, also known as trichomycosis axillaris, is a superficial bacterial infection of the hair shafts in areas with apocrine sweat glands, most commonly the axillae (armpits) and less often the pubic region. It is characterized by the presence of yellowish, greenish, or blackish concretions surrounding the hair shafts. While not a serious health threat, it can be bothersome due to odor and staining of clothing.
Symptoms
Visible nodules or concretions along the hair shafts in the armpits or pubic region.
Nodules can be yellow, green, black, or red depending on the bacteria involved.
Excessive sweating (hyperhidrosis) may be present.
Possible odor.
Staining of clothing in the affected area.
Itching may or may not be present.
Causes
Trichomycosis is caused by bacteria of the Corynebacterium genus, specifically *Corynebacterium tenuis* is the most common culprit. These bacteria thrive in warm, moist environments and feed on apocrine sweat. Factors contributing to its development include:
Excessive sweating (hyperhidrosis)
Poor hygiene
Warm, humid climates
Close shaving of armpits or pubic region, which may create micro-abrasions.
Medicine Used
Topical Antibiotics: Clindamycin, erythromycin, or benzoyl peroxide solutions or lotions are commonly prescribed.
Topical Antiseptics: Benzoyl peroxide washes.
Shaving: Removing the hair in the affected area is often recommended as it eliminates the site of infection.
Aluminum Chloride: Antiperspirants containing aluminum chloride can help reduce sweating.
Is Communicable
Trichomycosis is considered mildly contagious, but transmission is uncommon. It is spread through direct skin-to-skin contact or sharing contaminated items like towels or clothing. However, factors like pre-existing hyperhidrosis and individual susceptibility play a significant role in whether an infection develops.
Precautions
Maintain good hygiene by washing the affected area regularly with soap and water.
Use antiperspirants to control excessive sweating.
Keep the armpits and pubic area dry.
Avoid sharing towels, clothing, or razors.
Consider hair removal (shaving or waxing) in the affected area, but be sure to practice proper hygiene before and after.
Wear loose-fitting clothing to promote air circulation.
How long does an outbreak last?
With proper treatment and hygiene, trichomycosis usually clears up within a few weeks. However, recurrence is common if preventative measures are not followed. Without treatment, the condition can persist for months or even years.
How is it diagnosed?
Visual Examination: A doctor can often diagnose trichomycosis by simply examining the affected area and observing the characteristic nodules on the hair shafts.
Wood's Lamp Examination: The coral-red fluorescence produced by Corynebacterium under Wood's lamp can help in diagnosis.
Microscopic Examination: Microscopic examination of the affected hair shafts may reveal the presence of bacteria.
Culture: Bacterial culture is rarely necessary but can be used to identify the specific Corynebacterium species involved.
Timeline of Symptoms
Trichomycosis development is gradual:
Initial Stage: Often asymptomatic.
Early Stage: Noticing a slight discoloration on hair shafts and possible mild odor.
Progressive Stage: Nodules become more visible, odor may increase, staining of clothing may occur.
Advanced Stage: Concretions are prominent, potential for skin irritation or itching, noticeable odor.
Important Considerations
Trichomycosis is a cosmetic issue rather than a serious health concern.
It is more common in men than women.
Differential diagnosis should rule out other conditions that can affect hair shafts, such as pediculosis pubis (pubic lice) or piedra.
Consult a doctor or dermatologist for proper diagnosis and treatment.
Maintaining good hygiene is key to preventing recurrence.