To the Editor.—
Fox-Fordyce disease (FFD) occurs mainly in women as itchy follicular papules in areas densely populated with apocrine glands, such as the axillae, areolae, pubic area, and perianal area.1 Several authors feel that an important event in the pathogenesis of FFD is the formation of a keratin plug in the upper infundibulum of the hair follicle.1-3 This plug obstructs the opening of the apocrine sweat duct into the follicle and results in the formation of an apocrine sweat vesicle. Eventually this leads to the formation of spongiosis and inflammation of the hair follicle wall. This inflammation may account for the itching. Keratotic follicular plugging also occurs in acne vulgaris and keratosis pilaris, both of which may improve with topical tretinoin treatment. The histologic similarities among these three diseases suggested to me the possibility that local tretinoin therapy might be effective for FFD.
Report of a Case.—
Tkach JR. Tretinoin Treatment of Fox-Fordyce Disease. Arch Dermatol. 1979;115(11):1285. doi:10.1001/archderm.1979.04010110001001