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JAMA Dermatology Clinicopathological Challenge
September 2015

Creamy Yellow Concretions in Axillary Hair

Author Affiliations
  • 1Department of Dermatology, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain
  • 2Department of Histopathology, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain
JAMA Dermatol. 2015;151(9):1023-1024. doi:10.1001/jamadermatol.2015.0989

A man in his 20s was referred to our department because of the presence of a sticky material around the underarm hair for approximately 1 year. The patient explained that he usually plays soccer and sweats abundantly. He did not apply deodorant or any other products in the underarm, and he ensured proper hygiene of the area. The lesions did not produce itching. Physical examination revealed creamy yellow concretions along several hair shafts, in both armpits, with strong axillary odor (Figure, A). These concretions did not disappear when cleansed with alcohol. Hair samples of the affected areas were sent for microscopy examination (Figure, B-D) and microbiologic culture. Treatment with antiseptic soap and a miconazole nitrate cream was initiated. After 2 weeks of treatment, the lesions had resolved and the patient had normal axillary hairs. Confirmation of the suspected diagnosis was made with the results of complementary tests.

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