Pathophysiology, clinical findings, and management of Fox ForDyce disease: A systematic review.

BACKGROUND Fox-ForDyce (FFD), also known as apocrine military, is an uncommon chronic inflammation of the apocrine sweat glands. It's characterized by pruritic, papular eruptions in apocrine-gland bearing regions. FFD was described a century ago, but the exact pathogenesis of the disease and the management is not well understood. METHODS A research was done using PubMed database on 12 april 2020 in order to retrieve all case reports, case series, cohort studies, randomized and nonrandomized clinical trials were included describing FFD among patients. RESULTS A total of 43 articles and 68 patients were included in the study. The majority of patients were young females. The disease was bilateral in 90%, affected the axillae and to a lesser extent the pubic and the periareaolar areas and rarely the thoracic area, the abdominal area, and the face. FFD followed a relapsing and remitting course and an evident improvement in disease course was noted after menopause. CONCLUSION The typical FFD patient is a postpubertal female and premonopause, presenting with pruritic papules in apocrine-gland bearing regions. FFD can be sporadic or occurs in family, it can be asymptomatic in 1/(3-4) of patients, and can be triggered by laser hair removal and hormonal changes. Further randomized clinical trials assessing different treatment of FFD is now warranted.