Definition. A disorder of the sweat-glands in which the sweat is colored.
Symptoms. The color has been attributed to the presence in the sweat of the compounds of iron, indican, Prussian blue, cyanogen, phosphorus, hematin, chromogen and bacteria. Cases of true chromidrosis are extremely rare but three forms have been described according to their supposed origin: (1) from elimination of some substance taken into the system; (2) from neurotic disturbances of secretion; (3) from bacteria or false chromidrosis.
Colored sweat due to elimination may be blue, green or red. In a case of blue chromidrosis, protosulphate of iron was found in the sweat. The patient had previously taken iron in quantity. Green sweat is not uncommon in workers in copper and may be profuse enough to stain the clothing. Reddish sweat may come from the ingestion of iodine compounds. Hyperidrosis in the debilitated favors this elimination to the surface in some cases, doubtless where the substances have been given for medicinal purposes. Sudden changes in the color of the hair have been noted in cases of profuse sweating.
In the neurotic form the color of the staining is some shade of brown, black or blue. It is usually symmetrically distributed, most often about the orbital region, especially the lower lid. Other parts affected in order of frequency are the cheeks, forehead, side of the nose, more rarely the whole face, chest, abdomen, back of the hands, axillae, groins and popliteal space. It may appear rapidly or slowly and change color in like manner. It may persist for years or disappear in a few days.
The form due to growths of bacteria occurs in moist regions, as the axillary and genital, and is associated with a disease of the hair known as leptothrix. The red color is due to colonies of microorganisms (bacterium prodigiosum), unconnected with the function of the sweat-glands and, therefore, a false chromidrosis.
Etiology and Pathology. A very large proportion of all cases of chromidrosis occur in young, unmarried women, mostly nervous or neurasthenic types, and frequently sufferers from chronic constipation or uterine disturbance. There is good ground for the belief that the disease is, at least primarily, a hysterical neurosis of the glands. The contributing relationship of constipation has been shown by relapses following a recurrence of the previously relieved constipation. The theory that indican is derived from the indol of the feces and, on reaching the surface, is oxidized or changed by some ferment into indigo has been partially proven. The deposit upon the skin is removed, with difficulty, with water; but is easily removed with either chloroform or glycerin. The nature of the eliminative and the bacterial forms of chromidrosis has already been mentioned.
Diagnosis. Barring imposture, there is no other condition which can easily be mistaken for chromidrosis. The hysterical element and the possibilities of accident and deceit should always be borne in mind.
Prognosis and Treatment. Final recovery is nearly certain, although the condition is persistent or relapsing. Gastrointestinal disturbances should be carefully watched and a culture of the bacillus Bulgaricus given if indicated. It may be necessary to cure or relieve constipation, neurotic disorders, internal diseases, etc. Antiparasitics such as formalin, boric acid, chloroform or ether may be needed for the parasitic variety. When the cause is an accident of occupation, or arises from drugs taken internally, avoidance of the cause is the only remedy. Conium, Mercurius vivus, Dulcamara and Nux vomica may be studied.