Histopathology and Management of Axillary Osmidrosis

Objective This study was designed to investigate the etiology of the axillary osmidrosis by studying the histological structure of the apocrine glands and to evaluate the effect of excision of apocrine glands under the deep dermis via a small transverse incision. Methods Histologically, biopsy samples from 20 patients with osmidrosis and 8 healthy volunteers were observed both macrographically and microscopically to compare the character of the skin and the distribution, density, structure and function of the apocrine glands. Clinically, 121 patients with axillary bromidrosis underwent excision of apocrine glands under the deep dermis and all these patients were followed-up for long-term results. Results The apocrine glands of the axillary were located at the deep layer of the dermis and superficial layer of the subcutaneous tissue. Compared with normal people, the density of the apocrine of the osmidrosis patients was significantly higher. Glandular epithelia were columnar or cubical. Decapitated gland with enlarged lumen and accumulated secretion were discovered. For those 121 patients underwent excision of apocrine gland under the deep dermis, the total effective rate was 100% after a follow-up period ranging from 6 to 18 months with well-concealed inconspicuous scars and no axil lary skin necrosis. Conclusion Apocrine gland played the most important role in the etiology of osmidrosis and excision of apocrine glands under the deep dermis via a small transverse incision might be the surgical treatment of choice for axillary osmidrosis with its high effectiveness and minimal invasiveness.