Ultraviolet-induced fluorescence trichoscopy of trichobacteriosis axillaris

A 23-year-old female presented with complaint of malodour from bilateral axillae for two years, which worsened during summers. Examination revealed firmly adherent, yellow-white concretions along multiple hair shafts in both axillae associated with an offensive smell [Figure 1]. These concretions showed bluish fluorescence under Wood’s lamp [Figure 2]. Polarized trichoscopy showed pale-yellow, cotton-like waxy structures forming sheaths, nodules, and concretions along the hair shafts [Figure 3], which showed bluish fluorescence on ultraviolet-induced fluorescence trichoscopy [Figure 4]. Microscopic examination of 10% potassium hydroxide mount revealed irregular cottony concretions along hair shafts. She was diagnosed with trichobacteriosis axillaris (trichomycosis axillaris) based on the above findings. The patient was advised to shave her axillary hair and prescribed clindamycin phosphate 1% gel for twice daily topical application resulting in remission within two weeks.

Close

Figure 1:

Firmly adherent, yellow-white concretions along multiple hair shafts over right axilla.

Export to PPT

Close

Figure 2:

Bluish fluorescence under Wood’s lamp.

Export to PPT

Close

Figure 3:

Polarized trichoscopy showing pale-yellow, cotton-like waxy structures forming sheaths, nodules, and concretions along the hair shafts (DermLite DL5, ×20).

Export to PPT

Close

Figure 4:

Ultraviolet-induced fluorescence trichoscopy showing bluish fluorescent concretions (DermLite DL5, ×20).

Export to PPT