Bromhidrosis

Classification according to ICD-10
L75	Diseases of the apocrine sweat glands
L75.0	Bromhidrosis
ICD-10 online (WHO version 2019)

The bromhidrosis or bromhidrosis ( Greek βρῶμος ( brômos ), odor of animals'; ἱδρώς ( hidrós ), sweat ') or osmidrosis ( ancient Greek ὀσμή osmē , I smell') is a disease in which there is a strong body odor of those affected .

A distinction is made between two forms:

• Apocrine bromhidrosis

• Eccrine bromhidrosis

Apocrine bromhidrosis

The apocrine sweat or sebum from the olfactory sweat glands is metabolized by bacteria into fatty acids and amines , which leads to a strong odor. Depending on the composition, it smells musty, rancid, sour and is very stressful for those affected and often leads to psychological problems. Although they wash themselves several times a day, the fear of “smelling” remains, which can lead to delusions of smell as a special form of dysmorphophobia .

Apocrine scent glands are innervated by adrenergic nerve fibers, so that increased sweat production is particularly noticeable during stress, which makes the statement understandable that one can “ smell fear ”, whereby this is a signal processing below the conscious perception threshold and therefore not one Bromhidrosis acts.

Eccrine bromhidrosis

In eccrine bromhidrosis, the eccrine sweat glands are involved in causing odor. A distinction is also made:

• Keratogenic eccrine bromhidrosis as a special form of hyperhidrosis , in which the increased sweat produced continuously moisturizes the horny layer of the skin and promotes the proliferation of the local bacterial flora . With the breakdown of the keratin in the cornea , short-chain fatty acids and amines and thus an unpleasant body odor develop , especially in the groin area , armpits and feet (spaces between the toes) as well as other intertriginous areas. The scalp can also have an unpleasant odor, which is usually less noticeable, presumably because the corresponding “fragrances” evaporate relatively quickly despite the hairiness.
• Eccrine bromhidrosis caused by metabolism, in which a metabolic disease leads to the excretion of malodorous chemical components such as short-chain fatty acids (sweat-like), ammonia (urine-like) and amines as well as dimethyl sulfoxide (DMSO; with a garlic-like odor).

therapy

In the case of keratogenic eccrine bromhidrosis, hygienic measures in connection with local antisepsis z. B. be with 70% alcohol , which can lead to a decimation of the problem germs and thus at least to an improvement in odor formation. In the majority of cases, however, this form of therapy is ineffective.

With the treatment of botulinum toxin , only the eccrine sweat glands can be temporarily rendered inoperable. However, a suction curettage can permanently remove a lot, but not all, of the sweat glands (both apocrine and eccrine).

Psychological stress

As a strong sweat or body odor is usually interpreted as a lack of hygiene by outsiders , those affected usually experience extreme psychological stress in their free time and at work. The result is often social isolation and even job loss.

See also

• Pheromone

Individual evidence

1. ^ Wilhelm Gemoll , Karl Vretska: Greek-German school and hand dictionary. 10th edition. Verlag Hölder-Pichler-Tempsky, Vienna 2008, ISBN 978-3-230-03321-5 .
2. ↑ Bromhidrosis (overview) - Altmeyers Encyclopedia - Department of Dermatology . March 6, 2016 ( enzyklopaedie-dermatologie.de [accessed June 16, 2018]).

This article is about a health issue. It is not used for self-diagnosis and does not replace a diagnosis by a doctor. Please note the information on health issues !