TRICHOMYCOSIS

AXILLARIS AND

PUBIS

Trichomycosis axillaris, a bacterial infection of the hair shaft (not fungal as the name implies), is characterized by what appears to be nodular thickenings on the hair shaft, composed of colonies of aerobic Corynebacterium. The condition occurs both in the axillae and pubic areas, and not just in the axillae, as the name implies. The bacteria produce various pigments, giving the nodules a range of colors. In a study from the United Kingdom, axillary infection was noted in 27 percent of adult male students; in hospitalized mentally retarded patients, the finding was present in 42 percent of male patients and in 7 percent of female patients (many of the females had no axillary hair).

Trichomycosis is asymptomatic except for the patient's concern regarding the lesions themselves and because they are malodorous. The concretions on the hair shaft are usually a tan color but may be reddish, yellow, or black . Lesions are most dense in and may be present only in the central portion of the axillary hair. The same lesions may occur in the pubic hair as well.

The diagnosis is usually made on the basis of the physical findings. The concretions can be visualized using a potassium hydroxide preparation. Pediculosis pubis infestation with multiple eggs on the hair shaft should be ruled out.

The involved hair can be removed by shaving. Benzoyl peroxide wash and gel are effective as treatment and prevention against recurrence of trichomycosis.