Pot barevný

Žlutý pot

• Apokrinní potní žlázy jsou méně četné než ekrinní a vyskytují se lokalizovaně: hlavně v axilách, okolo mamil, u pupku, perigenitálně a perianálně. Jsou uloženy v koriu a ústí do vlasového folikulu. Jsou řízeny adrenergními nervovými vlákny. Na rozdíl od čirého hypotonního ekrinního potu, je pot apokrinních žláz hustý a zkalený a obsahuje organické složky. Jejich rozkladem bakteriální kožní flórou vzniká nepříjemný zápach. Apokrinní žlázy začínají svou činnost v pubertě a jejich sekret se na projevech hyperhidrózy nepodílí. [4]
• Produkují hustší zkalenou tekutinu žluté barvy, která obsahuje více bílkovin a tuku. [3]
• Zažloutlý pot na prádle, by se měl odstranit koncentrátem ocet -voda v poměru 1:4 a pak běžně vyprat. [3]

Chromhidrosis

• Secretion barevného potu
• More common in blacks than in whites, but facial chromhidrosis is described only in whites [5]
• Apocrine in origin and apocrine glands are found in the genital, axillary, areolar, and facial skin [5]
• Noted after puberty, when the apocrine glands are activated [5]
• Chromhidrosis is reported only on the face, axillae and breast areola
• Lipofuscin pigment is responsible for the colored sweat
• Produced in the apocrine gland
• Yellowish brown pigment that is normally found in the cytoplasm of relatively nondividing cells (eg, neurons) [5]
• In chromhidrosis, lipofuscins are found in a higher-than-normal concentration or a higher-than-normal state of oxidation in apocrine glands [5]
• Various oxidative states account for:
• žlutý pot
• Zelený pot
• Modrý pot
• černý pot [5]
• The yellow, green, and blue apocrine secretions produce a yellow fluorescence under a Wood lamp (UV 360 nm), whereas the dark brown and black apocrine secretions seldom autofluoresce. Substance P is also postulated to be an important neurotransmitter in this process. [5]
• Eccrine chromhidrosis
• Rare
• With ingestion of certain dyes or drugs [5]

Pseudochromhidrosis

• Clear eccrine sweat becomes colored on the surface of the skin as a result of

Extrinsic dyes

• paints
• chromogenic bacteria [5]
• Especially Corynebacterium species [5]
• Pseudomonas infection
• červený pot
• fungi [5]
• tomato powder and paprika
• Růžový pot
• Stains could be removed by prolonged soaking in water
• 6-month history of eating a tomato-flavored prepackaged food
• Urine sample and sweat matched analysis of the tomato powder and paprika in the snacks [6]
• dermatitis simulata
• samoopalovací krém
• Hnědý pot

Hyperbilirubinemia

Poisoning

• Copper exposure
• Modrý pot

Bleeding diathesis

• červený pot, hematohidrosis

Alkaptonuria (ochronosis)

• Hnědý pot
• Urinary homogentisic acid levels to exclude alkaptonuria [5]

Diagnóza chromatohydrózy

• Wood lamp examination may be positive
• Manual expression or pharmacologic stimulation with intradermal epinephrine or oxytocin (Pitocin) can be used to stimulate sweat secretion
• Clothing fibers in contact with the secretions may also fluoresce yellow-green with standard UV microscopy
• Histologic Findings
• Normal in size and morphology
• Increased number of yellow-brown lipofuscin granules
• Granules are positive on periodic acid-Schiff stains and demonstrate autofluorescence under a UV excitation wavelength of 360-395 nm
• Schmorl stains may also be weakly positive

Terapie

• Manually or pharmacologically empty the glands
• Symptom-free period cca 48-72h or until the glands replenish the pigment [5]

• BOTOX® injections
• Mixed results
• Improvement of facial chromhidrosis lasting 19 weeks
• May suppress apocrine secretion by blocking cholinergic stimulation and substance P release [5]

• Capsaicin cream (Dolorac, Zostrix)
• Derived from plants of Solanaceae family
• Use 0.025% cream
• Crystalline alkaloid found in red peppers
• Commonly used for the temporary relief of pain from rheumatoid arthritis, osteoarthritis, and neuralgias
• Depletes neurons of substance P, a neurotransmitter important in apocrine sweat production
• Relapse occurs when therapy is stopped [5]

Prognóza

• Persists throughout life [5]
• Slow regression is noted, as apocrine glands regress with time [5]
• Good if an extrinsic cause can be identified and addressed appropriately [5]

Literatura: