A novel modality using microwave technology for the treatment of Fox-Fordyce disease (FFD)

Abstract

Fox-Fordyce disease (FFD) (also known as apocrine miliaria) is a rare dermatologic condition characterized by multiple skin-colored, equidistant, perifollicular papules distributed in areas rich in apocrine glands. These areas typically include the axillae, anogenital, and periareolar regions.1 This condition primarily affects young females between 15 and 35 years of age, and rarely presents before puberty. The disease is often severely pruritic and may be exacerbated by sympathetic stimulation such as stress, exercise, excitement, and hot weather.1, 2, 3 The diagnosis is typically made clinically but histopathologic examination may display infundibular plugging, parakeratosis, spongiosis, and acanthosis.4, 5 Perifollicular foam cells are now believed to be a distinct and specific feature of FFD.4 Therapeutic modalities are commonly lackluster and no definitive treatment exists for this entity. MiraDry (Miramar Labs Incorporated, Santa Clara, CA) is a novel microwave device that was recently approved by the Food and Drug Administration in 2011 for the treatment of primary axillary hyperhidrosis. It targets the eccrine, apocrine, and apoeccrine sweat glands in addition to hair follicles by targeting the dermal-hypodermal junction through dielectric heating.6 We report a case of axillary FFD treated with this novel noninvasive microwave technology.