Bromhidros

Bromhidros, also known as bromhidrosis, is a medical condition characterized by an abnormally strong and persistent body odor. The odor most often originates in the armpits (axillae) and other apocrine gland–rich areas and results from the bacterial breakdown of sweat secretions.

Pathophysiology and contributing factors: Apocrine sweat contains proteins and lipids that are metabolized by skin microbiota, producing volatile odorous compounds such as short-chain fatty acids (notably isovaleric acid), sulfur-containing compounds, and other volatile molecules. The intensity of the odor can vary with hormonal changes, hygiene, climate, and diet. Secondary bromhidrosis can be related to infections, metabolic disorders (for example trimethylaminuria), kidney or liver disease, or the consumption of odoriferous foods (garlic, onions, certain spices). Some drugs can also influence body odor.

Diagnosis: Diagnosis is typically clinical, based on the characteristic odor and its localization, most often in apocrine-bearing areas. Evaluation may include history, physical examination, and exclusion of secondary causes such as infection or metabolic disorders. In some cases, odor analysis or specialized metabolic tests may be used to identify underlying conditions like trimethylaminuria.

Treatment and management: Management emphasizes hygiene and reducing sweat production. Options include topical antiperspirants containing aluminum salts; antiseptic washes (e.g., chlorhexidine); topical or oral antibiotics to address skin flora; and treatments to reduce apocrine sweating, such as botulinum toxin injections. In refractory cases, surgical options to remove or disable axillary sweat glands (liposuction-assisted curettage or gland excision) may be considered. Dietary adjustments and treatment of any underlying metabolic disorder are advised when applicable. Osmidrosis is a term often used synonymously with axillary bromhidrosis.