Bilateral Facial Aporine Chromhidrosis

A young woman presented to the office with a history of bluish discoloration involving the superior malar region bilaterally. When the bluish discoloration became darker, she would press on her cheeks resulting in excretion of “black sweat” that temporarily lightened her skin color. Examination revealed ill-defined slightly swollen soft plaques involving both superior cheeks. Upon pressure on the cheeks, a dark brown fluid was expressed. Histologic examination revealed collections of ectopic apocrine glands within midreticular dermis. The diagnosis of apocrine chromhidrosis was made, an uncommon cause of chromhidrosis and one in which bilateral facial presentation is rare.