(Osmidrosis; Fetid sweat)
Definition. A condition of the sweat wherein it is offensive when secreted or becomes so soon after.
Symptoms. Like hyperidrosis, which is frequently present at the same time, bromidrosis may be general or partial. The local forms are most common and usually affect the feet only, though the axillary and genital regions may be the seat of the disorder. In most cases the odor is not markedly offensive and a few cases have been recorded where abnormal odors of the perspiration have been agreeable, such as that of pineapple, violets, etc. Bromidrosis of the feet is likely to be most noticeable and, in extreme cases, has been compared to the odor of putrid cheese, penetrating through stockings and shoes to such a degree as to make the victims shun indoor society. The associated hyperidrosis renders the feet sodden, often red at the borders; occasionally blisters form, and the tenderness may temporarily prevent walking.
Etiology and Pathology. Young people are most subject to bromidrosis of the feet. Occupations which require much standing seem to favor it. A few cases are due to chlorotic, anemic and nervous disorders; some to bacteria; and in others the causes are obscure. In nearly all cases the foul odor is due to decomposition of the fatty acids of the sweat after secretion. The sweat-soaked epidermis probably furnishes suitable soil for the growth of bacteria. Micrococci, similar to those found in cases of bromidrosis, can be usually found between the toes unaffected with offensive sweating. Some were cultivated by Thin, and these he calls bacterium faetidum. The micrococci can be found by drying some of the sweat on a cover glass and staining it with methyl violet. Parkes asserts that the only cause is the covering of the feet, because barefooted soldiers do not suffer from the disease.
Prognosis and Treatment. These are the same as suggested for hyperidrosis with which bromidrosis is associated; hence the high frequency currents are to be remembered. Antiparasitics and deodorizers are the most effective palliative applications and best employed after bathing with hot water. Salicylic acid (1 part to 30 of bay rum or cologne), formalin solutions (1 to 10 per cent. in alcohol), mercuric chlorid (1 part to 400 of rose or cologne water), potassium permanganate (1 per cent. solution), and hydrogen peroxide (1 part to 3 of water) are among the best. Among drugs see indications for Hydrastis, Nitric acid, Osmium, Pet., Phosphorus, Rhododendron, Sepia, Silicea, Staphysagria, Sul., Thuja and Zincum met.