Immunohistochemical differentiation and localization analysis of sweat glands in the adult human axilla.
BACKGROUND
The classic concept of axillary glands differentiates between eccrine glands, producing abundant clear, nonodorous sweat; and apocrine glands, excreting small amounts of turbid, odorous milky sweat. A third type of sweat glands, the "apoeccrine" glands, were recently identified. To define the different types of sweat glands and their location and number, the authors carried out a prospective histologic study on adult human axillary skin, including various immunohistochemical markers.


METHODS
Forty-three consecutive Caucasian, subjectively normhidrotic patients, who underwent a surgical procedure in the axilla unrelated to the axillary glands, were included in the study. For verification of normhidrosis, the gravimetric test was carried out by measuring the amount of sweat secretion per minute. Then, a 1 x 1-cm measuring piece of skin and subcutaneous tissue was excised in the apex of the axilla, divided into three samples--altogether, 129 samples--and processed for histologic examination.


RESULTS
In the dermis, the authors found only very few eccrine (average, 0.3 gland/cm in only 12 percent of all patients) and apocrine glands (average, 0.1 gland/cm in only 4.7 percent of patients), and no apoeccrine glands in any patient. In the subcutaneous tissue, the mean number of glands per centimeter squared was 10 for the eccrine glands, nine for the apocrine glands, and six for the apoeccrine glands.


CONCLUSIONS
In the authors' Caucasian subjects, all or most of the sweat glands were found in the subcutaneous tissue near the border to the dermis and not in the dermis. For extremely hyperfunctioning sweat glands, the authors recommend less radical surgical methods, with the preservation of skin, based on the knowledge that most glands are localized in the subcutaneous tissue.
Beer
Gertrude M
GM
Division for Plastic, Hand, and Reconstructive Surgery, Department of Surgery, Institute of Clinical Pathology, University Hospital Zurich, Zurich, Switzerland. gertrude.beer@access.unizh.ch
Baumüller
Stephan
S
Zech
Nicolas
N
Wyss
Pius
P
Strasser
Doris
D
Varga
Zsuzsanna
Z
Seifert
Burkhardt
B
Hafner
Jürg
J
Mihic-Probst
Daniela
D
D000328:Adult; D000368:Aged; D001050:Apocrine Glands / Q000033:anatomy & histology / Q000737:chemistry / Q000378:metabolism; D001365:Axilla / Q000033:anatomy & histology*; D015415:Biomarkers; D002352:Carrier Proteins / Q000032:analysis; D020405:Dermis / Q000033:anatomy & histology; D004439:Eccrine Glands / Q000033:anatomy & histology / Q000737:chemistry / Q000378:metabolism; D005260:Female; D006023:Glycoproteins / Q000032:analysis; D006801:Humans; D016256:Lewis X Antigen / Q000032:analysis; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008297:Male; D008545:Melanoma / Q000556:secondary / Q000601:surgery; D026901:Membrane Transport Proteins; D008875:Middle Aged; D009928:Organ Specificity; D009418:S100 Proteins / Q000032:analysis; D040521:Subcutaneous Tissue / Q000033:anatomy & histology; D013542:Sweat / Q000378:metabolism; D013545:Sweat Glands / Q000033:anatomy & histology* / Q000737:chemistry / Q000378:metabolism; D013546:Sweating
D015415:Biomarkers; D002352:Carrier Proteins; D006023:Glycoproteins; D016256:Lewis X Antigen; D026901:Membrane Transport Proteins; C488892:PIP protein, human; D009418:S100 Proteins