Sudoriparous Abscess vs. Axillary Lymphadenitis with Abscess
Left picture: In all probability, a sudoriparous abscess of the axilla is present in the developed girl because apocrine sudoriparous glands are now present as shown in an exemplary histological section (Micrographs of sebaceous glands. www.mc.vanderbilt.edu). It led to a loss of the acid protective film, and therefore, to a local immunodeficiency. Right picture: It is an axillary lymphadenitis with abscess as cause of the swelling and fluctuation in the armpit. Classic sudoriparous gland abscesses do not occur before puberty because the acid protective film is present at this age. On the other hand, multiple abscesses of the eccrine sweat glands can be observed in newborns, infants, and toddlers if they are undernourished or immunodeficient. They are localized precursors of staphylococcal infection on the back of the head, back, and the buttocks, and show multiple papules and pustules with possible progression into the deep layers of the skin.
Left picture: Teenager with a painful swelling of the armpit according to the history and to the local findings, similar to the contralateral picture. The presented picture shows a histological section of part of a sebaceous gland as found in this developed girl. The sebaceous gland lies close to a hair follicle on the right side of the picture and enters the latter in the upper part of the picture. Right picture: Schoolchild with inflammatory swelling of the armpit. Palpation is painful and fluctuation recognizable. An inflammatory focus is present in the corresponding arm. Left picture: This teenager has a local finding with painful and fluctuating inflammatory swelling of the armpit, similar to the contralateral picture, but without visible pus. The girl is developed and has a hairy armpit. Her corresponding arm shows no inflammatory focus.