A Case of the Blues: Pseudochromhidrosis in an Adolescent Following Injury.
Alyssa L Kesselman
✦ AI-curated · Sources linked
Case in brief
A 17-year-old female developed intermittent bright blue discoloration of her right elbow and upper arm after prior orthopedic injuries. Evaluation by multiple specialists, including imaging, cardiologic assessment, and laboratory testing, was normal. Bacterial culture suggested a chromogenic organism, supporting a diagnosis of pseudochromhidrosis. The discoloration resolved completely and remained absent after treatment with systemic erythromycin and topical clindamycin.
What made this case unusual
The striking blue discoloration was localized to the arm with prior orthopedic injuries, while extensive imaging and other evaluations were unrevealing; culture instead suggested a chromogenic organism.
Diagnostic / clinical pearl
Include pseudochromhidrosis in the differential diagnosis of unusual skin discoloration; bacterial culture may help identify a chromogenic organism when other evaluations are normal.
Why it matters
Recognizing this possibility early may help avoid unnecessary diagnostic procedures and facilitate timely treatment.