The observed pathophysiology is a keratin plug in the hair follicle infundibulum obstructing the apocrine acrosyringium and producing an apocrine anhidrosis. Histologically, there is a rupture of the apocrine excretory duct and a resulting spongiotic inflammation. Extravasation of sweat and inflammation is postulated to cause the intense itching. Geographic influence is not evident. Many case reports mention heat, humidity, and stress as exacerbating factors.
Patients often suffer greatly from severe pruritus.
Therefore, quality of life may be adversely affected. No racial predilection is evident. This condition frequently appears under conditions of heat, humidity, and friction, often appearing suddenly. Many patients present after decades of symptoms. Few patients are asymptomatic.