Spot Dx — What’s lighting up these follicles?

Pat is a 31-year-old accountant who presents complaining of several months of progressively malodourous underarms.

Pat is a 31-year-old accountant who presents complaining of several months of progressively malodourous underarms.

In the past few weeks he has noticed his axillary hair appears yellow-white in parts. Pat is used to sweating a lot and self-manages with a regular antiperspirant, in addition to regular bathing and laundry.

This offensive odour is new, even though he has not changed any skin or laundry products or self-care routine.