What is the cause of strong foot odor, also known as bromhidrosis (Hyperhidrosis)?

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Last updated: February 26, 2025View editorial policy

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Differential Diagnosis for Strong Foot Odour

  • Single most likely diagnosis
    • Hyperhidrosis: This condition is characterized by excessive sweating, which can lead to strong foot odour due to the bacterial breakdown of sweat. It is a common condition that affects many people, making it the most likely diagnosis.
  • Other Likely diagnoses
    • Poor foot hygiene: Infrequent washing of the feet, especially between the toes, can lead to the accumulation of bacteria and fungi, causing strong odour.
    • Fungal infections (e.g., athlete's foot): Fungal infections can cause foot odour due to the breakdown of skin cells and sweat by fungi.
    • Bacterial infections (e.g., pitted keratolysis): Certain bacterial infections can cause foot odour by breaking down sweat and skin cells.
  • Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
    • Diabetes: Uncontrolled diabetes can lead to foot ulcers and infections, which can cause strong foot odour. If left untreated, these infections can lead to serious complications, including amputation.
    • Peripheral artery disease: This condition can cause poor circulation to the feet, leading to tissue death and strong odour. If left untreated, it can lead to gangrene and amputation.
  • Rare diagnoses
    • Isovaleric acidemia: This is a rare genetic disorder that affects the breakdown of certain amino acids, leading to the production of isovaleric acid, which can cause strong foot odour.
    • Trimethylaminuria: This is a rare genetic disorder that affects the breakdown of trimethylamine, a compound found in certain foods, leading to strong body odour, including foot odour.
    • Eczema (dyshidrotic eczema): This is a rare type of eczema that affects the feet and can cause strong foot odour due to the breakdown of skin cells and sweat.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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