The strong sweaty smell of 'apocrine' bromhidrosis seems caused by an enzyme defect in the propionate and butyrate degrading enzymes
The classical view of dermatology regarding the cause of a strong sweaty underarm odor is that a defect function of apocrine sweat glands is present.
As a result dermatologists consider chirurgical removal of the apocrine sweat glands as the only way to treat such an odor.
We made a chemical analysis of clothes of patients using GC-MS. On the outer limit of the GC was a peak in butyric acid shown.
Butyric acid seem to build up in the clothes of patients over time.
When we investigated into the human metabolism regarding butyric acid we found immediately the butyrate degrading enzyme
This enzyme is mostly present in the liver, degrading butyrates (butyric acid salts) which are taken up as main energy source for the large intestinal tract sourced by the bacterial fermentation processes within the gut.
The same pattern applies to propionates (propionic acid salts) which are degradated by the EC 220.127.116.11 enzyme.
As a result it is very likely that a strong 'sweaty' smell which does not disappear after showering is caused by a defect in such enzymes.