Hyperhidrosis

From Anvita Health Wiki

Contents 1 More Specific Terms 2 Introduction 3 Classification 4 Etiology 5 Epidemiology 6 Clinical-manifestations 7 Laboratory 8 Management 9 More General Terms 10 Additional Terms 11 References

More Specific Terms

• diaphoresis
• night sweats

Introduction

• Excessive exocrine sweating ( perspiration).

Classification

• localized hyperhidrosis

• palmar/ plantar hyperhidrosis
• axillary hyperhidrosis

• more dependent upon temperature than palmar/ plantar hyperhidrosis
• may occur concurrently with palmar/ plantar hyperhidrosis

• compensatory hyperhidrosis around leg ulcers
• isolated patches on glabrous skin

• generalized hyperhidrosis

Etiology

• localized sweating of palms & or soles or axillae

• idiopathic
• anxiety
• neurologic

• generalized hyperhidrosis

• fever of any etiology
• neurologic diorders

• spinal cord injuries
• peripheral neuropathies
• CNS lesions

• endocrine disorders

• hyperthyroidism
• diabetes mellitus
• pheochromocytoma

• hypoglycemia*
• serotonin syndrome
• hypotension
• menopause
• anxiety
• alcohol
• night sweats ( nocturnal diaphoresis)

• pharmacologic agents

• antidepressants

• venlaxafine, bupropion, SSRI, tricyclic antidepressants, duloxetine, opiates, clozapine, cholinergic agonists, nitrates, nitroprusside, nicotine, propafenone, fludarabine

• drug withdrawal - clonidine

• allergic drug reactions
• * beta-blocker do NOT block perspiration response to hypoglycemia

Epidemiology

• threshold of what prompts patient to complain of hyperhidrosis varies with individual

Clinical-manifestations

• axillary hyperhidrosis is independent of axillary odor
• social & emotional embarrassment
• staining of clothing
• reduction of self esteem
• occupational disability

• inability to handle intruments, tools or paper ( palmar hypehidrosis)

Laboratory

• no objective clinical testing is indicated, unless systemic cause is suspected

Management

• localized sweating of palms & or soles or axillae
• aluminum-containing antiperspirants
• systemic anticholinergic agent

• propantheline: start 15 mg PO TID
• doses sufficient to suppress hyperhidrosis often associated with unacceptable side effects

• iontophoresis
• surgery

• excision of axillary skin
• thoracic sympathectomy is a last resort

• botulinum toxin injection for axillary hyperhydrosis

• 50 U single dose in each axilla

More General Terms

• perspiration (sweating)

Additional Terms

• anhidrosis (adiaphoresis)

References

1. Stedman's Medical Dictionary 26th ed, Williams & Wilkins, Baltimore, 1995
2. Saunders Manual of Medical Practice, Rakel (ed), WB Saunders, Philadelphia, 1996, pg 928-929

hyperhidrosis