Palmar hyperhidrosis: clinical, pathophysiological, diagnostic and therapeutic aspects

Abstract

Palmar hyperhidrosis affects up to 3% of the population and inflict significant impact on quality of life. It is characterized by chronic excessive sweating, not related to the necessity of heat loss. It evolves from a localized hyperactivity of the sympathetic autonomic system and can be triggered by stressful events. In this study, the authors discuss clinical findings, pathophysiological, diagnostic and therapeutic issues (clinical and surgical) related to palmar hyperhidrosis.

Early investigations in drug delivery of onabotulinum toxin A using combined fractional ablative laser with impact ultrasound vs. injections of onabotulinum toxin A for palmar hyperhidrosis: a right-left comparison trial

“…Palmar hyperhidrosis is a common disorder with substantial negative impact on quality of life . Palliative nonsurgical treatments include antiperspirants, iontophoresis, oral anticholinergic drugs and intradermal injection of botulinum toxin (BTX) . Antiperspirants, although convenient, require repeated applications and cause skin irritations.…”

“…Despite the high efficacy of BTX injections for palmar hyperhidrosis, pain can be a major limitation of treatment. Thoracoscopic sympathectomy is well indicated for idiopathic palmar hyperhidrosis, although there may be compensatory sweating elsewhere …”

“…Thoracoscopic sympathectomy is well indicated for idiopathic palmar hyperhidrosis, although there may be compensatory sweating elsewhere. 1,2 In recent years, LADD has been reported to enhance uptake of several drugs. [4][5][6] The use of ablative fractional laser drug delivery of BTX was previously reported for treatment of periorbital wrinkles, 7 but this is the first trial of LADD for palmar hyperhidrosis to be reported in the literature.…”

The Influence of Body Mass Index on the Outcomes of Video-assisted Thoracoscopic Sympathectomy for Primary Hyperhidrosis Patients

“…The diagnosis of PH is mainly clinical, with a history of excessive sweating in affected areas, starting in childhood for most of the patients and increasing in severity at the ages of hormonal and sexual maturation during adolescence (Romero, Haddad, Miot, & Cataneo, 2016). The severity of hyperhidrosis has been linked to several factors, such as ethnic composition, geographical location, climate and body weight.…”

Sudomotor Dysfunction

“…Sweating occurs in the palms and soles but may also involve the axillae and groin. 19 Patients may feel socially embarrassed to shake hands, and in severe cases sweat smears the ink when writing on paper.…”