Hyperhidrosis—aetiopathogenesis, diagnosis, clinical symptoms and treatment

Abstract

Although primary hyperhidrosis is a common disease, secondary symptomatic hyperhidrosis is rather rare. Primary hyperhidrosis is a complex neuropathic dysregulation with a genetic predisposition and is diagnosed when patients show pathologic sweating patterns and excessive sweating for at least 6 months and fulfill at least four of the following criteria: affected areas are axillae and/or palms and/or soles and/or forehead; symmetry; no night sweating; at least once a week; onset before the age of 25; positive family history; negative impact on daily activities. Frequently used therapies are topical aluminum salts and anticholinergics, iontophoresis in water, and intracutaneous botulinum toxin. Anticholinergics are also used as systemic treatment. Surgical procedures are used as a last result. Furthermore procedures using thermolysis have been developed.

Hyperhidrosis: A Central Nervous Dysfunction of Sweat Secretion

“…In contrast, secondary HH occurs as a result of an underlying disease, such as endocrine disorders, infections, or neurologic diseases [1,5]. Accordingly, the pathological mechanisms of secondary HH are largely determined by the underlying condition [3]. In the generalized form of HH, it can be difficult to differentiate between primary and secondary HH, and further screening may be required.…”

“…Systemic oral medication, such as anticholinergics, may be considered; however, the use of such medications are limited by systemic anticholinergic side effects. In some countries, endoscopic thoracic sympathectomy is used as last option, which, although rare, may be associated with serious side effects [3,9,22,26,54]. For focal axillary HH a variety of local surgical procedures have been described, ranging from curettage, laser-assisted ablation to partial and radical excision techniques [54][55][56][57].…”

“…The term ‘excessive’ is usually based on descriptions of symptoms recorded from patients’ medical histories and can therefore lead to the impression that HH can be reduced to a mere problem of sweat amount [ 2 ]. However, HH is a complex neuronal dysregulation involving an alteration in the control mechanisms of sweating that results in a mismatch between the required and actual sweat production [ 2 , 3 ].…”

Hiperhidrozė: Klasifikacija, Diagnostika Ir Gydymas

“…Pirminės HH diagnostika remiasi paciento HIPERHIDROZĖ: KLASIFIKACIJA, DIAGNOSTIKA IR GYDYMAS Ieva Jasponytė Vilniaus universiteto Medicinos fakultetas anamneze, klinika ir papildomais testais, esant poreikiui: jodo ir krakmolo testas paveiktos anatominės lokalizacijos dydžiui bei gravimetrija prakaito kiekiui išmatuoti [3]. Pirminė HH diagnozuojama, kai matomas padidėjęs prakaitavimas be aiškios priežasties tęsiasi daugiau negu 6 mėnesius ir pacientas atitinka 4 ar daugiau iš šių kriterijų: paveiktos pažastys ir (ar) delnai, ir (ar) pėdos, ir (ar) kakta, būdinga simetrija, nėra naktinio prakaitavimo, padidėjęs prakaitavimas bent kartą per savaitę, ligos pradžia iki 25 gyvenimo metų, teigiama šeimos anamnezė, padidėjęs prakaitavimas trukdo kasdienei veiklai [4].…”

Comparison of a novel aluminum lactate‐based with an aluminum chloride‐based antiperspirant in excessive axillary and inguinal perspiration: first randomized controlled trial

“…The primary anhidrotic mode of action of aluminum salts such as aluminum chloride hexahydrate relies on the blockage of the eccrine sweat ducts. Their long-term use may even lead to an atrophy of the glandular secretory cells, thereby reducing the actual sweat production [8].…”