Trauma, possible cause of localized unilateral hyperhidrosis of the face?

Abstract

Introduction. Localized unilateral hyperhidrosis (LUH) is a rare disorder of unknown origin, with multiple possible triggering factors and unknown pathogenesis. Although there are cases of LUH of the face reported, this is the first to report isolated ipsilateral hyperhidrosis of the face after blunt force trauma. Case outline. A 54-year old Caucasian woman presented with localized unilateral facial hyperhidrosis (LUH) of five years duration. Ipsilateral blunt trauma of the temple that preceded the condition for three months was identified as the most probable cause. For sharp demarcation the Minor or ?starch-iodine? test is performed which revealed presence and extent of the facial sweating on the left side of the face. Treatment with Sol. 20% aluminium chloride hexahydrate (Retrargin sol.) was conducted with partial response. Conclusion. After ruling out underlying diseases as a cause of LUH, a prior trauma should be considered as a potential cause. The possible mechanism could be the lesion of sympathetic chain as a result of cervical traction due to a facial blunt force trauma, although it cannot be positively proven.