Hyperhidrosis is a medical condition in which a person exhibits excessive sweating, more than is required for the regulation of body temperature. Although it is primarily a physical burden, hyperhidrosis can deteriorate the quality of life of the people who are affected, frequently leading to psychological, physical, and social consequences. Hyperhidrosis can lead to difficulties in professional fields, with more than 80% of patients experiencing moderate to severe emotional effects from the disease. This excess of sweat happens even if the person is not engaging in tasks that require muscular effort, and it does not depend on the exposure to heat. Common places to sweat can include underarms, face, neck, back, groin, feet, and hands. It has been called by some researchers "the silent handicap". Both diaphoresis and hidrosis can mean either perspiration (in which sense they are synonymous with sweating) or excessive perspiration, in which case they refer to a specific, narrowly defined, clinical disorder.
Classification
Hyperhidrosis can either be generalized, or localized to specific parts of the body. Hands, feet, armpits, groin, and the facial area are among the most active regions of perspiration due to the high number of sweat glands (eccrine glands in particular) in these areas. When excessive sweating is localized (e.g. palms, soles, face, underarms, scalp) it is referred to as primary hyperhidrosis or focal hyperhidrosis. Excessive sweating involving the whole body is termed generalized hyperhidrosis or secondary hyperhidrosis. It is usually the result of some other, underlying condition. Primary or focal hyperhidrosis may be further divided by the area affected, for instance, palmoplantar hyperhidrosis (symptomatic sweating of only the hands or feet) or gustatory hyperhidrosis (sweating of the face or chest a few moments after eating certain foods). Hyperhidrosis can also be classified by onset, either congenital (present at birth) or acquired (beginning later in life). Primary or focal hyperhidrosis usually starts during adolescence or even earlier and seems to be inherited as an autosomal dominant genetic trait. It must be distinguished from secondary hyperhidrosis, which can start at any point in life, but usually presents itself after 25 years of age. Secondary hyperhidrosis commonly accompanies conditions such as diabetes mellitus, Parkinson's disease, hyperthyroidism, hyperpituitarism, anxiety disorder, pheochromocytoma, and menopause. One classification scheme uses the amount of skin affected. In this scheme, excessive sweating in an area of 100 cm2 (16 in2) or more is differentiated from sweating that affects only a small area. Another classification scheme is based on possible causes of hyperhidrosis.
Causes The cause of primary hyperhidrosis is unknown. Anxiety or excitement can exacerbate the condition. A common complaint of people is a nervous condition associated with sweating, then sweating more because the person is nervous. Other factors can play a role, including certain foods and drinks, nicotine, caffeine, and smells. Similarly, secondary (generalized) hyperhidrosis has many causes including certain types of cancer, disturbances of the endocrine system, infections, and medications.
Primary
Primary (focal) hyperhidrosis has many causes.
Idiopathic unilateral circumscribed hyperhidrosis Reported association with: Blue rubber bleb nevus Glomus tumor POEMS syndrome Burning feet syndrome (Gopalan's) Trench foot Causalgia Pachydermoperiostosis Pretibial myxedema Gustatory sweating associated with: Encephalitis Syringomyelia Diabetic neuropathies Herpes zoster (shingles) Parotitis Parotid abscesses Thoracic sympathectomy Auriculotemporal or Frey's syndrome Miscellaneous Lacrimal sweating (due to postganglionic sympathetic deficit, often seen in Raeder's syndrome) Harlequin syndrome Palmoplantar hyperhidrosis
Cancer A variety of cancers have been associated with the development of secondary hyperhidrosis including lymphoma, pheochromocytoma, carcinoid tumors (resulting in carcinoid syndrome), and tumors within the thoracic cavity.
Endocrine Certain endocrine conditions are also known to cause secondary hyperhidrosis including diabetes mellitus (especially when blood sugars are low), acromegaly, hyperpituitarism, pheochromocytoma (tumor of the adrenal glands, present in 71% of patients) and various forms of thyroid disease.
Medications Use of selective serotonin reuptake inhibitors (e.g., sertraline) is a common cause of medication-induced secondary hyperhidrosis. Other medications associated with secondary hyperhidrosis include tricyclic antidepressants, stimulants, opioids, nonsteroidal anti-inflammatory drugs (NSAIDs), glyburide, insulin, anxiolytic agents, adrenergic agonists, and cholinergic agonists.
Miscellaneous In people with a history of spinal cord injuries Autonomic dysreflexia Orthostatic hypotension Posttraumatic syringomyelia Associated with peripheral neuropathies Familial dysautonomia (Riley-Day syndrome) Congenital autonomic dysfunction with universal pain loss Exposure to cold, notably associated with cold-induced sweating syndrome Associated with probable brain lesions Episodic with hypothermia (Hines and Bannick syndrome) Episodic without hypothermia Olfactory Associated with systemic medical problems Parkinson's disease Fibromyalgia Congestive heart failure Anxiety Obesity Menopausal state Night sweats Compensatory Infantile acrodynia induced by chronic low-dose mercury exposure, leading to elevated catecholamine accumulation and resulting in a clinical picture resembling pheochromocytoma. Febrile diseases Vigorous exercise A hot, humid environment
Diagnosis Symmetry of excessive sweating in hyperhidrosis is most consistent with primary hyperhidrosis. To diagnose this condition, a dermatologist gives the person a physical exam. This includes looking closely at the areas of the body that sweat excessively. A dermatologist also asks very specific questions. This helps the physician understand why the person has excessive sweating. Sometimes medical testing is necessary. Some patients require a test called the sweat test. This involves coating some of their skin with a powder that turns purple when the skin gets wet. Excessive sweating affecting only one side of the body is more suggestive of secondary hyperhidrosis and further investigation for a neurologic cause is recommended.
… excerpt ends here. Continue reading the full article.
