Hyperhidrosis



Hyperhidrosis


George Kontochristopoulos

Andreas Katsambas

Dimitrios Rigopoulos



BACKGROUND

Hyperhidrosis is a dermatologic condition characterized by excessive and uncontrolled sweating, more than required for regulation of body temperature.1,2 Prevalence estimates of hyperhidrosis in different studies range from 0.6% to 17%.3,4 A large epidemiological survey in the United States that included 150 000 households reported a prevalence of 2.8%.5 The disease most commonly occurs among people aged 25 to 64 years. Of these, approximately 1.4% present with axillary hyperhidrosis. Men and women are equally affected. In a recent study, using epidemiological data from UK and US health care databases, the lifetime prevalence of hyperhidrosis was calculated to be between 1% and 1.6%.6


PRESENTATION

Patients with hyperhidrosis present with a chief complaint of excessive sweating. The excessive perspiration is most often reported to occur in the underarms, palms, or soles and less commonly other anatomic sites. In some cases, patients may report that it occurs following certain triggers, such as eating, or postsurgically in circumstances involving nerve damage.




PATHOGENESIS

The etiology of primary hyperhidrosis is not well understood. Positive family history has been reported in 34.1% to 65% of patients, suggesting a genetic predisposition.9,10,11,12

There is evidence that primary hyperhidrosis is inherited in an autosomal dominant mode of transmission with incomplete disease penetrance.13 The loci 14q11.2-q13 and 2q31.1, identified in Japanese and Chinese populations, respectively, have been associated with primary hyperhidrosis.14,15,16 Moreover, several genetic disorders are associated with hyperhidrosis, such as pachydermoperiostosis, pachyonychia congenita, ectodermal dysplasia, Book syndrome, Meleda disease, nail patella syndrome, and inflam-matory familiar palmoplantar keratoderma, among others.

Primary hyperhidrosis has been speculated to result from hyperactivity of the sympathetic nervous system due to emotional or thermal stimuli leading to overstimulation of the eccrine sweat glands. In addition, anatomical/histological changes, as well as metabolic, enzymatic, and neurological dysfunctions, have been observed in patients with primary hyperhidrosis, thus indicating a complex etiopathogenesis.17,18,19,20,21 Other trigger factors include spicy foods, drinks, alcohol, caffeine, and smells.

Secondary hyperhidrosis can be related to any number of underlying conditions, such as infections; endocrine, metabolic, neurologic, cardiovascular, and respiratory disorders; spinal cord injury; tumors; drugs; anxiety; and stress.1,2 It can commence at any point of life, and there is no gender predilection.

Jun 29, 2020 | Posted by in Dermatology | Comments Off on Hyperhidrosis
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