Hyperhidrosis Definition (Medical Appendix)

DEFINITION

1. Hyperhidrosis is the excessive production of sweat which may be localised or
generalised.

CLINICAL FEATURES

2. In the localised type the most frequent sites are the palms and soles of the
intertriginous areas such as the axillae, inguinal folds, and perineum.
3. The patient may complain of intense discomfort from the excessive sweating, so
much so that in some cases the ability to work is impaired. The skin of the palms and
soles may thicken and develop a blue-grey colour. Nail deformities may occur.

AETIOLOGY

4. Localised hyperhidrosis may be caused by –
4.1. emotional factors such as anxiety, anguish and fear. The degree of excess
sweating is dependent upon the height of emotional excitement.
4.2. tabes dorsalis, acrocyanosis, and some forms of keratoderma, and, when
unilateral, in unilateral nerve disorders such as hemiplegia.
5. Generalised hyperhidrosis may be caused by –
5.1. being in a hot humid environment such as is encountered in the tropics or
simply by warmth.
5.2. febrile illness, including malaria, or exercise.
5.3. hormonal and metabolic disturbance such as hyperthyroidism, diabetes
mellitus, pregnancy and the menopause.
5.4. Concussion, Parkinson’s disease, and other disturbances of the sympathetic
nervous system, including tumours producing transection of the spinal cord, as
well as other irritative lesions of the spine. In these conditions, the excess
sweating may be segmental or unilateral.
5.5. It is not unusual to see increased sweating after long debilitating illnesses in
which weakness is pronounced, including tuberculosis and malignancy.
5.6. Such stimulating agents as caffeine, alcohol, aspirin and the cholinergic drugs
induce hyperhidrosis.
5.7. In some cases hyperhidrosis is a familial disorder.
6. Many cases of hyperhidrosis have no obvious underlying cause and are thus
idiopathic.
7. Gustatory hyperhidrosis deserves special mention. Certain individuals experience
excessive sweating of the forehead, upper lip, perioral region or sternum a few
moments after eating certain foods. It may also be caused by tumours or injury to
the parotid gland.
CONCLUSION

8. Hyperhidrosis is a condition of excess production of sweat which may be localised
or generalised. There are many causes, these having been listed above.
REFERENCES
Champion R H. Disorders of Sweat Glands – Hyperhidrosis. In: (Eds) Champion R H,
Burton J L and Ebling F J G. Textbook of Dermatology. Oxford. Blackwell Scientific
Publications. 5th Ed. 1992:1752-1757.
Ryan T J. Disease of the Skin – Sweating. In: (Eds) Weatherall D J, Ledingham J G G
and Warrell D A. Oxford Textbook of Medicine. Oxford. Oxford University Press. 2nd Ed.
1987:20.56-20.57.
April 1993