Palmoplantar hyperhidrosis

Palmoplantar hyperhidrosis
Palmoplantar hyperhidrosis
	Hyperhidrosis seen on the hands.
Specialty	Dermatology

Palmoplantar hyperhidrosis is excessive sweating localized to the palms of the hands and soles of the feet. It is a form of focal hyperhidrosis in that the excessive sweating is limited to a specific region of the body. As with other types of focal hyperhidrosis (e.g. axillary and craniofacial) the sweating tends to worsen during warm weather.^[1]

Signs and symptoms

Palmoplantar hyperhidrosis is a frequent disorder when excessive amounts of sweat are inappropriately secreted by the eccrine glands in the palms and soles.^[2]

Causes

There is little knowledge about the pathogenesis of focal hyperhidrosis. Focal hyperhidrosis may indicate a complicated autonomic nervous system malfunction involving both parasympathetic and sympathetic pathways.^[3] Given that 30% to 50% of patients have a family history of hyperhidrosis, there may be a genetic susceptibility.^[4]

Diagnosis

Because the excessive sweating is easily noticeable, palmoplantar hyperhidrosis is a clinical diagnosis.^[2]

Treatment

For palmoplantar hyperhidrosis, 20% aluminum chloride hexahydrate in absolute anhydrous ethyl alcohol (Drysol) is the most effective topical treatment.^[4] Other topical treatments such as potassium permanganate, tannic acid (2 to 5 percent solutions), resorcinol, boric acid, formaldehyde, methenamine, and glutaraldehyde have yielded less than desirable results.^[2]

Iontophoresis is a well-known treatment for hyperhidrosis that involves applying a direct electrical current to the skin.^[5] Iontophoresis has been combined with a variety of substances, such as tap water, salt water, and anticholinergic medications.^[6]

Botulinum toxin type A (Botox) injections are safe, efficient, and frequently enhance the quality of life for those who suffer from hyperhidrosis.^[7] The toxin damages the sweat glands' post-ganglionic sympathetic innervation and prevents acetylcholine from being released at the neuromuscular junction.^[8]

References

^ James, William; Berger, Timothy; Elston, Dirk (2005). Andrews' Diseases of the Skin: Clinical Dermatology. (10th ed.). Saunders. ISBN 0-7216-2921-0.
^ ^a ^b ^c Thomas, Isabelle; Brown, Justin; Vafaie, Janet; Schwartz, Robert A. (2004-03-01). "Palmoplantar Hyperhidrosis: A Therapeutic Challenge". American Family Physician. 69 (5): 1117–1121. Retrieved 2024-05-07.
^ Haider, A. (2005-01-04). "Focal hyperhidrosis: diagnosis and management". Canadian Medical Association Journal. 172 (1): 69–75. doi:10.1503/cmaj.1040708. ISSN 0820-3946. PMC 543948. PMID 15632408.
^ ^a ^b Stolman, Lewis P. (1998). "Treatment of Hyperhidrosis". Dermatologic Clinics. 16 (4). Elsevier BV: 863–869. doi:10.1016/s0733-8635(05)70062-0. ISSN 0733-8635. PMID 9891696.
^ Bouman, H. D.; Lentzer, E. M. G. (1952). "The treatment of hyperhidrosis of hands and feet with constant current". American Journal of Physical Medicine. 31 (3): 158–169. ISSN 0002-9491. PMID 14943812.
^ Sato, K.; Timm, D. E.; Sato, F.; Templeton, E. A.; Meletiou, D. S.; Toyomoto, T.; Soos, G.; Sato, S. K. (1993-11-01). "Generation and transit pathway of H+ is critical for inhibition of palmar sweating by iontophoresis in water". Journal of Applied Physiology. 75 (5). American Physiological Society: 2258–2264. doi:10.1152/jappl.1993.75.5.2258. ISSN 8750-7587.
^ Tan, Stephen R.; Solish, Nowell (2002). "Long-Term Efficacy and Quality of Life in the Treatment of Focal Hyperhidrosis with Botulinum Toxin A". Dermatologic Surgery. 28 (6). Ovid Technologies (Wolters Kluwer Health): 495–499. doi:10.1046/j.1524-4725.2002.01159.x. ISSN 1076-0512.
^ Shelley, W.B.; Talanin, N.Y.; Shelley, E.D. (1998). "Botulinum toxin therapy for palmar hyperhidrosis". Journal of the American Academy of Dermatology. 38 (2). Elsevier BV: 227–229. doi:10.1016/s0190-9622(98)70242-7. ISSN 0190-9622. PMID 9486678.