Contents
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Overview Overview
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Physiology Physiology
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Central Control of Sweating Central Control of Sweating
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Thermoregulatory Sweating Thermoregulatory Sweating
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Emotional Sweating Emotional Sweating
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Sympathetic Control of Sweating Sympathetic Control of Sweating
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Sweat Gland Physiology Sweat Gland Physiology
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Assessment of Sudomotor Function Assessment of Sudomotor Function
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Thermoregulatory Sweat Test Thermoregulatory Sweat Test
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Sudomotor Axon Reflex Tests Sudomotor Axon Reflex Tests
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Punch Skin Biopsy Punch Skin Biopsy
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Anhidrosis Anhidrosis
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General Concepts General Concepts
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Representative Case Representative Case
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Multiple System Atrophy Multiple System Atrophy
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Autonomic Ganglionopathy Autonomic Ganglionopathy
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Small Fiber Neuropathies Small Fiber Neuropathies
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Ross Syndrome Ross Syndrome
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Isolated Acquired Idiopathic Anhidrosis Isolated Acquired Idiopathic Anhidrosis
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Focal Central Nervous System Disorders Focal Central Nervous System Disorders
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Drug-Induced Anhidrosis Drug-Induced Anhidrosis
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Management Management
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Hyperhidrosis Hyperhidrosis
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Representative Case Representative Case
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Generalized Hyperhidrosis Generalized Hyperhidrosis
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Neurologic Causes Neurologic Causes
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Medical Disorders Medical Disorders
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Primary Focal Hyperhidrosis Primary Focal Hyperhidrosis
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Primary Focal or Essential Hyperhidrosis Primary Focal or Essential Hyperhidrosis
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Postmenopausal Hyperhidrosis Postmenopausal Hyperhidrosis
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Idiopathic Unilateral Circumscribed Hyperhidrosis Idiopathic Unilateral Circumscribed Hyperhidrosis
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Idiopathic Paroxysmal Localized Hyperhidrosis Idiopathic Paroxysmal Localized Hyperhidrosis
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Cold-Induced Hyperhidrosis Cold-Induced Hyperhidrosis
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Compensatory Hyperhidrosis Compensatory Hyperhidrosis
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Secondary Facial Hyperhidrosis Secondary Facial Hyperhidrosis
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Gustatory Sweating Gustatory Sweating
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Lacrimal Sweating Lacrimal Sweating
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Harlequin Syndrome Harlequin Syndrome
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Focal Hyperhidrosis Associated with Intrathoracic Mass Lesions Focal Hyperhidrosis Associated with Intrathoracic Mass Lesions
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Hyperhidrosis Associated with Focal Central Nervous System Lesions Hyperhidrosis Associated with Focal Central Nervous System Lesions
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Drug-Induced Hyperhidrosis Drug-Induced Hyperhidrosis
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Management Management
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Anticholinergic Drugs Anticholinergic Drugs
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Clonidine Clonidine
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Topiramate Topiramate
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Aluminum Chloride Aluminum Chloride
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Iontophoresis Iontophoresis
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Botulinum Toxin Botulinum Toxin
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Local Excision Local Excision
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Sympathetic Denervation Sympathetic Denervation
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References References
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Cite
Abstract
Disorders of sweating can be subdivided into two main groups, anhidrosis (deficient sweating) and hyperhidrosis (excessive sweating). Both anhidrosis and hyperhidrosis may have a generalized, regional, or focal distribution. Distal anhidrosis is typical of peripheral neuropathy. Global anhidrosis occurs in disorders such as multiple system atrophy or widespread autonomic ganglionopathy or neuropathy but it may also be idiopathic. Hyperhidrosis may be generalized or localized and may be primary, compensatory, or symptomatic of a central or peripheral lesion. Commonly used drugs can produce anhidrosis or hyperhidrosis. The distribution of sweating abnormalities is assessed by history, examination, thermoregulatory sweat test and sudomotor axon reflex tests. Primary (essential) focal hyperhidrosis affects the palms, soles, axilla, or face and may be socially disabling. Treatment of essential hyperhidrosis includes oral muscarinic antagonists or clonidine, topical aluminum chloride, iontophoresis, botulinum toxin A, sweat gland excision, and sympathectomy or sympathectomy (mainly for palmar hyperhidrosis).
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