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]
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Student Independent Investigation: Inherited Palmoplantar Keratoderma
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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]
See also
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.
Further reading
- Iwase, Satoshi; Ikeda, Takehiko; Kitazawa, Hiroki; Hakusui, Shigetaka; Sugenoya, Junichi; Mano, Tadaaki (1997). "Altered response in cutaneous sympathetic outflow to mental and thermal stimuli in primary palmoplantar hyperhidrosis". Journal of the Autonomic Nervous System. 64 (2–3). Elsevier BV: 65–73. doi:10.1016/s0165-1838(97)00014-3. ISSN 0165-1838.
- Eilertsen, Trond; Kvammen, Bjørn Øivind; Grimstad, Øystein (2024). "Botulinum Toxin A and B for Palmoplantar Hyperhidrosis". Dermatology and Therapy. 14 (3): 805–811. doi:10.1007/s13555-024-01113-3. ISSN 2193-8210. PMC 10965841. PMID 38424385.