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Oily Skin / Hyperhidrosis (Excess Sweating)
Hyperhidrosis is excessive sweating. classified as (a) generalised, and (b) localised
CAUSES OF EXCESS SWEATING ARE:
A. Generalised hyperhidrosis or hyperhidrosis of a relatively large area 1. Exercise 2. Environmental exposure to heat 3. Drugs and drug poisoning: Antipyretics, emetics, insulin, meperedine, antidepressants (cyclobenzaprine, fluoxetine), systemic cholinergic agents and prostigmine, or poisoning with mercury, arsenic, insecticides and herbicides. 4. Systemic disorders a. Infection, e.g. febrile illnesses (defervescent phase), chronic illnesses (tuberculosis, malaria and brucellosis). b. Cardiovascular disorders, e.g. shock, congestive heart failure, endocarditis and vasculitis. c. Neurological disorders, e.g. Parkinsonism, post-encephalitic (‘sweating sickness’), dysautonomic states. d. Endocrine disorders, e.g. hyperpituitarism, hyperthyroidism, diabetes. Insipidus. e. Neoplasm, e.g. Lymphoma, carcinoid syndrome, insulinoma and pheochromocytoma. f. Nutritional and metabolic disorders and others: Diabetes mellitus, hypoglycemia, porphyria, obesity, gout rickets, infantile scurvy, debility, alcoholism. Drug withdrawal in drug addicts, pregnancy, menopause and anxiety.
5. Compensatory hyperhidrosis a. Diabetes mellitus with neuropathy. b. After sympathectomy. c. Associated with diffuse anhidrosis, e.g. extensive miliaria rubra. d. Perilesional hyperhidrosis surrounding an anhidrotic area, e.g. quinacrine dermatitis.
6. Associated with past history of spinal cord injuries
7. Associated with peripheral neuropathies a. Hereditary sensory neuropathy type III (Familial dysautonomia or Riley-Day syndrome).
8. Associated with probable brain lesions a. Episodic hyperhidrosis with hypothermia (Hines-Bannick syndrome). b. Episodic hyperhidrosis without hypothermia. c. Episodic hyperhidrosis with hypertension after brain injury. d. Olfactory hyperhidrosis (facial Sweating from perfume smells).
10. Others Indiopathic, emotional, post-orgasmic, exposure to cold.
B. Localised hyperhidrosis or hyperhidrosis of a relatively small area
a. Physiological. b. Pathological: Associated with encephalitis, syringomyelia, Pancoast’s syndrome, cervical sympathectomy, upper dorsal sympathectomy, upper dorsal sympathectomy, diabetic neuropathies, herpes zoater of preauricular area, parotitis or parotid adscesses, fre’y syndrome.
Volar Hyperhidrosis (Hyperhidrosis fo Palms and Soles) Excessive sweating of palms and soles is often a cause of social embarrassment but can also be a source of disability at work, play or studies. palmoplantar keratoderma with clinodactyly, nail-patella syndrome, Raynaud’s disease, erythromelalgia, AV fistula, cold injury and rheumatoid arthritis. Axillary Hyperhidrosis Gustatory Hyperhidrosis Auriculotemporal syndrome or Frey’s Syndrome Night sweat
INVESTIGATION OF HYPERHIDROSIS sweat visualization methods
TREATMENT Anticholinergic druss Propantheline bromide Calcium channel blockers Sedatives tranquilizers Amitryptiline Clonidine hydrochloride Indomethacin psychotherapy and biofeedback Topical Treatment aluminium chloride hexahydrate in anhydrous ethyl alcohol, Local applications of anticholinergic drugs Iontophoresis Tap water iontophoresis Surgical Treatment Hurley—Shelley surgical technique72 Odous in Human Skin Bromhidrosis or osmidrosis is malodorous or offensive sweating. Axillarry Keratinogenic Plantar Intertrigionous Metabolic Heritable aminoacidurias Exogenous Foods, drugs, chemicals result from bacterial alteration of apocring sweat and is largely axillary in origin. Scrupulous cleaning germicida soap, topical bacteriostatic or bactericidal agents metallic aluminum, zircominum, zinc salts or hexachlorophene. Topical aluminium chloride Apocrine chromhidrosis (true chromhidrosis)is secretion of coloured apocrine sweat
Topical Treatment antimicrobials Antiperspirants topical antiperspirant hexahydrated aluminum chloride in 20-25% solution in absolute ethanol. Anticholinergic topical drugs Iontopgoresis Anticholinergic drugs Ganglion-blocking drugs Others Ditiazem Surgical treatments Botulinum A toxin subcutaneous injection.
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