Hyperhidrosis - Hyperhidrosis

Japanese: 多汗症 - たかんしょう（英語表記）Hyperhidrosis

What is the disease?

Sweat regulates body temperature. When body temperature rises, sweat is produced, and the heat of evaporation of sweat lowers body temperature. When excessive sweating occurs and the surface of the skin becomes wet with sweat, this condition is called hyperhidrosis (Figure 105).

What is the cause?

There are various types of sweating, such as thermal sweating when the temperature is high, psychological sweating when you are mentally stressed, and gustatory sweating when you eat spicy food.

There are also secondary hyperhidrosis, which occurs when excessive sweating is caused by a disease, and primary hyperhidrosis, which occurs in healthy people without any particular disease. Furthermore, there are generalized hyperhidrosis, where the areas of excessive sweating spread all over the body, and localized hyperhidrosis, where sweating is increased in certain parts of the body.

How symptoms manifest

Localized hyperhidrosis is often Armpit ( Armpit ) These areas are known as psychological sweating areas, and mental stress increases sweating. drop ( Dripping ) Some people sweat so much that their hands drip off their hands. People with excessive palm sweating have trouble with documents getting wet because anything they touch gets wet with their sweat. They may also avoid touching other people and feel inferior.

Excessive sweating on the soles of your feet can cause odor, Tinea pedis ( Foot pain ) (athlete's foot) and bacterial infections. Hyperhidrosis of the hands and feet occurs most often in otherwise healthy young people.

In generalized hyperhidrosis, infectious diseases, endocrine and metabolic diseases, Collagen disease ( Public health center ) It may be caused by a malignant tumor, a central nervous system disease, etc. There is also primary generalized hyperhidrosis without any particular underlying disease.

Testing and diagnosis

If you have a lot of sweating, you can judge whether you have excessive sweating or not just by looking at it or touching it with your hands. To make an objective judgment or to evaluate the effectiveness of treatment, you can measure the amount of sweating using iodine paper, which turns blue-purple when it absorbs sweat, or a sweat recorder.

In the case of generalized hyperhidrosis, we will look for the underlying disease. If hyperthyroidism is suspected, we will perform a thyroid function test. Pheochromocytoma ( Classy smell prevention ) When this is suspected, catecholamine metabolites in the urine are measured.

Treatment methods

Treatments for hyperhidrosis include topical medication, tap water iontophoresis, intradermal injection of botulinum toxin, and sympathetic nerve blocking treatment. Each treatment has its own advantages and disadvantages, and there is no definitive treatment.

Topical medications include aluminum chloride solution and benzalkonium chloride solution. Topical medications are applied once a day before going to bed.

Tap water iontophoresis is a suitable method for treating hyperhidrosis of the palms, soles, and armpits. The sweaty areas are immersed in tap water and a direct current is passed through them. When treatment is stopped, sweating returns to normal. Battery-powered devices for tap water iontophoresis are available on the market.

When botulinum toxin is injected into the skin, it stops sweating at the injection site. The effects of botulinum toxin last for 3 to 4 months.

If the symptoms of excessive palm sweating are severe, there is a procedure called thoracic sympathectomy using a thoracoscope. This method can definitely stop palm sweating, but it has a drawback that many people Compensatory hyperhidrosis ( Taisho eradication ) Compensatory hyperhidrosis is when excessive sweating appears on other parts of the body (such as the back or stomach).

What to do if you notice an illness

Palmar hyperhidrosis tends to appear during puberty and becomes milder as you grow older. There are various treatments available, each with its own advantages and disadvantages, so it is important to choose the most suitable method.

Kenji Saga

Figure 105 Palmar hyperhidrosis
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Figure 105 Palmar hyperhidrosis

Source: Houken “Sixth Edition Family Medicine Encyclopedia” Information about the Sixth Edition Family Medicine Encyclopedia

Japanese:

どんな病気か

　汗は体温調節を行っています。体温が上がると汗が出て、汗の気化熱で体温を下げます。必要以上に汗が出て皮膚の表面が汗で濡れてしまう状態を多汗症といいます（図105）。

原因は何か

　汗には、温度が高い時に出る温熱性発汗、精神的に緊張した時に出る精神性発汗、辛いものを食べた時に出る味覚性発汗などがあります。

　また、原因になる病気があって多汗が生じる続発性多汗症と、とくに病気がなく健康な人に発生する原発性多汗症とがあります。さらに、多汗部位が全身に広がっている全身性多汗症と、体の一部で発汗が増えている限局性多汗症とがあります。

症状の現れ方

　限局性多汗症は、多くは腋(わき)の下、手のひら、足の裏に発生します。これらの部位は精神性発汗部位であり、精神的緊張により発汗が増えます。手から汗が滴(したた)り落ちるほど汗の量が多い人もいます。手のひらの多汗の人は手で触れるものが汗で濡れるために、書類などが濡れて困っています。また、他人に手を触れることを避け、劣等感をもっていることもあります。

　足の裏に多汗があるとにおいの原因になったり、足白癬(あしはくせん)（水虫）や細菌感染を起こしやすくなります。手足の多汗症は、それ以外には病気のない健康な若い人に多く発症します。

　全身性多汗症では感染症、内分泌・代謝性疾患、膠原病(こうげんびょう)、悪性腫瘍、中枢神経疾患などが原因になっていることがあります。とくに原因になる疾患のない原発性全身性多汗症もあります。