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Hyperhidrosis - Management
Additional information
- Causes of generalized hyperhidrosis include:
- Pregnancy.
- Anxiety.
- Prescribed drugs:
- Anticholinesterases (pyridostigmine, neostigmine).
- Antidepressants (venlafaxine, duloxetine, selective serotonin reuptake inhibitors, tricyclic antidepressants, trazodone, and mirtazapine).
- Pilocarpine (eye drops to treat glaucoma).
- Bethanechol (a bladder stimulant).
- Propanolol.
- Substance or alcohol abuse or withdrawal (see the CKS topic on Alcohol - problem drinking).
- Cardiovascular disorders: heart failure, myocardial ischaemia, shock (see the CKS topics on Heart failure - chronic and Angina).
- Respiratory failure.
- Infections, such as tuberculosis (see the CKS topic on Tuberculosis), and brucellosis (which can cause nocturnal sweating), HIV, abscess, and malaria.
- Malignancy: Hodgkin's disease, myeloproliferative disorders.
- Endocrine or metabolic disorders or conditions: thyrotoxicosis, hypoglycaemia, phaeochromocytoma, acromegaly, carcinoid tumour, hyperpituitarism, obesity, gout, menopause.
- Neurological disorders and lesions: Parkinson's disease, diencephalic epilepsy, hypothalamic lesions.
- Familial dysautonomia (Riley–Day syndrome).
- Causes of secondary focal hyperhidrosis include:
- Neurological disorders, such as stroke (see the CKS topic on Stroke and TIA), peripheral neuropathies, diabetic autonomic neuropathy (see the CKS topic on Diabetes type 2) and other neuropathies, spinal cord lesions, and tumours (all which may directly cause hyperhidrosis, or indirectly result in compensatory hyperhidrosis).
- Intrathoracic neoplasms (e.g. mesothelioma — see the CKS topic on Lung cancer - suspected) or a cervical rib, both of which can cause unilateral hyperhidrosis.
- Gustatory sweating (sweating induced by food or drink) may be due to:
- Diabetic neuropathy (see the CKS topic on Diabetes type 2).
- Herpes zoster of the preauricular area.
- Invasion of the cervical sympathetic trunk by a tumour.
- Injury or surgery to the parotid gland such as that experienced in Frey's (auriculotemporal) syndrome.
- Cutaneous disorders: blue rubber-bleb nevus, other eccrine nevus or nevus sudoriferous, sudoriferous angioma, glomus tumour.
- Other: Raynaud's phenomenon, erythromelalgia, arteriovenous fistula, cold injury, rheumatoid arthritis, pachyonychia congenita, pachydermoperiostosis, nail-patella syndrome.
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