Essential hyperhidrosis—pathogenesis and treatment

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SWEATING normally subserves the important function of body thermo-regulation; however, in hyperhidrosis, sweating is excessive and apparently without useful purpose. The hyperhidrosis is most pronounced on the hands, particularly on the palmar surfaces, although the feet and axillae may be similarly affected. The incidence is most common among teenagers and young adults, though some children are aware of the problem in the first decade of life.

When severe, the condition is most embarrassing socially, particularly when the patient must greet others with a handshake. It may prove to be a serious employment handicap for anyone who must meet and associate with clients in business. It is likewise a serious detriment to those who work with their hands, such as stenographers, artists, and draftsmen, because their creative work is constantly threatened by damage from perspiration.

In advanced cases, when medical treatment fails to control the symptoms, it may prove necessary to perform upper thoracic sympathectomy, which seems to be the most effective means of curing the problem. This paper is a report of seven patients with essential hyperhidrosis who were surgically treated at the Cleveland Clinic Hospital.


The term essential hyperhidrosis is used because the etiology is not known. Sweating may be produced either by exocrine or by exocrine sweat glands. The exocrine glands are confined to the axillary and pelvic regions, and to the areolar area of the nipples, and have no thermoregulatory function. The exocrine glands are located everywhere in the skin and are concerned mainly with thermoregulatory . . .



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