Palmoplantar Hyperhidrosis

Palmoplantar hyperhidrosis refers to excessive sweating that primarily affects the palms of the hands and the soles of the feet. It’s a form of focal hyperhidrosis, often idiopathic, meaning its exact cause is unknown. This condition can start in childhood or adolescence and continue into adulthood. Palmoplantar hyperhidrosis can have a profound impact on both the physical and psychological aspects of life, from difficulty in handling objects to social embarrassment.

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Key Points

What is palmoplantar hyperhidrosis?

Palmoplantar hyperhidrosis is the excessive and uncontrollable sweating of the hands and feet. Unlike generalised hyperhidrosis, it’s localised to these specific areas and is more commonly not associated with an underlying medical condition.

Who gets palmoplantar hyperhidrosis?

This condition can affect individuals of any age, but it typically begins in childhood or adolescence. There’s no clear gender predisposition. A family history of hyperhidrosis may increase the likelihood of developing the condition.

Clinical features

Symptoms include excessive sweating that can make the skin appear white or macerated, and may lead to skin peeling. This sweating is often exacerbated by stress or warm temperatures and can interfere with everyday tasks like writing, walking, or using electronic devices.

Diagnosis and differential diagnosis

Diagnosis is generally based on the clinical presentation. Tests are only occasionally conducted to rule out secondary causes. It’s important to differentiate palmoplantar hyperhidrosis from other conditions that cause excessive sweating, such as thyroid issues or infections.

Impact and complications

The condition can significantly affect daily activities, social life, and employment. Constant moisture can lead to skin breakdown, infections, and discomfort. It also poses substantial emotional and psychological challenges.

Treatment Options for Palmoplantar Hyperhidrosis

The approach to treating palmoplantar hyperhidrosis centers on reducing excessive sweating and minimising its impact on daily activities. Topical treatments, such as aluminium chloride hexahydrate in higher concentrations and compounded anticholinergic creams, are commonly employed. Iontophoresis, which involves the use of a mild electrical current, is another treatment option. Anti-sweat injections have been proven effective in reducing sweat production, though they may be costly and painful. For more severe cases, oral medications, specifically anticholinergics, are prescribed. In extreme cases, sympathectomy surgery may be considered, although it carries significant risks. While treatments can effectively manage symptoms of palmoplantar hyperhidrosis, their effectiveness and the duration of relief vary among individuals.

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