[A clinico-physiological analysis of essential hyperhidrosis]

Area of Science:

• Neurology
• Dermatology
• Psychology

Background:

• Essential hyperhidrosis (EH) is a condition characterized by excessive sweating.
• Previous research suggests autonomic nervous system (ANS) dysfunction in EH.
• Understanding the specific ANS involvement in different EH subtypes is crucial for targeted treatment.

Purpose of the Study:

• To differentiate between permanent EH (PEH) and remitting EH (REH) based on ANS dysfunction.
• To investigate the role of suprasegmental and segmental ANS involvement in EH pathogenesis.
• To explore the potential role of denervation hypersensitivity in PEH.

Main Methods:

• Comparative analysis of 30 EH patients and 20 healthy controls.
• Categorization of EH patients into PEH and REH groups based on clinical data.
• Assessment of anxiety levels (reactive and personality) using MIL test scales.
• Evaluation of sympathetic nervous system function through evoked cutaneous sympathetic potentials, cardiovascular effects, and diurnal catecholamine excretion.

Main Results:

• Both PEH and REH patients exhibited suprasegmental ANS disorders, indicated by increased anxiety and MIL test scores.
• PEH patients additionally showed segmental vegetative disorders, including reduced conduction in sweating fibers, diminished cardiovascular sympathetic effects, and lower diurnal catecholamine excretion.
• Reduced conduction in sympathetic sweating fibers was observed in PEH patients.

Conclusions:

• Essential hyperhidrosis comprises two distinct forms: PEH and REH, differing in the extent of suprasegmental and segmental ANS involvement.
• PEH is associated with segmental autonomic dysfunction, specifically in sweating pathways.
• Denervation hypersensitivity to blood catecholamines is implicated in the pathogenesis of PEH.