[Hyperhidrosis-aetiopathogenesis, diagnosis, clinical symptoms and treatment]

Although primary hyperhidrosis is a common disease, secondary symptomatic hyperhidrosis is rather rare. Primary hyperhidrosis is a complex neuropathic dysregulation with a genetic predisposition and is diagnosed when patients show pathologic sweating patterns and excessive sweating for at least 6 months and fulfill at least four of the following criteria: affected areas are axillae and/or palms and/or soles and/or forehead; symmetry; no night sweating; at least once a week; onset before the age of 25; positive family history; negative impact on daily activities. Frequently used therapies are topical aluminum salts and anticholinergics, iontophoresis in water, and intracutaneous botulinum toxin. Anticholinergics are also used as systemic treatment. Surgical procedures are used as a last result. Furthermore procedures using thermolysis have been developed.