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03-03-2011 | Article

Criteria for differentiating primary from secondary hyperhidrosis identified


Free abstract

MedWire News: A researcher has identified the symptoms that help distinguish primary hyperhidrosis from secondary hyperhidrosis in findings that could improve clinical management of the condition.

Hyperhidrosis - excessive sweating - can be primary, likely relating to over activity of the nervous system, or secondary due to medications or other general medical conditions.

As dermatologists will occasionally need to diagnose underlying causes of secondary hyperhidrosis, distinguishing between the two forms is important.

Hobart Walling, from the University of Iowa in Iowa City, USA, looked at the medical charts of 415 patients diagnosed with hyperhidrosis over a 13-year period.

Of these, 387 (93%) had primary hyperhidrosis while 28 (7%) had secondary hyperhidrosis.

Walling found that symptoms distinguishing patients with primary hyperhidrosis from those with secondary hyperhidrosis included excessive sweating for 6 months or more, excessive sweating at the armpits, palms, soles, and the head or skull, compared with elsewhere, and occurring on both sides of the body.

These patients also tended not to have episodes of sweating at night and onset of the condition was normally before the age of 25 years. Walling adds that a positive family history of hyperhidrosis also favored primary compared with secondary hyperhidrosis.

In contrast, secondary hyperhidrosis appeared to affect anywhere on the body, more often on only one side of the body, was present at night, and generally occurred after the age of 25 years.

"These criteria discriminate well between primary hyperhidrosis and secondary hyperhidrosis and may facilitate optimal clinical management," Walling concludes in the Journal of the American Academy of Dermatology.

MedWire ( is an independent clinical news service provided by Current Medicine Group, a trading division of Springer Healthcare Limited. © Springer Healthcare Ltd; 2011

By Lucy Piper