Diagnosis and treatment of hyperhidrosis

Endoscopic Thoracic sympathectomy for Primary Palmar hyperhidrosis

“…4 The incidence of hyperhidrosis in the United States has been reported as 2.8% of the general population, aff ecting men and women equally with the highest prevalence among 25 to 64 year old population. 4,5 The average age of onset is 25 years; however this can diff er depending on the aff ected area. Palmar hyperhidrosis has the earliest average onset at age 13.…”

“…Palmar hyperhidrosis has the earliest average onset at age 13. 5 A complete history and physical exam are important initial steps in the evaluation of excessive sweating. When the symptoms are characteristic of primary focal hyperhidrosis, then diagnosis can be made without any requirement of laboratory testing.…”

“…2 If there are no other obvious causes, such as hyperpituitarism, diabetes mellitus, and spinal cord injury, a TSH is often obtained to evaluate for hyperthyroidism as a cause. 5 The Multi-Specialty Working Group on Hyperhidrosis in the United States has proposed some criteria for the diagnosis of hyperhidrosis. 4,6 (Table 1) Once the diagnosis is made, the severity of hyperhidrosis should be determined.…”

“…The Hyperhidrosis Disease Severity Scale (HDSS) is a qualitative measure of the severity of the patient's condition based on the eff ect on activities of daily living. 2,5 A score of 3 or 4 indicates severe hyperhidrosis and a score of 1 or 2 indicates mild or moderate primary hyperhidrosis. It is important to measure the disease severity using the HDSS score because it helps to determine proper course of treatment and to monitor the results of treatment.…”