Flashcards in Chapter 40 - Diseases of the Eccrine and Apocrine Sweat Glands Deck (18):
When the temperature rises, what are the two main mechanisms that the skin uses to cool the body?
Radiative cooling due to cutaneous vasodilation and evaporative cooling due to sweat
Which anatomic locations don't have any eccrine sweat glands?
Clitoris, labia minora, glands penis, external auditory canal, and lips
True or false: patients with primary hyperhidrosis often have a positive family history for the condition.
True; 80% give a positive family history
True or false: the right axilla usually produces more sweat than the left.
Can epidermolysis bullosa simplex be associated with palmoplantar hyperhidrosis? What about familial dysautonomia (Riley-Day syndrome)?
Yes to both
True or false: Sweating is absent when a patient has a fever over 39 degrees Celsius.
True! Due to apparent inhibition of the hypothalamic centre for sweating
True or false: foods and drinks an induce sweating in normal individuals.
True, especially spicy foods, citrus, and alcohol
What is the principle terminal neurotransmitter in eccrine sweating?
Acetylcholine, via sympathetic nervous system
What is the diagnostic criteria for primary hyperhidrosis?
1) Focal, visible excess sweating, 2) Present for at least 6 months, 3) No apparent secondary causes, 4) 2 of the following: a) Bilateral and symmetric, b) Impairs activities of daily life, c) At least 1 episode per week, d) Age of onset <25 years, e) Positive family history, f) Stops during sleep
What are the 2 major forms of primary hyperhidrosis?
Volar (palmoplantar) (50-60%) and axillary (30-50%)
What are the 5 types of secondary hyperhidrosis?
Cortical, hypothalamic, medullary, spinal or local.
What are some causes of hypothalamic (thermal) hyperhidrosis? Hint: think of broad categories
Infection, tumors, endocrine/metabolic causes, vasomotor dysfunction, neurologic causes, drugs/toxins, and miscellaneous causes such as POEMS syndrome
What happens in spinal (cord transection) sweating?
Lack of sweating belwo the level of injury, bouts of mass refex sweating (except belwo T8-T10)
What is the main mediator in axon reflex (local inflammatory) sweating?
What 3 situations/disorders leads to compensatory hyperhidrosis?
1) miliaria, 2) diabetes mellitus, 3) post-sympathectomy
What is the treatment for hyperhidrosis?
Topical (aluminum chloride hexahydrate, aluminum tetrachloride), iontophoresis, oral anticholinergics, alpha adrenergic blockers, biofeedback therapy, botulinum toxin, surgery
What are the 3 types of causes for anhidrosis? Hint: think broad categories
1) central and neuropathic diseases/medication disrupting the neural pathway, 2) non-neural alterations in gland itself, 3) idiopathic origin