Chapter 81 - Hyperhidrosis and Anhidrosis

Question 1

TABLE 81-2
Primary Focal (Essential) Hyperhidrosis

Focal visible excessive sweating _____ duration without apparent cause and at least _____ of the following:

Answer 1

Focal visible excessive sweating ≥6 months’ duration without apparent cause and at least 2 of the following:
- Bilateral and relatively symmetric
- Age of onset typically before age of 25 years
- Cessation of sweating from the focal areas during sleep
- Frequency of at least once per week
- Positive family history
- Sweating impairs daily activities

Question 2

TABLE 81-2
Primary Focal (Essential) Hyperhidrosis

_____ and relatively _____

Answer 2

Focal visible excessive sweating ≥6 months’ duration without apparent cause and at least 2 of the following:
- Bilateral and relatively symmetric
- Age of onset typically before age of 25 years
- Cessation of sweating from the focal areas during sleep
- Frequency of at least once per week
- Positive family history
- Sweating impairs daily activities

Question 3

TABLE 81-2
Primary Focal (Essential) Hyperhidrosis

Age of onset typically before age of _____

Answer 3

Focal visible excessive sweating ≥6 months’ duration without apparent cause and at least 2 of the following:
- Bilateral and relatively symmetric
- Age of onset typically before age of 25 years
- Cessation of sweating from the focal areas during sleep
- Frequency of at least once per week
- Positive family history
- Sweating impairs daily activities

Question 4

TABLE 81-2
Primary Focal (Essential) Hyperhidrosis

_____ of sweating from the focal areas during sleep

Answer 4

Focal visible excessive sweating ≥6 months’ duration without apparent cause and at least 2 of the following:
- Bilateral and relatively symmetric
- Age of onset typically before age of 25 years
- Cessation of sweating from the focal areas during sleep
- Frequency of at least once per week
- Positive family history
- Sweating impairs daily activities

Question 5

TABLE 81-2
Primary Focal (Essential) Hyperhidrosis

Frequency of at least _____ per week

Answer 5

Focal visible excessive sweating ≥6 months’ duration without apparent cause and at least 2 of the following:
- Bilateral and relatively symmetric
- Age of onset typically before age of 25 years
- Cessation of sweating from the focal areas during sleep
- Frequency of at least once per week
- Positive family history
- Sweating impairs daily activities

Question 6

TABLE 81-2
Primary Focal (Essential) Hyperhidrosis

_____ family history

Answer 6

Focal visible excessive sweating ≥6 months’ duration without apparent cause and at least 2 of the following:
- Bilateral and relatively symmetric
- Age of onset typically before age of 25 years
- Cessation of sweating from the focal areas during sleep
- Frequency of at least once per week
- Positive family history
- Sweating impairs daily activities

Question 7

TABLE 81-2
Primary Focal (Essential) Hyperhidrosis

Sweating impairs _____

Answer 7

Focal visible excessive sweating ≥6 months’ duration without apparent cause and at least 2 of the following:
- Bilateral and relatively symmetric
- Age of onset typically before age of 25 years
- Cessation of sweating from the focal areas during sleep
- Frequency of at least once per week
- Positive family history
- Sweating impairs daily activities

Question 8

TABLE 81-3
Hyperhidrosis Disease Severity Scale

IMPACT OF SWEATING ON DAILY ACTIVITIES
Intolerable; always interferes

Answer 8

4

Question 9

TABLE 81-3
Hyperhidrosis Disease Severity Scale

IMPACT OF SWEATING ON DAILY ACTIVITIES
Barely tolerable; frequently interferes

Answer 9

3

Question 10

TABLE 81-3
Hyperhidrosis Disease Severity Scale

IMPACT OF SWEATING ON DAILY ACTIVITIES
Tolerable; sometimes interferes

Answer 10

2

Question 11

TABLE 81-3
Hyperhidrosis Disease Severity Scale

IMPACT OF SWEATING ON DAILY ACTIVITIES
Never noticeable; never interferes

Answer 11

1

Question 12

TABLE 81-4
Treatment Options for Primary Focal
Hyperhidrosis

First-Line Topical Options (2)

Answer 12

• Over-the-counter antiperspirants and aluminum chloride hexahydrate (10%–35%)
• Topical glycopyrrolate (0.5%–2%)

Question 13

TABLE 81-4
Treatment Options for Primary Focal
Hyperhidrosis

Second-Line Agents (3)

Answer 13

• Intradermal botulinum toxin injections
• Electromagnetic energy thermolysis
• Tap water iontophoresis

Question 14

TABLE 81-4
Treatment Options for Primary Focal
Hyperhidrosis

Severe or Refractory Cases

Answer 14

Endoscopic thoracic sympathectomy

Question 15

TABLE 81-4
Treatment Options for Primary Focal
Hyperhidrosis

Second-Line Agents (4)

Answer 15

• Glycopyrrolate or oxybutynin
• Clonidine
• Propranolol
• Benzodiazepines