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SWEATING AND ITS DISORDERS

 Sweating is a normal response that is due to production of a hypotonic solution from specialized glands called eccrine glands.  It is found all over the body except certain areas like lips, some parts of genitalia.

 Sweat results cooling in of the body and helps to maintain the temperature of the body.

 Apocrine glands are another specialized glands mainly seen in the axillae and anogenital area.  These produce sweat that results in “scent” production.  They become active after puberty.

BROM HIDROSIS

In this condition sweating is of increased odor (some would call it a foul odor)

In apocrine bromhidrosis the sweat that is produced from the axillae is acted upon by normal bacteria on the surface of the skin to produce the body odor.

 In eccrine bromhidrosis the sweat is produced on the palms, soles or flexural areas.  Excess  garlic  ingestion  can cause bromhidrosis.

 Treatment of bacteria on the skin helps to reduce odor.

1. Frequent washing with antibacterial soaps.
2. Shaving of hair over the area.

CHROM HIDROSIS

This is production of colored sweat over the armpits.  This is due to production of a pigment in the body.  The glands are otherwise normal except production of different colors of sweat.

The cause is unknown.

Treatment

Regular washing of the area helps.

 In very troublesome cases removal of the affected area by surgery can help.

 FOX FORDYCE DISEASE

 This is an eruption of apocrine glands caused due to obstruction of the opening of these glands.  This starts after adolescence and affects the axillae and genital areas.  It causes itchy papules on these areas.  The disease results in a chronic course.

 Treatment

1. Tretinoin cream 0.1%
2. Topical steroids.
3. Intralesional steroids.
4. Rarely surgery to remove the area may help.

 HYPERHIDROSIS

 This means excessive sweating.  This is very common.  Primary (unknown cause) Hyperhidrosis is increased sweating on palms, soles and axillae.  Increased stress, mainly emotional increases sweating.

 It may limit one’s work as sweating stains and interferes with work.  Patients who work in sterile areas or require dry palms are at disadvantage.

 NEVUS SUDORIFEROUS

 This refers to an area of increased sweating with no visible changes otherwise.

 Treatment

1. 20% Aluminum Chloride hex hydrate .  This is applied at night and washed away in the morning.

Treatment may be required indefinitely at least once or twice a week.

2. Tap water iontophoresis

These require small machines that emit a mild electrical discharge as a result the opening of sweat glands gets blocked.  If the patient desires he may buy a machine for use at home. 

3. Surgical removal of the area may be tried.

 Other measures include systemic oxyphencyclimine propantheline bromide, sympathectomy but all these are limited by the side effects.

 GRANULOSIS RUBRA NASI

 This is a very rare skin condition that starts in children and interestingly settles in adulthood.  It begins as redness on the nose and later becomes permanent.  Tiny papules may also develop in the area.

 Patient is only worried cosmetically.

 Treatment

No treatment is effective.