Which clinical history findings are characteristic of axillary hyperhidrosis?

Updated: Feb 12, 2019
  • Author: Richard H S Karpinski, MD, FACS; Chief Editor: Gregory Gary Caputy, MD, PhD, FICS  more...
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Answer

Patients with axillary hyperhidrosis usually complain of constant or frequent sweating, with streams of wetness running down their sides. This diathesis wets and ruins clothing and produces social embarrassment or functional problems from skin maceration. Severely affected patients also may have secondary microbial infections. Unlike functional sweating, which may be triggered by exercise, exertion, or high temperature, hyperhidrosis may require no trigger at all or may be stimulated by emotional situations and/or anxiety. Most patients with axillary hyperhidrosis have tried multiple antiperspirants and various medications and often have devised various coping methods involving clothing strategies. Many have consulted various physicians, often to no avail.

Some patients may have unilateral axillary hyperhidrosis or a more severe diathesis on one side than the other. Many patients with axillary hyperhidrosis also are afflicted with palmar, facial, or plantar hyperhidrosis to some degree.

The problem usually begins with puberty but also may present in mid childhood, especially in Asian populations.

A study by Thorlacius et al suggested that with regard to differentiating axillary and palmar hyperhidrosis from physiologically normal sweat production, a gravimetric testing result of 100 mg of sweat/5 min may be an acceptable cut-off point. [5]


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