Diagnosis and management of hyperhidrosis

@article{Benson2013DiagnosisAM,
  title={Diagnosis and management of hyperhidrosis},
  author={Ruth A Benson and Rachel Palin and Peter E. Holt and Ian M. Loftus},
  journal={BMJ : British Medical Journal},
  year={2013},
  volume={347}
}
#### Summary points Primary hyperhidrosis is characterised by sweating in excess of that needed for normal thermoregulation.1 The condition often goes unreported because of embarrassment,2 and management is hindered by a poor evidence base and lack of clinical guidelines. Anxiety about social situations and relationships, and problems with daily living, such as an inability to hold a pen at work, can affect quality of life.3 Hyperhidrosis may be associated with bromhidrosis (unpleasant odour… 
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References

SHOWING 1-10 OF 69 REFERENCES
Palmar hyperhidrosis: evidence of genetic transmission.
TLDR
It is concluded that primary palmar hyperhidrosis is a hereditary disorder, with variable penetrance and no proof of sex-linked transmission, and may lead to earlier diagnoses and advances in medical and psychosocial interventions.
Hyperhidrosis: evolving concepts and a comprehensive review.
Patient's estimation of efficacy of various hyperhidrosis treatments in a dermatological clinic.
TLDR
The characteristics of sweating in patients referred for hyperhidrosis and their quality of life were investigated, using the Dermatology Life Quality Index and the Hyperhidrosis Disease Severity Scale and their estimation of efficacy of the treatments given, using a patient's global assessment score and thequality of life scores.
An epidemiological study of hyperhidrosis.
TLDR
A descriptive, multicenter study of patterns of patients referred for treatment of focal hyperhidrosis, demonstrating novel findings, especially in the differing presentations ofhyperhidrosis between men and women.
Primary focal hyperhidrosis: current treatment options and a step‐by‐step approach
  • I. Hoorens, K. Ongenae
  • Medicine
    Journal of the European Academy of Dermatology and Venereology : JEADV
  • 2012
TLDR
The challenge for the dermatologist remains to evaluate the severity of hyperhidrosis to achieve the best therapeutic outcome, this can be done most effectively using the Hyperhidrosis Disease Severity Scale (HDSS).
Hyperhidrosis: Anatomy, Pathophysiology and Treatment with Emphasis on the Role of Botulinum Toxins
TLDR
Clinical features, anatomy and physiology of hyperhidrosis are presented with a review of the world literature on treatment and studies on BoNT-A iontophoresis are emerging; however, data on duration and frequency of application is inconsistent.
Hyperhidrosis--causes and treatment of enhanced sweating.
TLDR
A step-by-step approach is recommended for the treatment of hyperhidrosis, which affects the axillae, hands, feet, and face--areas principally involved in emotional sweating.
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