| Hypohidrosis | |
|---|---|
| Other names | Anhidrosis[1] |
| Specialty | Dermatology, neurology |
| Prognosis | hyperthermia,heat stroke, and death |
Hypohidrosis[2] is amedical condition in which a person exhibits diminished sweating in response to appropriate stimuli. In contrast withhyperhidrosis, which is a socially troubling yet often harmless condition, the consequences of untreated hypohidrosis includehyperthermia, heat stroke and death.[3] An extreme case of hypohidrosis in which there is a complete absence of sweating and the skin is dry is termedanhidrosis.[4] The condition is also known asadiaphoresis,[5]ischidrosis,[6]oligidria,[7]oligohidrosis[8] andsweating deficiency.
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Causes include:
Physical agents
Dermatological
Neuropathic
Sweat is readily visualized by a topical indicator such as iodinated starch (Minor test) or sodium alizarin sulphonate, both of which undergo a dramatic colour change when moistened by sweat. Athermoregulatory sweat test can evaluate the body’s response to a thermal stimulus by inducing sweating through a hot box (also called ahot room), a thermal blanket, or physical exercise. Failure of the topical indicator to undergo a colour change during thermoregulatory sweat testing indicates hypohidrosis, and further tests may be required to localize thelesion.[9]
Magnetic resonance imaging of the brain and/or spinal cord is the best modality for evaluation when the lesion is suspected to be localized to thecentral nervous system.[10]
Skin biopsies are useful when anhidrosis occurs as part of adermatological disorder. Biopsy results may reveal the sweat gland destruction,necrosis orfibrosis, in addition to the findings of the primary dermatological disorder.[11]
The treatment options for hypohidrosis and anhidrosis are largely limited to preventing overheating and attempting to resolve or prevent further deterioration of any known underlying causes.
Those with hypohidrosis should avoid drugs that can aggravate the condition (see "Medications", under§ Causes). They should limit activities that raise the core body temperature and if exercises are to be performed, they should be supervised and be performed in a cool, sheltered, and well-ventilated environment.
When the cause is known, treatment should be directed at the primary pathology. In autoimmune diseases, such asSjögren syndrome andsystemic sclerosis, treatment of the underlying disease usingimmunosuppressive drugs may lead to improvement in hypohidrosis. In neurological diseases, the primary pathology is often irreversible. In these instances, prevention of further neurological damage, such as good glycaemic control indiabetes, is the cornerstone of management. Inacquired generalized anhidrosis, spontaneous remission may be observed in some cases.Corticosteroid pulse therapy has increased sweating in some people.[12]
Horses can also have hypohidrosis.[13] Management includes avoiding exercise in warm weather and using water or other cooling devices.[13] Horses may have inflammation of the airway, which may reduce the horse's ability to use panting as a form of thermoregulation.[13]