Palmoplantar hyperhidrosis is excessive sweating localized to the palms of the hands and soles of the feet. It is a form of focal hyperhidrosis in that the excessive sweating is limited to a specific region of the body. As with other types of focal hyperhidrosis (e.g. axillary and craniofacial) the sweating tends to worsen during warm weather.[1]
| Palmoplantar hyperhidrosis | |
|---|---|
 | |
| Hyperhidrosis seen on the hands. | |
| Specialty | Dermatology |
Palmoplantar hyperhidrosis is a frequent disorder when excessive amounts of sweat are inappropriately secreted by the eccrine glands in the palms and soles.[2]
There is little knowledge about the pathogenesis of focal hyperhidrosis. Focal hyperhidrosis may indicate a complicated autonomic nervous system malfunction involving both parasympathetic and sympathetic pathways.[3] Given that 30% to 50% of patients have a family history of hyperhidrosis, there may be a genetic susceptibility.[4]
Because the excessive sweating is easily noticeable, palmoplantar hyperhidrosis is a clinical diagnosis.[2]
For palmoplantar hyperhidrosis, 20% aluminum chloride hexahydrate in absolute anhydrous ethyl alcohol (Drysol) is the most effective topical treatment.[4] Other topical treatments such as potassium permanganate, tannic acid (2 to 5 percent solutions), resorcinol, boric acid, formaldehyde, methenamine, and glutaraldehyde have yielded less than desirable results.[2]
Iontophoresis is a well-known treatment for hyperhidrosis that involves applying a direct electrical current to the skin.[5] Iontophoresis has been combined with a variety of substances, such as tap water, salt water, and anticholinergic medications.[6]
Botulinum toxin type A (Botox) injections are safe, efficient, and frequently enhance the quality of life for those who suffer from hyperhidrosis.[7] The toxin damages the sweat glands' post-ganglionic sympathetic innervation and prevents acetylcholine from being released at the neuromuscular junction.[8]