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<title>Focal hyperhidrosis</title>

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<span id="openzim-page-title" class="mw-page-title-main"><span class="mw-page-title-main">Focal hyperhidrosis</span></span>

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</style><table class="infobox infobox-has-images-with-white-backgrounds"><tbody><tr><th colspan="2" class="infobox-above" style="background:#ccc">Focal hyperhidrosis</th></tr><tr><th scope="row" class="infobox-label">Other names</th><td class="infobox-data">primary hyperhidrosis</td></tr><tr><td colspan="2" class="infobox-full-data"></td></tr></tbody></table><style data-mw-deduplicate="TemplateStyles:r1236303919">

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<p><b>Focal hyperhidrosis</b>, also known as <b>primary hyperhidrosis</b>, is a <a href="Disease" title="Disease">disease</a> characterized by an excessive <a href="Sweating" class="mw-redirect" title="Sweating">sweating</a> localized in certain body regions (particularly palms, feet and underarms). Studies suggest that this condition, affecting between 1% and 3% of the US population, seems to have a genetic predisposition in about two thirds of those affected.<sup id="cite_ref-pmid30215934_1-0" class="reference"><a href="#cite_note-pmid30215934-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup>

</p><p>Focal <a href="Hyperhidrosis" title="Hyperhidrosis">hyperhidrosis</a> is sometimes referred to as <i>The Silent Handicap</i>,<sup id="cite_ref-2" class="reference"><a href="#cite_note-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup> as it has a significant impact on the quality of life, affecting the individual socially, psychologically, emotionally and professionally.<sup id="cite_ref-Solish_et_al_2007_3-0" class="reference"><a href="#cite_note-Solish_et_al_2007-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup>

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<div class="mw-heading mw-heading2"><h2 id="Genetics">Genetics</h2></div>

<p>In 2006, researchers uncovered that primary <a href="Palmar_hyperhidrosis" class="mw-redirect" title="Palmar hyperhidrosis">palmar hyperhidrosis</a>, referring to excess sweating on the palms of the hands and feet, maps to the gene locus 14q11.2-q13.<sup id="cite_ref-4" class="reference"><a href="#cite_note-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup>

</p><p>Based on previous research using mice and rats, researchers looked towards the role of <a href="Aquaporin_5" class="mw-redirect" title="Aquaporin 5">aquaporin 5</a> (AQP5), a water channel protein, in human individuals with primary focal hyperhidrosis.<sup id="cite_ref-5" class="reference"><a href="#cite_note-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup> AQP5 has been identified as a candidate gene in many hyperhidrosis studies. Using a family that had members with primary focal hyperhidrosis, researchers found that there was no connection between primary focal hyperhidrosis and AQP5. There was also no significant connection between the gene 14q11.2-q13 locus, which was linked to primary palmar hyperhidrosis, and primary focal hyperhidrosis in this family.<sup id="cite_ref-6" class="reference"><a href="#cite_note-6"><span class="cite-bracket">[</span>6<span class="cite-bracket">]</span></a></sup>

</p><p>The expression of the AQP5 protein and AQP5 <a href="MRNA" class="mw-redirect" title="MRNA">mRNA</a> was significantly higher in a patient group in comparison to the control group. In 2011, using a control group (individuals without primary focal hyperhidrosis) and a patient group (individuals with primary focal hyperhidrosis) researchers found that there was no difference between the number of sweat coils in the axillary <a href="Sweat_glands" class="mw-redirect" title="Sweat glands">sweat glands</a>. This indicates that there is nothing <a href="Morphology_(biology)" title="Morphology (biology)">morphologically</a> different between individuals with and without primary focal hyperhidrosis. The discrepancies between the studies above call on further studies to confirm or deny the role of AQP5, and the role of other proteins, in hyperhidrosis.<sup id="cite_ref-7" class="reference"><a href="#cite_note-7"><span class="cite-bracket">[</span>7<span class="cite-bracket">]</span></a></sup>

</p><p>Beyond looking at the genes and individual proteins that play a role in primary focal hyperhidrosis, researchers have looked at the patterns of <a href="Heredity" title="Heredity">heredity</a> for this trait. In a 2003 study, using multiple families, researchers found that primary focal hyperhidrosis was not a <a href="Sex-linked_gene" class="mw-redirect" title="Sex-linked gene">sex-linked gene</a>, since male-to-male transmission was seen in multiple families. Instead evidence supported an <a href="Autosomal_dominant" class="mw-redirect" title="Autosomal dominant">autosomal dominant</a> pattern of inheritance with an incomplete disease <a href="Penetrance" title="Penetrance">penetrance</a>. 21 patients in this study reported a positive family history of hyperhidrosis (62%). Researchers were able to uncover this by creating <a href="Pedigree_chart" title="Pedigree chart">pedigrees</a> of all the participants in the study. Not every member of the pedigree exhibited forms of hyperhidrosis, which allowed the researchers to track the patterns of inheritance. The findings in this study indicated that primary focal hyperhidrosis is typically an hereditary disorder.<sup id="cite_ref-8" class="reference"><a href="#cite_note-8"><span class="cite-bracket">[</span>8<span class="cite-bracket">]</span></a></sup>

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<div class="mw-heading mw-heading2"><h2 id="Diagnosis">Diagnosis</h2></div>

<p>Typical regions of excessive sweating include the hand palms, underarms, the sole of the foot, and sometimes groin, face, and scalp. Indeed, profuse sweating is present mostly in the underarms, followed by the feet, palms and facial region.<sup id="cite_ref-9" class="reference"><a href="#cite_note-9"><span class="cite-bracket">[</span>9<span class="cite-bracket">]</span></a></sup>

</p><p>Evidence demonstrates that a positive family history is also present (see the <i>Genetics</i> part).<sup id="cite_ref-10" class="reference"><a href="#cite_note-10"><span class="cite-bracket">[</span>10<span class="cite-bracket">]</span></a></sup>

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<div class="mw-heading mw-heading2"><h2 id="Treatments">Treatments</h2></div>

<p>The Canadian Hyperhidrosis Advisory Committee has published a comprehensive set of guidelines which outlines key aspects of treatment related to this condition. Topical hyperhidrosis gels containing <a href="Aluminum_chloride_hexahydrate" title="Aluminum chloride hexahydrate">aluminum chloride hexahydrate</a> are usually first choice treatments for this condition.<sup id="cite_ref-Solish_et_al_2007_3-1" class="reference"><a href="#cite_note-Solish_et_al_2007-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup>

</p><p>In addition to topical <a href="Antiperspirants" class="mw-redirect" title="Antiperspirants">antiperspirants</a> (whose main active ingredients usually are aluminum or zirconium salts) treatment options include: <a href="Iontophoresis" title="Iontophoresis">iontophoresis</a> (hands, feet), onabotulinumtoxinA (<a href="Botox" class="mw-redirect" title="Botox">Botox</a>) injections (underarms, hands, feet, and other localized areas),<sup id="cite_ref-Stashak2014rev_11-0" class="reference"><a href="#cite_note-Stashak2014rev-11"><span class="cite-bracket">[</span>11<span class="cite-bracket">]</span></a></sup> electromagnetic/<wbr>microwave energy <a href="Thermolysis" class="mw-redirect" title="Thermolysis">thermolysis</a> of underarm sweat glands (<a href="MiraDry" title="MiraDry">miraDry</a>),<sup id="cite_ref-12" class="reference"><a href="#cite_note-12"><span class="cite-bracket">[</span>12<span class="cite-bracket">]</span></a></sup> laser-assisted removal of the sweat glands (underarms),<sup id="cite_ref-2014rev_13-0" class="reference"><a href="#cite_note-2014rev-13"><span class="cite-bracket">[</span>13<span class="cite-bracket">]</span></a></sup> other local procedures such as liposuction and curettage of the sweat glands (underarms), medications of the anticholinergic type that are taken by mouth, and <a href="Sympathectomy" title="Sympathectomy">sympathectomy</a> surgery for sweating of the hands or head that can't be controlled by other means.<sup id="cite_ref-2014rev_13-1" class="reference"><a href="#cite_note-2014rev-13"><span class="cite-bracket">[</span>13<span class="cite-bracket">]</span></a></sup>

</p><p><a href="Sofpironium_bromide" title="Sofpironium bromide">Sofpironium bromide</a> is approved for the treatment of primary axillary hyperhidrosis.<sup id="cite_ref-14" class="reference"><a href="#cite_note-14"><span class="cite-bracket">[</span>14<span class="cite-bracket">]</span></a></sup>

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<div class="mw-heading mw-heading2"><h2 id="References">References</h2></div>

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<li id="cite_note-5"><span class="mw-cite-backlink"><b><a href="#cite_ref-5">^</a></b></span> <span class="reference-text"><cite id="CITEREFGreszKwonGongAgre2004" class="citation journal cs1">Gresz V, Kwon T, Gong H, Agre P, Steward M, King L, et al. (2004). "Immunolocalization of AQP-5 in rat parotid and submandibular salivary glands after stimulation of inhibition of secretion in vivo". <i>American Journal of Physiology. Gastrointestinal and Liver Physiology</i>. <b>289</b> (1): <span class="nowrap">151–</span>161. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1152%2Fajpgi.00480.2003">10.1152/ajpgi.00480.2003</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/14988067">14988067</a>. <a href="S2CID_(identifier)" class="mw-redirect" title="S2CID (identifier)">S2CID</a> <a rel="nofollow" class="external text" href="https://api.semanticscholar.org/CorpusID:10012101">10012101</a>.</cite></span>

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<li id="cite_note-6"><span class="mw-cite-backlink"><b><a href="#cite_ref-6">^</a></b></span> <span class="reference-text"><cite id="CITEREFDel_SorboBrancatiDe_JoannaValente2011" class="citation journal cs1">Del Sorbo F, Brancati F, De Joanna G, Valente E, Lauria G, Albanese A (2011). "Primary focal hyperhidrosis in a new family not linked to known loci". <i>Dermatology</i>. <b>223</b> (4): <span class="nowrap">335–</span>342. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1159%2F000334936">10.1159/000334936</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/22237135">22237135</a>. <a href="S2CID_(identifier)" class="mw-redirect" title="S2CID (identifier)">S2CID</a> <a rel="nofollow" class="external text" href="https://api.semanticscholar.org/CorpusID:33908389">33908389</a>.</cite></span>

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<li id="cite_note-7"><span class="mw-cite-backlink"><b><a href="#cite_ref-7">^</a></b></span> <span class="reference-text"><cite id="CITEREFDuMinYangChen2016" class="citation journal cs1">Du G, Min M, Yang J, Chen J, Tu Y (2016). "Overexpression of AQP5 Was Detected in Axillary Sweat Glands of Primary Focal Hyperhidrosis Patients". <i>Dermatology</i>. <b>232</b> (2): <span class="nowrap">150–</span>155. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1159%2F000444081">10.1159/000444081</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/26930592">26930592</a>. <a href="S2CID_(identifier)" class="mw-redirect" title="S2CID (identifier)">S2CID</a> <a rel="nofollow" class="external text" href="https://api.semanticscholar.org/CorpusID:1160454">1160454</a>.</cite></span>

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<li id="cite_note-8"><span class="mw-cite-backlink"><b><a href="#cite_ref-8">^</a></b></span> <span class="reference-text"><cite id="CITEREFKaufmannSaadiaPolinHague2003" class="citation journal cs1">Kaufmann H, Saadia D, Polin C, Hague S, Singleton A, Singleton A (2003). "Primary hyperhidrosis--evidence for autosomal dominant inheritance". <i>Clinical Autonomic Research Journal</i>. <b>13</b> (2): <span class="nowrap">96–</span>98. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1007%2Fs10286-003-0082-x">10.1007/s10286-003-0082-x</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/12720093">12720093</a>. <a href="S2CID_(identifier)" class="mw-redirect" title="S2CID (identifier)">S2CID</a> <a rel="nofollow" class="external text" href="https://api.semanticscholar.org/CorpusID:27224801">27224801</a>.</cite></span>

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<li id="cite_note-9"><span class="mw-cite-backlink"><b><a href="#cite_ref-9">^</a></b></span> <span class="reference-text"><cite id="CITEREFHaiderSolish2005" class="citation journal cs1">Haider A, Solish N (2005). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC543948">"Focal hyperhidrosis: diagnosis and management"</a>. <i>Canadian Medical Association Journal</i>. <b>172</b> (1): <span class="nowrap">69–</span>75. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1503%2Fcmaj.1040708">10.1503/cmaj.1040708</a>. <a href="PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC543948">543948</a></span>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/15632408">15632408</a>.</cite><span class="cs1-maint citation-comment"><code class="cs1-code">{{cite journal}}</code>: CS1 maint: overridden setting (link)</span></span>

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<li id="cite_note-10"><span class="mw-cite-backlink"><b><a href="#cite_ref-10">^</a></b></span> <span class="reference-text"><cite id="CITEREFWalling2011" class="citation journal cs1">Walling HW (2011). "Clinical differentiation of primary from secondary hyperhidrosis". <i>Journal of the American Academy of Dermatology</i>. <b>64</b> (4): <span class="nowrap">690–</span>695. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1016%2Fj.jaad.2010.03.013">10.1016/j.jaad.2010.03.013</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/21334095">21334095</a>.</cite></span>

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<li id="cite_note-Stashak2014rev-11"><span class="mw-cite-backlink"><b><a href="#cite_ref-Stashak2014rev_11-0">^</a></b></span> <span class="reference-text"><cite id="CITEREFStashakBrewer2014" class="citation journal cs1">Stashak AB, Brewer JD (29 October 2014). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4218921">"Management of hyperhidrosis"</a>. <i>Clinical, Cosmetic and Investigational Dermatology</i>. <b>7</b>: <span class="nowrap">285–</span>99. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://doi.org/10.2147%2FCCID.S53119">10.2147/CCID.S53119</a></span>. <a href="PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4218921">4218921</a></span>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/25378942">25378942</a>.</cite></span>

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<li id="cite_note-12"><span class="mw-cite-backlink"><b><a href="#cite_ref-12">^</a></b></span> <span class="reference-text"><cite id="CITEREFJacob2013" class="citation journal cs1">Jacob C (March 2013). "Treatment of hyperhidrosis with microwave technology". <i>Seminars in Cutaneous Medicine and Surgery</i>. <b>32</b> (1): <span class="nowrap">2–</span>8. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/24049923">24049923</a>.</cite></span>

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<li id="cite_note-2014rev-13"><span class="mw-cite-backlink">^ <a href="#cite_ref-2014rev_13-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-2014rev_13-1"><sup><i><b>b</b></i></sup></a></span> <span class="reference-text"><cite id="CITEREFBrownGordonHill2014" class="citation journal cs1">Brown AL, Gordon J, Hill S (August 2014). "Hyperhidrosis: review of recent advances and new therapeutic options for primary hyperhidrosis". <i>Current Opinion in Pediatrics</i>. <b>26</b> (4): <span class="nowrap">460–</span>5. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1097%2Fmop.0000000000000108">10.1097/mop.0000000000000108</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/24905102">24905102</a>. <a href="S2CID_(identifier)" class="mw-redirect" title="S2CID (identifier)">S2CID</a> <a rel="nofollow" class="external text" href="https://api.semanticscholar.org/CorpusID:33641836">33641836</a>.</cite></span>

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<li id="cite_note-14"><span class="mw-cite-backlink"><b><a href="#cite_ref-14">^</a></b></span> <span class="reference-text"><cite class="citation pressrelease cs1"><a rel="nofollow" class="external text" href="https://botanixpharma.com/fda-approves-sofdra-topical-gel/">"FDA Approves Sofdra topical gel"</a> (Press release). <a href="Botanix_Pharmaceuticals" title="Botanix Pharmaceuticals">Botanix Pharmaceuticals</a>. 20 June 2024. <a rel="nofollow" class="external text" href="https://web.archive.org/web/20240620230416/https://botanixpharma.com/fda-approves-sofdra-topical-gel/">Archived</a> from the original on 20 June 2024<span class="reference-accessdate">. Retrieved <span class="nowrap">20 June</span> 2024</span>.</cite></span>

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