Sweat glands Dan Flashcards
which condition are exacerbated by sweating?
Bromhidrosis Susceptability to development of contact dermatitis Miliaria Keratolysis Exfoliativa Juvenile Plantar dermatosis Transient Acantholytic dermatosis Hailey-Hailey disease
Which genoderms can cause hyperhidrosis?
Palmoplantar keratoderma Pachyonychia Congenita Congenital Icthyosiform Erythroderma (bullous & non-bullous) Dyskeratosis Congenita Nail Patella syndrome EB simplex>junctional Apert syndrome Dermatopathia pigmentosa reticularis Pachydermoperiostosis
NB these are the major cortical causes of secondary hyperhidrosis along with
Hereditary Sensory & autonomic neuropathies
What are the causes of central hypothalamic hyperhidrosis?
Infection, febrile illnesses
Malignancies - lymphoma, phaeo, carcinid
Vasomotor - SLE, RA, Raynauds, MI, reflex symp dyst
Neurologic - abscess, tumour, stroke
Drugs - alcohol, opiates, NSAIDs, catecholamines
Others - POEMS syndrome, diabetic neuropathy
Which genoderms can cause hypohidrosis?
Ectodermal Dysplasias
Incontinentia Pigmenti
Fabry disease
Bazex
What skin conditions cause obstruction of sweat glands?
Ichthyoses
Psoriasis
Eczematous dermatoses
Bullous diseases
T/F
Eccrine glands open directly to skin surface
True
apocrine glands open into a hair follicle
Where are apoeccrine glands found?
In the axilla in adults
Which sites have no eccrine glands?
lips, ear canal, clitoris and lab minora
T/F
sweat glands become fully functional about 1 year of age
False
age 2
T/F
adrenergic synapses innervate sweat glands
False
sympathetic innervation but synapses are muscarinic cholinergic not adrenergic
however ciculating catecholamines also stimulate sweat glands
Which 3 higher centres control sweating centrally?
- hypothalamic (thermal)
- medullary (gustatory)
- cortical (mental/emotional)
T/F
Primary hyperhidrosis may be inherited in an autosomal dominant fasion
True
What are the diagnostic criteria for primary hyperhidrosis?
- Focal, visible excessive sweating
- Present for 6 months or more
- No secondary cause identified
- At least 2 of;
At least one episode per week
Bilateral and symmetrical
Onset less than 25 yrs old
Impairs ADLs
Stops when sleeping
Fam Hx
T/F
palpmoplantar hyperhidrosis may start in childhood
True
usually childhood or puberty
axillary HH doesnt start until puberty
T/F
axillary hyperhidrosis is more common than volar (palmoplantar)
False
slightly less common
T/F
axillary hyperhidrosis is associated with body odour
False
excess sweat is eccrine and bromhidrosis is rare
T/F
Craniofacial hyperhidrosis is the same as gustatory sweating
False
Is excess sweating of head presenting in middle age
Triggered by heat, exercise, eating
What are the broad causes of secondary hyperhidrosis?
Central (CNS) -hypothalamic (thermal) -medullary (gustatory) -cortical (mental/emotional) Peripheral nerves sweat glands
T/F
Frey’s syndrome occurs in the distribution of the maxillary nerve (CNV2)?
False
Usually in distribution of auriculotemporal nerve - temple and temporal scalp; branch of CNV3
Chorda tympani syndrome is variant – sweating along jaw and chin
T/F
Frey’s syndrome occurs in 5% of pts undergoing parotid surgery
False
40%
Other than parotid surgery what can cause Frey’s syndrome?
syringomyelia encephalitis sympathectomy, thyroidectomy lung cancer subclavian aneurysm
What spinal cord pathology can cause secodnary hyperphidrosis?
SSS for Secondary Spinal Sweating
Spinal injury
Syringomyelia
Syphylis - Tabes dorsalis
T/F
in spinal injuries causing hyperhidrosis there is often loss of thermal sweating in skin below the level of the spinal injury
True
What is autonomic dysreflexia?
due to spinal injury at or above T6
During attacks there is massive sympathetic discharge causing sweating above the level of cord transaction + hypertension, tachy or brady cardia, flushing, headache, piloerection and paraesthesias
In these pts, direct stimulation of a sympathetic axon can cause sweating in a localised area of skin
Can be triggered by inflammatory mediators from skin conditions inc psoriasis and dermatitis