dermatologic disorders
Hyperhidrosis
Key Points
Hyperhidrosis can be focal or generalized. Asymmetric hyperhidrosis suggests a neurologic cause. Although generalized sweating is usually normal, consider cancer, infection, and endocrine disorders as directed by patient symptoms. Obtain laboratory tests to determine systemic causes based on clinical findings. Treat usingaluminum chloridesolutions, tap-water iontophoresis, topicalglycopyrroniumtosylate, oralglycopyrrolateoroxybutynin, botulinum toxin, or a microwaved-based device. Consider surgical options in patients who do not respond to drug or device therapy; these include excision of axillary sweat glands and endoscopic transthoracic sympathectomy for palmar sweating, which carries risk of significant adverse effects. 