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    عبدالعزيز احمد علي عتش
    This document discusses disorders of sweat glands including hyperhidrosis and miliaria. Hyperhidrosis is defined as increased sweating and can be generalized due to things like heat, exercise, or medical conditions, or localized to areas like the palms, soles, or axillae. Treatment includes topical aluminum chloride, iontophoresis, botulinum toxin injections, or sympathectomy surgery. Miliaria is a sweat rash caused by occlusion of sweat ducts leading to vesicles or papules, usually in hot environments. Treatment focuses on cooling the skin and avoiding irritants.

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    This document discusses disorders of sweat glands including hyperhidrosis and miliaria. Hyperhidrosis is defined as increased sweating and can be generalized due to things like heat, exercise, or medical conditions, or localized to areas like the palms, soles, or axillae. Treatment includes topical aluminum chloride, iontophoresis, botulinum toxin injections, or sympathectomy surgery. Miliaria is a sweat rash caused by occlusion of sweat ducts leading to vesicles or papules, usually in hot environments. Treatment focuses on cooling the skin and avoiding irritants.

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    This document discusses disorders of sweat glands including hyperhidrosis and miliaria. Hyperhidrosis is defined as increased sweating and can be generalized due to things like heat, exercise, or medical conditions, or localized to areas like the palms, soles, or axillae. Treatment includes topical aluminum chloride, iontophoresis, botulinum toxin injections, or sympathectomy surgery. Miliaria is a sweat rash caused by occlusion of sweat ducts leading to vesicles or papules, usually in hot environments. Treatment focuses on cooling the skin and avoiding irritants.

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    © All Rights Reserved
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    26 views23 pages

    SGD

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    عبدالعزيز احمد علي عتش
    This document discusses disorders of sweat glands including hyperhidrosis and miliaria. Hyperhidrosis is defined as increased sweating and can be generalized due to things like heat, exercise, or medical conditions, or localized to areas like the palms, soles, or axillae. Treatment includes topical aluminum chloride, iontophoresis, botulinum toxin injections, or sympathectomy surgery. Miliaria is a sweat rash caused by occlusion of sweat ducts leading to vesicles or papules, usually in hot environments. Treatment focuses on cooling the skin and avoiding irritants.

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    ‫ﻧﺖ‬

    ‫َ‬ ‫ﻤ َﺘﻨَ ﺎ اﻧ َ‬
    ‫ﻚ‬ ‫ﻋﻠ ْ‬
    ‫ﻣﺎ َ‬ ‫ﻋ ْﻠ َ‬
    ‫ﻢ ﻟَﻨَ ﺎ اﻻ َ‬ ‫ﺤﺎ َﻧ َ‬
    ‫ﻚ ﻻَ ِ‬ ‫ﻮا ُ‬
    ‫ﺳ ْﺒ َ‬ ‫ﻗ ُ‬
    ‫ﺎﻟ ْ‬ ‫َ‬
    ‫ﻴﻢ‬
    ‫ﻜ ُ‬‫ﺤ ِ‬ ‫ﻴﻢ ْ‬
    ‫اﻟ َ‬ ‫ﻌ ِﻠ ُ‬ ‫ْ‬
    ‫اﻟ َ‬
    Disorders of sweat
    glands
    Hyperhidrosis
    Definition:
    Hyperhidrosis is increased eccrine
    sweating.
    Types:
     Generalized hyperhidrosis
    o Hot humid environment.
    o Vigorous exercise.
    o Fevers (e.g. tuberculosis, malaria, brucellosis,
    endocarditis),
    o Metabolic diseases (diabetes, hypoglycemia,
    hyperthyroidism),
    o Menopause,
    o Drugs (e.g. fluoxetine, NSAIDs)
    Types:
     Palmoplanter (Emotional) hyperhidrosis:
    o This type is usually localized to the
    palms, soles or axillae
    o Worse during warm temperature.
    o It may be triggered by anxiety, stress or
    fear.
    Types:
     Gustatory hyperhidrosis:
    o Sweating on the lips, forehead and nose
    after eating certain foods occur
    physiologically in many people.
    o Hot spicy foods are the most likely
    cause.
    Treatment :
     In many patients, all that is necessary is simple
    reassurance and explanation that the disorder
    is likely to improve spontaneously.

     Topical and systemic treatments are only


    temporarily suppressive.
    Treatment :
    Topical therapy

     Eccrine duct blocking agents: as 20% solution


    of aluminium chloride in absolute ethyl alcohol
    at night.

     Iontophoresis:

     Botulinum toxin A injection


    Treatment :
    Systemic therapy

     Atropine-like drugs but their side effects


    (dryness of mouth, constipation, glaucoma,
    hyperthermia and convulsions) are often more
    troublesome than the hyperhidrosis itself.
    Treatment :
    Surgical treatment

     Only those patients in whom a severe disability


    is arising from the hands or axillae warrant
    surgical intervention as sympathectomy.
    Miliaria (Sweat rash, Prickly rash)

    Definition
    Erythematous papules associated with
    sweat duct occlusion following heat
    exposure.
    Miliaria (Sweat rash, Prickly rash)

    Epidemiology
    Miliaria are most common in first week of
    life as infant adjusts to environment; also,
    occur in any age with excessive heat and
    sweating.
    Miliaria (Sweat rash, Prickly rash)

    Pathogenesis
    The eccrine sweat pore become macerated and then
    occludes the duct.
    This leads to superficial clear vesicles (miliaria crystallina)
    or deep, more painful red papules or nodules (miliaria
    rubra).
    Most common sites trunk, neck and in occluded areas.
    Miliaria (Sweat rash, Prickly rash)

    Clinical picture:
    In miliaria rubra, he typical lesions develop in areas of
    friction with clothing and flexures.
    The lesions are uniformly minute erythematous papules or
    papulovesicles which may be present in very large numbers.
    Miliaria (Sweat rash, Prickly rash)

    Clinical picture:
    Characteristically, they lead to intense discomfort and
    unbearable pricking sensation.
    Secondary bacterial infection is a common complication.
    Miliaria (Sweat rash, Prickly rash)
    Miliaria (Sweat rash, Prickly rash)
    Miliaria (Sweat rash, Prickly rash)
    Miliaria (Sweat rash, Prickly rash)

    Treatment:
    • The most effective treatment for miliaria is to place the
    patient in a cool environment.
    • Avoidance of excessive clothing and excessive use of soap
    and contact of skin with irritants.
    Miliaria (Sweat rash, Prickly rash)
    Treatment:
    • Soothing local applications e.g. Calamine lotion.

    • Oral antihistamines for itching and antibiotics if there is


    secondary infection.
    • Oral ascorbic acid 500 mg twice daily may diminish the
    severity of miliaria.

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