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Hyperhidrose – Ätiopathogenese, Diagnostik, Klinik und Therapie

  • J. Wohlrab
  • B. Kreft
CME
  • 39 Downloads

Zusammenfassung

Die Hyperhidrose tritt meist als primäre, selten als sekundäre symptomatische Hyperhidrose auf. Die primäre Hyperhidrose wird als komplexe neuropathische Dysregulation mit genetischer Disposition verstanden, die ein pathologisches Schwitzverhalten mit vermehrter Schweißsekretion über mindestens 6 Monate bedingt und mindestens 4 der folgenden Diagnosekriterien erfüllt: Betroffenheit der Axillae und/oder der Handinnenflächen und/oder der Fußsohlen und/oder des Stirnbereiches, symmetrisches Auftreten, kein nächtliches Schwitzen, Häufigkeit des Auftretens mindestens wöchentlich, Beginn der Erkrankung vor dem 25. Lebensjahr, positive Familienanamnese sowie Beeinträchtigung der täglichen Aktivitäten. Zur Therapie der primären Hyperhidrose werden v. a. topisch Aluminiumsalze und Anticholinergika, Leitungswasseriontophorese sowie intrakutan Botulinumtoxin angewendet. In der systemischen Therapie kommen ebenfalls verschiedene Anticholinergika zum Einsatz. Meist als Ultima-Ratio-Therapie werden chirurgische Verfahren angewendet. Außerdem sind Verfahren zur Thermolyse entwickelt worden.

Schlüsselwörter

Schweißdrüsen Anticholinergika Schweißsekretion Schwitzverhalten  Aluminiumsalze 

Hyperhidrosis—aetiopathogenesis, diagnosis, clinical symptoms and treatment

Abstract

Although primary hyperhidrosis is a common disease, secondary symptomatic hyperhidrosis is rather rare. Primary hyperhidrosis is a complex neuropathic dysregulation with a genetic predisposition and is diagnosed when patients show pathologic sweating patterns and excessive sweating for at least 6 months and fulfill at least four of the following criteria: affected areas are axillae and/or palms and/or soles and/or forehead; symmetry; no night sweating; at least once a week; onset before the age of 25; positive family history; negative impact on daily activities. Frequently used therapies are topical aluminum salts and anticholinergics, iontophoresis in water, and intracutaneous botulinum toxin. Anticholinergics are also used as systemic treatment. Surgical procedures are used as a last result. Furthermore procedures using thermolysis have been developed.

Keywords

Sweat glands Anticholinergics Sweating Sweating patterns Aluminum salts 

Notes

Einhaltung ethischer Richtlinien

Interessenkonflikt

J. Wohlrab gibt an Honorare bzw. Sponsoring für Vorträge, Beratung oder wissenschaftliche Projekte bzw. klinische Studien mit Relevanz von folgenden Unternehmen erhalten zu haben: Bombastus, Dermapharm, Galderma, Jenapharm, Leo, L’Oréal, Mavena, Mibe, Riemser. B. Kreft gibt an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

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Copyright information

© Springer Medizin Verlag GmbH, ein Teil von Springer Nature 2018

Authors and Affiliations

  1. 1.Universitätsklinik und Poliklinik für Dermatologie und VenerologieMartin-Luther-Universität Halle-WittenbergHalle (Saale)Deutschland
  2. 2.An-Institut für angewandte DermatopharmazieMartin-Luther-Universität Halle-WittenbergHalle (Saale)Deutschland

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