anhidrosis (adiaphoresis)

Introduction

inability to sweat normally

Etiology

• primary
  • absence of sweat glands
• secondary
  • diabetes
    • diabetic ketoacidosis
    • diabetic autonomic neuropathy
  • neuropathy
  • psoriasis
  • autonomic disorders
    • familial dysautonomia
    • Shy-Drager syndrome
    • Horner's syndrome
  • spinal cord disorder
    • spinal cord injury
    • spinal cord lesion
  • heat stroke
  • lumbar sympathectomy
  • spinal Meningioma
  • Guillain-Barre syndrome
  • injury to the external carotid artery
    • sympathetic innervation of sweat glands follows external carotid artery
  • severe eczema
  • Fabrys disease
  • dehydration
  • congenital insensitivity to pain with anhidrosis
  • Helweg-Larsen's Syndrome
  • hysterical neurosis
  • aspiration oropharyngeal contents
  • hypothyroidism (myxedema)
  • miliaria
  • hypothalamic dysfunction
  • botulism
  • mushroom poisoning
  • olanaceous alkaloid poisoning
  • drug adverse effect
    • anticholinergics
      • belladonna
      • atropine
      • benztropine (Cogentin)
      • oxybutynin (Ditropan)
      • scopolamine
      • tolterodine (Detrol)
      • cyclobenzaprine (Flexeril) Administration/Toxicity
    • antiparkinsonian agent Administration/Toxicity
    • antipsychotic
      • thorazine
      • phenothiazines
    • muscle relaxant
    • antihistamine
    • sympatholytic
    • tricyclic antidepressant overdose
      • Imipramine (Tofranil)
  • clidinium (Quarzan)
  • diphenhydramine (Benadryl)
  • flavoxate (Urispas)
  • hyoscyamine (Levsin/Anaspaz)
  • methotrimeprazine (Levoprome)
  • orphenadrine (Norflex)
  • propantheline (Pro-Banthine)
• risk factors
  • older age
  • skin disorders

Pathology

• failure of thermoregulatory cooling mechanisms

Clinical manifestations

• little or no perspiration
  • this may occur
    • over most of the body
    • in a single area
    • in scattered patches
• dizziness
• muscle cramps or weakness
• flushing
• feeling hot
• unaffected areas may try to compensate by sweating profusely
• vigorous exercise, hard physical work & hot weather precipitate symptoms

Diagnostic procedures

• sweat tests
  • quantitative sudomotor axon reflex test (QSART)
  • silastic sweat imprint
  • thermoregulatory sweat test

Complications

• heat exhaustion, heat stroke
• can be fatal

Management

• treatment not always indicated
• address underlying cause
• treat heat-related complications
  • muscle cramps
  • heat exhaustion
  • heat stroke

More general terms

• sweat gland disease; apocrine gland disease

Additional terms

• hyperhidrosis
• hypohidrosis
• perspiration (sweating)
• sweat gland