← All decks
Dermatology
Diseases of the Eccrine and Apocrine Sweat Glands
Built from Dermatology, 5th Edition
What’s inside
11 sections · 100 slides
Overview
- What sweat glands are and why they matter
- How this topic is organised
Sweat Gland Anatomy and Physiology
How eccrine and apocrine glands are built, and how the nervous system controls them
- Eccrine sweat glands
- Nerve control of sweating
- Nerve control of sweating: key points
- Apocrine sweat glands
Hyperhidrosis
Excessive sweating - primary (idiopathic) versus secondary (due to another cause)
- What hyperhidrosis is
- Primary hyperhidrosis: key features
- Criteria for the diagnosis of primary hyperhidrosis
- Two patterns of primary hyperhidrosis
- Primary cortical hyperhidrosis of the face
- Volar hyperhidrosis of the sole
Secondary Hyperhidrosis
Excess sweating driven by an underlying disease, drug, or abnormal nerve pathway
- What secondary hyperhidrosis is
- Drugs that can stimulate eccrine sweating – direct-acting cholinomimetic agents
- Drugs that can stimulate eccrine sweating – cholinesterase inhibitors
- Drugs that can stimulate eccrine sweating – adrenomimetic agents
- Drugs that can stimulate eccrine sweating – antidiabetic (hypoglycemic) agents
- Drugs that can stimulate eccrine sweating – CNS stimulants
- Drugs that can stimulate eccrine sweating – antidepressants
- Drugs that can stimulate eccrine sweating – other drug classes (antipsychotics, antipyretics, opioids)
- Cortical (emotional) hyperhidrosis: causes
- Causes of cortical (stress/emotional) hyperhidrosis
- Hypothalamic (thermoregulatory) hyperhidrosis
- Causes of hypothalamic hyperhidrosis, by category
- Medullary (gustatory) hyperhidrosis – physiologic type
- Medullary (gustatory) hyperhidrosis – pathologic type
- Gustatory sweating in Frey syndrome
- How Frey syndrome develops
- Spinal cord sweating and autonomic dysreflexia
- Compensatory hyperhidrosis
- Compensatory hyperhidrosis: one pattern, three triggers
- Compensatory hyperhidrosis of the face
- Non-neural hyperhidrosis
- Eccrine angiomatous hamartoma
- Other causes of secondary hyperhidrosis, by category
Diagnosis and Treatment of Hyperhidrosis
Telling primary from secondary disease, then working through a stepped treatment ladder
- Diagnostic approach
- Palmar hyperhidrosis on starch-iodine testing
- Measuring sweat objectively
- Sweating pattern of axillary hyperhidrosis on starch-iodine testing
- Initial patient evaluation for secondary hyperhidrosis
- Treatment: a stepped ladder
- First-line treatment: topical agents
- Treatment of hyperhidrosis
- Treatment of hyperhidrosis (continued)
- Botulinum toxin for hyperhidrosis
- Mapping the injection area for botulinum toxin
- Surgical treatment: the last resort
Hypohidrosis and Anhidrosis
Too little sweat, or none at all - a possible medical emergency in the heat
- Why not sweating can be dangerous
- Central and neuropathic hypohidrosis
- Causes of central and neuropathic hypohidrosis and anhidrosis
- Drugs that cause hypohidrosis and anhidrosis – blockade of neurotransmission
- Drugs that cause hypohidrosis and anhidrosis – dysfunction of the eccrine gland
- Peripheral (gland-level) anhidrosis
- Peripheral causes of hypohidrosis and anhidrosis due to sweat gland abnormalities
- Acquired idiopathic generalized anhidrosis
- Acquired idiopathic generalized anhidrosis
- Diagnosing and treating anhidrosis
Abnormalities of Sweat Composition
When the chemistry, smell, or colour of sweat itself is abnormal
- Electrolyte changes: cystic fibrosis
- Systemic disorders that affect the levels of electrolytes in sweat
- Odor: bromhidrosis
- Types of bromhidrosis
- Colour: chromhidrosis
Microscopic Clues and Sweat's Effect on Skin Disease
What a sweat gland biopsy can reveal, and how sweat itself worsens other skin diseases
- Diagnostic microscopic changes in eccrine glands
- Lafora disease: PAS-positive granules in eccrine duct cells
- Diagnostic microscopic changes in eccrine glands
- Diagnostic microscopic changes in eccrine glands (continued)
- How sweat affects other skin diseases
Miliaria and Related Eccrine Duct Disorders
What happens when the eccrine duct itself becomes physically blocked
- Miliaria: sweat retention from a blocked duct
- Three depths of duct blockage in miliaria
- Three types of miliaria
- Miliaria crystallina
- Miliaria crystallina
- Miliaria rubra ('prickly heat')
- Miliaria rubra across different patients
- Miliaria rubra of the back
- Miliaria profunda
- Miliaria: diagnosis and treatment
- Multiple sweat gland abscesses
- Neutrophilic eccrine hidradenitis (NEH)
- Neutrophilic eccrine hidradenitis: clinical appearance
- Neutrophilic eccrine hidradenitis: histopathology
- NEH: clinical picture and treatment
- Idiopathic palmoplantar hidradenitis
- Idiopathic palmoplantar hidradenitis
- Granulosis rubra nasi
- Keratolysis exfoliativa
- Keratolysis exfoliativa of the palm
- Severe keratolysis exfoliativa of the plantar surface
Disorders of the Apocrine Sweat Gland
Fox–Fordyce disease - the classic condition of blocked apocrine glands
- Fox–Fordyce disease: overview
- Fox–Fordyce disease: clinical features
- Fox–Fordyce disease of the axilla
- Fox–Fordyce disease: pathology and treatment
Key Takeaways
Pulling together the eccrine and apocrine sweat gland disorders in this chapter
- Key takeaways
- References
- References (continued)
- References (continued)
- References (continued)
- References (continued)
- References (continued)
- Dermatology, 5th Edition (2-Volume Set)