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anhidrosis (adiaphoresis)
inability to sweat normally [1]
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 [3]
- 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
a) older age
b) 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
Special laboratory:
- sweat tests
a) quantitative sudomotor axon reflex test (QSART)
b) silastic sweat imprint
c) thermoregulatory sweat test
Complications:
- heat exhaustion, heat stroke
- can be fatal
Management:
- treatment not always indicated
- address underlying cause
- treat heat-related complications
a) muscle cramps
b) heat exhaustion
c) heat stroke
Related
hyperhidrosis
hypohidrosis
perspiration (sweating)
sweat gland
General
sweat gland disease; apocrine gland disease
References
- Ahydrosis: Mayo Clinic
http://www.mayoclinic.com/health/anhidrosis/DS01050
- DiagnosisPro
http://en.diagnosispro.com
- NEJM Knowledge+ Question of the Week Feb 18, 2020
https://knowledgeplus.nejm.org/question-of-week/1356/