687957
Description
Flashcards by Morgan Morgan, updated more than 1 year ago
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Created by Morgan Morgan
about 10 years ago
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| Question | Answer |
| Definition? | Excessive Sweat Production. Can be general and affect all of the body, or it can be local, affecting the armpits, palms of hands and plantar of feet. It can be embarrassing and distressing for the patient. |
| Causes? | Primary – abnormality in the sympathetic nervous system. Temperature control. Secondary – Menopause, Hyperthyroidism, Gustatory – eating hot/spicy food, Being drunk or being high on drugs like cocaine and ecstasy. Addicts withdrawing from drugs/alcohol. Medication such as anti-depressants. Stress or anxiety. |
| Clinical features? | Visible beads of sweat on the plantar aspect of the foot. Interdigital maceration. Socks saturated with moisture. Sweat stains on shoes. Inside of the shoe shows signs of rotting. |
| Treatment? | Avoid triggers such as hot/spicy food or alcohol. Anti-perspirants – ammonium chloride solutions. Astringents – surgical spirit. Use footbaths – with tepid/warm water. Epsom salts and potassium permanganate. Change socks/hosiery daily or more frequently. Wear cotton/wool socks. Wear leather shoes. Rotate shoes – allow shoes to dry out for 24 hours. Wear sandals in the summer. Iontophoresis. Botox. Sympathectomy. |
| What is iontophoresis? | Feet are placed in a bowl of water and a weak electric current is passed through the water. The current is thought to help block the sweat glands. Each session lasts between 20-30 mins. Two or four sessions per week. Proved to be effective in 80% to 90% of cases. |
| What is botox? | Powerful protein which blocks the signals from the brain to the sweat glands, reducing the amount of sweat that is produced. Around 12-45 injections of botox are given in the affected areas. Procedure takes about 30-45 minutes. Effects last from 2-8 months. Limited availability on NHS. |
| Sympathectomy? | Selectively destroys the parts of the sympathetic chain that supply the sweat glands. |
| Complications of hyperhidrosis? | Loss of skin elasticity resulting in inter-digital fissures and blisters. Loss of skin resistance to fungal infection and bacterial infection. |
| Definition of anhidrosis | Occurs when the sweat glands stop working. |
| Causes of anhidrosis? | Autonomic nerve damage under activity of the the sympathetic nervous system, e.g, diabetes, alcoholism and Parkinson's disease. Hypothyroidism. Peripheral Vascular disease. Peripheral neuropathy. Skin damage - clogged ducts, conditions that block sweat ducts. Skin injuries, e.g. severe burns. Certain medications. Dehydration. |
| Clinical features | Dry, scaly rough skin.Inelastic and may have fissures. Reduces tissue viability. |
| Differential diagnosis? | Fungal infection |
| Management? | Restore elasticity and reduce desquamation and flaking. Prevent fissuring with silicone heel pads. Remove callous and seed corns. Eliminate any fungal infection. Nail care. Avoid sandals. Use passive/plain and active emollients. Emollient footbath. Dermatological referral. |
| Two types of emollient? | Passive/Plain Active |
| Passive/Plain? | No active ingredient. Prevents loss of moisture from the skin. |
| Active | Contain ingredients that attract moisture to the skin - urea. |
| What is bromhidrosis? | Action of bacteria on hyperhidrotic skin. |
| Bromhidrosis is largely due to bacterial breakdown of which gland secretions? | Apocrine gland, giving ammonia and fatty acids. |
| Which species of bacteria causes this? | Corynebacterium. |
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