abnormal sweating
Introduction
Introduction Sweating is the way the body regulates body temperature. When we feel hot, or during exercise, sweating can help the body reduce body temperature to normal levels through the evaporation of sweat. However, it is not a good thing that sweat is abnormal.
Cause
Cause
1. Small sweat glands: There are 2 to 5 million small sweat glands in adults, with an average of 143 to 339 per square centimeter. The palms of the hands and feet are the most, about 620 per square centimeter, and the thighs are at least 120 per square centimeter. The activity of the small sweat glands is dominated by sympathetic nerves, mainly cholinergic fibers. Experiments have shown that local injection of choline acetate can cause a large amount of sweat secretion from small sweat glands. Local injection of adrenaline can also cause an increase in sweat gland secretion, which discharges a small amount of sweat. The secretion of sweat glands in normal people is obviously related to temperature, exercise volume and mental factors. 99% of the sweat component is water, 1% is a solid component, and contains most of the organic matter urea and lactic acid; the inorganic substance is the most sodium chloride, and there are calcium, magnesium, phosphorus, and cadmium. The sweat also contains a variety of amino acids. The relative density of sweat is 1.001 to 1.006 and the pH is 5.5 + 0.5. The factors affecting the secretion of small sweat glands are: 1 temperature; 2 mental factors; 3 drugs such as aspirin; 4 diet such as eating spicy food, drinking hot soup; 5 diseases such as tuberculosis and night sweats.
2. Apocrine glands: divided into two exclusion pathways, one is to open the hair follicle, and the other is to open to the skin. The sweat component is water, and the solid component includes iron, odorous substances, colored substances such as yellow, brown, green, cyan, red, and black. It can form a sweat in the crotch.
The gland still has a cooling and cooling mechanism to regulate body temperature, moisturize the skin with drugs, and metabolites to reduce the burden of kidney function.
First, congenital hereditary
1. Congenital ectodermal dysplasia without sweat.
2. Riley-Day syndrome (dehydration and dry syndrome is autosomal recessive. With hyperhidrosis).
3.Spanlang Tappeiner syndrome (hair loss, hyperhidrosis. Tongue corneal opacity syndrome is autosomal dominant inheritance.
Second, mental and neurological damage factors
1. Hyperhidrosis: caused by mental stress, emotional agitation, and neurological stimulation.
2. Sweat and rubella: Mental factors are important reasons.
3. Nasal redness: may be a vasomotor disorder.
Third, the disease caused
1. Night sweats: more common in tuberculosis patients night sweats.
2. Sjogren's syndrome: no sweating throughout the body.
3. Local sweatlessness: seen in congenital ichthyosis; systemic scleroderma; leprosy; chronic radiation dermatitis; transverse myelitis; syringomyelia.
4. Hyperhidrosis: seen in hemophilia and plague.
Fourth, the drug caused by sweating
When methylene blue is injected, the sweat is cyan, and the iodide can make the sweat reddish. Oral administration of chlorophene can make the sweat red.
5. Mixing of bacteria and organic matter in sweat
Such as dysentery is more common in the axillary apocrine gland.
6. Urea sweat
Examine
an examination
(1) medical history
The medical history should be asked in detail about the cause of the abnormal sweating. If you are nervous, emotional, whether there is nerve trauma, medication history and illness. If you have hemophilia, you can cause sweating, and the chlorpheniramine can cause redness of sweat. You should ask if you have the same patient at home to rule out genetic factors.
(2) Physical examination
The focus of the physical examination should be on whether there are signs of skin that induce sweating abnormalities. If the patient is found to have ichthyosis, it is the cause of local sweatlessness. Plaque lesions of tuberculous leprosy, in addition to local paresthesia, often have no local sweat. Chronic radiation dermatitis damage, in addition to dry skin, atrophy, telangiectasia, often there is no local sweat. Therefore, a detailed physical examination can find out the cause of abnormal sweating to confirm the diagnosis.
(3) Laboratory inspection
Hyperhidrosis can be tested positive for hemoglobin. Sweating test: suitable for local sweating dysfunction, after applying iodine to the skin lesions, after drying, respectively, intradermal injection of 1:1000 concentration of pilocarpine lye solution 0.1-0.2ml, gently sucking the needle tip Exfoliate and immediately sprinkle with a thin layer of starch. After 3-5 minutes, the normal skin starch showed a blue dot, indicating that the sweat function was normal. If there is no blue small spot in the lesion, it means partial sweating dysfunction without sweat discharge.
Diagnosis
Differential diagnosis
Tide sweat: refers to the sweat glands secrete sweat, tuberculous leprosy plaque damage, in addition to local sensory abnormalities, often local sweat-free. Chronic radiation dermatitis damage, in addition to dry skin, atrophy, telangiectasia, often there is no local sweat. Therefore, a detailed physical examination can find out the cause of abnormal sweating to confirm the diagnosis.
Sweating around the body: Excessive sweating can reduce the flow of blood circulation in the human body, and the circulation slows down, which causes the body's heat dissipation to decrease, resulting in an increase in body temperature. A lot of sweating can also cause the body's salt to be lost, and the cells are devastated by the lack of sodium. If the child is physically weak, sweating at night when he falls asleep, like water pouring, even sweating all night, through the wet clothes, accompanied by irritability, crying, weight loss and other symptoms, it is pathological sweating. Common causes are vitamin D deficiency rickets. In addition to sweating at night, it is accompanied by irritability, restless sleep, easy to wake up, square skull, alopecia areata, chicken chest and other symptoms.
Sputum palm sweating: It is a disease caused by excessive secretion of sweat glands caused by excessive sympathetic stimulation. Sympathetic innervation dominates the body's sweating. Under normal circumstances, the sympathetic nerve regulates the body's body temperature by controlling sweating, but the patient's sweating and facial flushing completely lose normal control. Hyperhidrosis and facial flushing make the patient daily. In helplessness, anxiety or panic.
The other side of the face is sweating on the other side but no sweat: Generally, the peripheral neuropathy of diabetes causes an autonomic disorder that dominates the secretion of sweat glands, and there is a phenomenon of sweating on the side of the face. Medically, one side of the body sweats, while the other side has no sweat, called "sweat." In the lying test, the supine position is counted for 1 minute, and then the pulse is counted for 1 minute after standing. The sympathetic excitability is enhanced by increasing the pulse from the lying position to the standing position by 10-20 times. If the position is reduced from 10 to 20 times from the standing position to the lying position, the parasympathetic excitability is enhanced.
Periodic chills, fever, sweating, fever, retreat symptoms: typical malaria symptoms, mostly periodic episodes, manifested as intermittent cold fever. Usually there is a clear chill in the attack, the whole body is shaking, pale, lips cyanosis, chills last about 10 minutes to 2 hours, then the body temperature rises rapidly, often up to 40 ° C or higher, complexion flush, dry skin, irritability After the high fever lasts for about 2 to 6 hours, the whole body is sweating and the body temperature drops below normal or normal after sweating. After a period of intermittent period, the above intermittent intermittent chills and high fever episodes were repeated.
Excessive sweating of hands and feet: hand and foot hyperhidrosis is mainly manifested in the palm of the hand, sweaty on the soles of the feet. Mild patients only show the palms moist, severe palms of the patients can secrete sweat visible to the naked eye. When sweating, the palms are cold, only a few patients Fingers can stay warm when sweating. Because the skin of the hands is often wet, soaking, the palms of the palms are obvious, often accompanied by dermatitis.
Sweat is like oil: sweat is sticky like oil. Also known as sticky sweat. "The source of miscellaneous diseases, the rhinoceros candle? The source of sweat": "A cloud of oil and sweat, that is, sweat is also." The sweat is like a fritter. It is like a rainy sweat, which is a dangerous sweat, similar to the disease.
No sweat or less sweat in the lower body: no sweat or less sweat in the lower body is an abnormal manifestation of sweating in diabetic autonomic neuropathy.
Khan: Chlohidrosis is a rare disease caused by the sweating of the apocrine glands, often caused by bacteria that produce pigments. Small sweat glands rarely emit color sweat, and accidental ingestion of certain drugs or dyes can also cause sweating. There are also records of yellow sweat and sweat in the Chinese medical literature. Such as "the source of the disease" yellow sweat records: "Yellow sweat is a disease, body swelling, fever, sweat and thirst, strong as feng shui, sweat dyed clothes, Zheng Huang Ruyi juice."
