By Gary M. White, MD
Hyperhidrosis. Hyperhidrosis is most common on the palms and soles or axilla.
Generalized sweating is a rather non-specific symptom. It may be related to obesity, hyperthyroidism, and menopause. Rarely, it may be caused by a pheochromocytoma, POEMS syndrome, or a brain lesion. Night sweats are classically a sign of tuberculosis and other chronic infections, but also lymphoma, dumping syndrome, and carcinoid syndrome.
Hyperhidrosis, here localized to one side of the nose.
Cases of unilateral localized hyperhidrosis of the face and scalp [BJD 1974;90;970][BJD 1992;126;416] or of the trunk [AD 1978;114;770] have been reported. Many cases are related to nerve injury such as a spinal cord lesion, intrathoracic neoplasm, syringomyelia, or after sympathectomy.
A novel locus for primary focal hyperhidrosis has been mapped to chromosome 2q31.1 [BJD 2015;172;1150] in one 6-generation family. The palms, the soles and/or axillae were variably affected. The mean age of onset was about 8 (range 3–12) years.
Sweating of the head and neck triggered by eating may occur. It may be idiopathic, due to damage to the sympathetic nervous system or from diabetes via autonomic neuropathy. Frey's syndrome is localized sweating of the face, e.g., after parotid gland surgery.
This tumor sweated constantly. The patient declined biopsy.
Blue Rubber Bleb Nevus Syndrome
Eccrine Angiomatous Hamartoma. A single or multiple brown or violaceous plaque--hyperhidrotic and painful. Histology shows eccrine glands and vascular elements.
Eccrine Nevus. A congenital or infantile-onset, skin-colored plaque that sweats.
Hyperhidrosis localized to pretibial myxedema has been reported [JAAD 1990;23;250].
Acquired idiopathic generalized anhidrosis is a rare disorder in which systemic anhidrosis occurs in the absence of any causative skin, metabolic, or neurological disorder. [BJD Feb 2013]
Herpes zoster may induce localized hypohidrosis [JAAD 2017;76;160].
See apocrine chromhidrosis. Blue secretions on bilateral malar cheeks. [Dermatology Online Journal 18(3)]
Blood in sweat. Hematohidrosis. [Indian Dermatol Online J. 2010 Jul-Dec; 1(1): 30–32]