anhidrosis

無汗症 　

WordNet

1. failure of the sweat glands (同)anhydrosis

Wikipedia preview

出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2015/05/09 08:18:04」(JST)

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Hypohidrosis
Classification and external resources
ICD-10	L74.4
ICD-9	705.0
DiseasesDB	21064

Hypohidrosis is diminished sweating in response to appropriate stimuli. While hyperhidrosis is a socially troubling but benign condition, hypohidrosis can lead to hyperthermia, heat exhaustion, heat stroke and potentially death.

Causes

Medications

• Anticholinergic agents
• Opioids
• Botulinum toxin
• Alpha-2 receptor antagonists
• Clonidine
• Barbiturates

Physical agents

• Tumors
• Burns
• Radiation
• Surgery
• Scars
• Sores

Dermatological

• X-linked hypohidrotic ectodermal dysplasia
• Incontinentia pigmenti
• Bazex disease
• Fabry disease
• Miliaria
• Sjogren syndrome
• Systemic sclerosis
• Graft-versus-host disease

Neuropathic

• Multiple system atrophy
• Dementia with Lewy bodies
• Multiple sclerosis
• Cerebrovascular accident
• Tumour
• Encephalitis
• Cervical myelopathy
• Diabetes mellitus
• Guillain–Barre syndrome
• Hereditary sensory and autonomic neuropathy
• Alcoholism
• Amyloidosis
• Ross syndrome
• Pure autonomic failure
• Horner's syndrome

Diagnosis

Sweat is readily visualized by a topical indicator such as iodinated starch (minor test) or sodium alizarin sulphonate, both of which undergo a dramatic colour change when moistened by sweat. A thermoregulatory sweat test can evaluate the body’s response to a thermal stimulus by inducing sweating through a hot box ⁄ room, thermal blanket or exercise. Failure of the topical indicator to undergo a colour change during thermoregulatory sweat testing indicates hypohidrosis, and further tests may be required to localize the lesion.

Magnetic resonance imaging of the brain and ⁄ or spinal cord is the best modality for evaluation when the lesion is suspected to be localized to the central nervous system.

Skin biopsies are useful when anhidrosis occurs as part of a dermatological disorder. Biopsy results may reveal the sweat gland destruction, necrosis or fibrosis, in addition to the findings of the primary dermatological disorder.

Management

The treatment options for hypohidrosis and anhidrosis is limited. Those with hypohidrosis should avoid drugs that can aggravate the condition (see medication-causes). They should limit activities that raise the core body temperature and if exercises are to be performed, they should be supervised and be performed in a cool, sheltered and well-ventilated environment. In instances where the cause is known, treatment should be directed at the primary pathology. In autoimmune diseases, such as Sjogren syndrome and systemic sclerosis, treatment of the underlying disease using immunosuppressive drugs may lead to improvement in hypohidrosis. In neurological diseases, the primary pathology is often irreversible. In these instances, prevention of further neurological damage, such as good glycaemic control in diabetes, is the cornerstone of management. In acquired generalized anhidrosis, spontaneous remission may be observed in some cases. Numerous cases have been reported to respond effectively to systemic corticosteroids. Although an optimum dose and regime has not been established, pulse methylprednisolone (up to 1000 mg ⁄ day) has been reported to have good effect.

References

Notes

• http://www.mayoclinic.com/health/anhidrosis/DS01050
• http://www.nlm.nih.gov/medlineplus/ency/article/003219.htm

UpToDate Contents

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• 1. 遺伝性感覚自律神経ニューロパチー hereditary sensory and autonomic neuropathies
• 2. ホルネル症候群 horners syndrome
• 3. ファブリー病の臨床的特徴および診断 clinical features and diagnosis of fabry disease
• 4. 思春期および成人における労作性熱中症：疫学、体温調節、危険因子、および診断 exertional heat illness in adolescents and adults epidemiology thermoregulation risk factors and diagnosis
• 5. 原発性局所多汗症 primary focal hyperhidrosis

English Journal

• Novel mutations in dystonin provide clues to the pathomechanisms of HSAN-VI.

• Manganelli F1, Parisi S1, Nolano M1, Tao F1, Paladino S1, Pisciotta C1, Tozza S1, Nesti C1, Rebelo AP1, Provitera V1, Santorelli FM1, Shy ME1, Russo T1, Zuchner S1, Santoro L2.
• Neurology.Neurology.2017 May 3. pii: 10.1212/WNL.0000000000003992. doi: 10.1212/WNL.0000000000003992. [Epub ahead of print]
• PMID 28468842

• Skin Ultrastructural Findings in Acquired Generalized Hypohidrosis/Anhidrosis in a Patient with Subclinical Sjögren Syndrome.

• Huang YJ1, Chih PL, Huang TH, Yu HS, Hsieh YL, Yu S.
• Acta dermato-venereologica.Acta Derm Venereol.2017 Apr 27. doi: 10.2340/00015555-2690. [Epub ahead of print]
• PMID 28448095

• An Innovative Cooling Jacket to Combat Heat Intolerance in Children with Anhidrosis.

• Inamadar AC1, Palit A1, Khurana N1.
• Pediatric dermatology.Pediatr Dermatol.2017 Apr 21. doi: 10.1111/pde.13144. [Epub ahead of print]
• PMID 28429544

Japanese Journal

• 症例報告 発汗回復に伴い点状膨疹出現範囲が移動した減汗性コリン性蕁麻疹の1例

• 中澤 慎介,青島 正浩,龍野 一樹 [他]
• 臨床皮膚科 = Japanese journal of clinical dermatology 69(6), 374-378, 2015-05
• NAID 40020477192

• 緊張性瞳孔で偶然発見されたRoss症候群の1例

• 岡田 匡充,稲富 雄一郎,加藤 勇樹,軸丸 美香,大林 光念,米原 敏郎,安東 由喜雄
• 臨床神経学 55(3), 160-164, 2015
• 66歳，女性．めまいを主訴に受診した際に，緊張性瞳孔と四肢腱反射消失をみとめた．また10歳代より，熱不耐症や左半身の発汗低下を自覚していた．ピロカルピン点眼試験では両側縮瞳，温熱発汗試験では顔面と左胸部に発汗低下をみとめ，Ross症候群と診断した．アセチルコリン皮内注射では鎖骨下と臍周囲の左側で発汗が低下していた．胃電図では平均周波数の低下とbradygastriaの頻度上昇，皮膚血流検査では左上 …
• NAID 130004921324

• ピロカルピン塩酸塩内服が有効であった特発性分節性無汗症の1例 (特集 毛包・脂腺系疾患 : 最近の話題)

• 指宿 千恵子,西岡 美南,福田 佳奈子 [他]
• 皮膚科の臨床 56(3), 365-369, 2014-03
• NAID 40020024599

Related Pictures

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★リンクテーブル★

リンク元	「無汗症」「無汗」
拡張検索	「acquired idiopathic generalized anhidrosis」

「無汗症」

　　[★]

英

anhidrosis、anhydrosis, anidrosis, adiaphoresis

同

無発汗症

関

発汗低下、乏汗症 oligohidrosis、減汗症 hypohidrosis

• 発汗刺激があっても発汗がまったくない状態である
• 全身性のものと局所性のもの、原因により先天性、後天性(続発性)のものがある。
• 皮膚は乾燥して粗造化し、鱗屑を付着する。掻痒感を呈することもある。
• これらは汗腺の機能的変化あるいは汗腺およびその周囲組織の器質的変化によって起こる。
• 病態からの分類

• 先天的な汗腺の機能欠如：無汗性外胚葉形成異常症
• 代謝異常：甲状腺機能低下症、脱水症、熱射病、ファブリー病
• 神経疾患：体温調節中枢の障害(間脳性視床下部疾患)、脊髄の障害、アルコール性神経炎、ハンセン病、糖尿病、多発神経炎
• 汗孔・汗管の閉塞：尋常性魚鱗癬、脂漏性皮膚炎、アトピー性皮膚炎、紅皮症、乾癬、常性天疱瘡、紅皮症、アミロイドーシス
• 汗腺の萎縮：強皮症、シェーグレン症候群、日光弾性線維症
• 薬剤性：アセチルコリン抑制薬、副交感神経遮断薬

「無汗」

　　[★]

英

anhidrosis, absent sweating adiaphoresis, adiapneustia

「acquired idiopathic generalized anhidrosis」

　　[★] 後天性特発性全身性無汗症