Hand sweat can drip? Doctor: it’s a disease to be treated
Jinyang news reporter Fu Chang, intern Zhang Chengchen, correspondent Hu Yingyi, sun Bingqian reported: hot summer, people sweat more. But different from normal sweating, there is such a disease, no matter in spring, summer, autumn and winter, palms will always “sweat”, and in severe cases, sweat even drops down, which brings serious trouble to patients’ daily life. This is palmar hyperhidrosis. Recently, 20-year-old boy Xiao Li (not his real name) underwent a magical thoracic surgery in Guangzhou Red Cross Hospital, successfully getting rid of the 20-year entanglement of palmar hyperhidrosis.
Palmar hyperhidrosis: a secret for 20-year-old boys
Xiao Li has found that his hands don’t like “sweating” since he can remember. Although this problem does not affect his health, it has caused great trouble to his life: in order to wipe sweat at any time, he needs to take a paper towel with him; when he plays with his mobile phone, he will slide his hand, and even can’t unlock his fingerprint; when he studies, the books and notebooks will soon get wet, and what’s more serious is that when the answer card gets wet, the words on it will be pasted, so he can only pad a paper towel on the test paper write.
In addition, palmar hyperhidrosis has also seriously affected Xiao Li’s psychological state and normal social life. “He will feel inferior because he is afraid that others will see his hand and dare not touch others with his hand.”. He said.
None of Xiao Li’s family has had similar symptoms. In order to cure the disease, he tried many methods, and even took Chinese medicine for more than a month, but the effect was not obvious. Seeing that he is becoming mature and about to enter the society, Xiao Li is in a bit of a hurry. So he came to Guangzhou Red Cross Hospital for treatment.
Through the blood routine, liver and kidney function, chest X-ray, ECG examination results and medical history collection, Xiao Li was diagnosed as severe primary palmar hyperhidrosis. After minimally invasive surgery to cut off the thoracic sympathetic nerve, Xiao Li’s palmar hyperhidrosis was effectively relieved, and he finally regained his confidence. In the interview, Xiao Li sighed that he finally realized how comfortable his hands were.
The prevalence of palmar hyperhidrosis in one parent was 1 / 4 of that in one child. The incidence of palmar hyperhidrosis in one parent was 1 / 4 of that in one child
What is palmar hyperhidrosis? According to Zang Dongyu, director of thoracic surgery department of Guangzhou Red Cross Hospital, hyperhidrosis is a disease caused by excessive secretion of sweat glands due to overexcited sympathetic nerves. The common parts include hands, feet, armpits and head and face. Palmar hyperhidrosis is one of the clinical manifestations of hyperhidrosis, which is characterized by abnormal increase of sweat secretion from both hands.
There is no significant difference in the incidence rate of hand and hidrosis between male and female, but incidence rate is about 0.3% in Eastern ethnic groups, especially in Southeast Asia, such as Indonesia, Thailand and Vietnam. This is higher than that of Western 0.15%-0.3%. In China’s coastal areas such as Taiwan, Guangdong, Fujian and Zhejiang, there are more palmar hyperhidrosis, with a incidence rate of 4.59%.
“Why there is a different incidence rate in different regions, there is no definite answer so far.” Zang Dongyu said. However, palmar hyperhidrosis has 12.5% familial genetic tendency, which is considered as an autosomal dominant genetic disease. If one of the parents is a palmar hyperhidrosis patient, the possibility of their children’s disease is 1 / 4.
It is reported that the general palmar hyperhidrosis patients have symptoms since childhood or adolescence. The average age of onset is 13 years old. The symptoms gradually worsen in adolescence, and gradually alleviate after 50 years old. The symptoms of palmar hyperhidrosis patients are sudden and intermittent, which are often aggravated after emotional tension, excitement, anxiety and exercise, when the external temperature rises, and stop sweating during sleep.
“In addition, palmar hyperhidrosis can occur alone, or accompanied by hyperhidrosis in the sole, armpit and other parts. The sweat is cold and wet, but odorless.” Zang Dongyu said.
The treatment of moderate and severe palmar hyperhidrosis is recommended
In fact, many people have experienced hand sweating, so what degree of palmar hyperhidrosis needs treatment?
According to Zang Dongyu, palmar hyperhidrosis can be divided into three stages: mild palmar hyperhidrosis is characterized by wet palms; moderate palmar hyperhidrosis can get a handkerchief wet when palms are sweating, while severe palmar hyperhidrosis, that is, Xiao Li’s case, refers to palmar hyperhidrosis with obvious drops.
“Strictly speaking, palmar hyperhidrosis is not a real disease. Simple palmar hyperhidrosis has little effect on human physiological health. But palmar hyperhidrosis makes patients feel helpless, anxious or panic every day, which brings great inconvenience to their study, work, social life and life, seriously affects their self-confidence and causes great psychological pain. ” Zang Dongyu said. Moreover, the skin of patients’ hands is often in a moist and soaked state, and their palms molt obviously, often accompanied by dermatitis. In winter, the extremities are wet and cold, which is easy to cause frostbite. Some fine work, such as accessories, drawing, electrician and so on, has nothing to do with palmar hyperhidrosis.
Therefore, Zang Dongyu suggested that if palmar hyperhidrosis is moderate or severe, it is necessary to go to the thoracic surgery department of the hospital for examination.
He said that before treatment, we should judge whether it is secondary palmar hyperhidrosis or primary palmar hyperhidrosis. The method to distinguish the two is mainly based on the detailed history collection, including determining the location of the disease as local / systemic hyperhidrosis, the frequency, duration, age of onset, family history, whether accompanied by fever, night sweat, weight loss and other symptoms. Primary palmar hyperhidrosis can be diagnosed only when all secondary palmar hyperhidrosis symptoms are excluded.
It is very important to determine whether it is secondary palmar hyperhidrosis or primary palmar hyperhidrosis because of the different treatment methods. “Secondary palmar hyperhidrosis often has definite causes, such as chronic infection, tuberculosis, malignant tumor, hyperthyroidism, central nervous system injury, etc., which can be solved by treatment according to the primary cause.” Zang Dongyu said, “but the etiology of primary palmar hyperhidrosis is still unclear. At present, most scholars believe that it is related to the sympathetic hyperfunction that dominates the sweat glands in the hands, and the treatment needs to be targeted at palmar hyperhidrosis.”
Minimally invasive resection of the thoracic sympathetic nerve with a small incision under the armpit
Zang Dongyu said that for primary palmar hyperhidrosis, traditional non-surgical treatment includes oral anticholinergic drugs, external application of astringents or antiperspirants, traditional Chinese medicine or acupuncture, but the effect of these methods is not very clear, and may have side effects, which is not advocated by doctors.
At present, surgical sympathectomy is the only long-term effective treatment for palmar hyperhidrosis. Thoracoscopic sympathectomy is a minimally invasive method, which has more advantages than traditional thoracotomy.
“Just cut a 1cm small opening under the armpit on both sides, enter the thoracic cavity through the small opening, and cut off the T3 or T4 sympathetic nerve. This kind of operation not only has a small wound, basically no bleeding during the operation and less postoperative pain, but also has a thoracoscope, which is equivalent to observing directly in the chest. The thoracoscope has a magnifying effect and looks clearer than direct vision, so the operation time can be shortened to about 40 minutes. ” Zang Dongyu said that the effective rate of the operation in the treatment of primary palmar hyperhidrosis is more than 95%, and the patient can be discharged in 2-3 days, which can significantly improve the symptoms and improve the quality of life.
At present, the best age for the operation is 12 to 50, he said.
In 2004, the American skin Association organized more than 20 experts to formulate the diagnostic reference standard of palmar hyperhidrosis. Without obvious inducement, hyperhidrosis can be seen by naked eye for more than 6 months, and can be diagnosed if it meets the following conditions (with fever, night sweat and weight loss, the possibility of secondary hyperhidrosis should be noted):
1. The bilateral sweating sites were symmetrical,
at least once a week
3. The onset age was less than 25 years old,
4. With positive family history,
5. No hyperhidrosis during sleep
6. Affect daily work and life