Patients with primary hyperhidrosis may most commonly have sensitive skin: Study

A new study published in the Journal of Drug and Dermatology found that any person with primary hyperhidrosis is more likely than the general population to have sensitive skin even in places where excessive perspiration is not present. The most prevalent eccrine gland illness, primary hyperhidrosis (PHH), is characterized by excessive perspiration brought on by increased sympathetic activation, which negatively affects quality of life. The patients with excessive perspiration on one or more eccrine-rich body parts that is symmetrical, absent during sleep, and interferes with everyday activities for more than 6 months are clinically diagnosed with PHH. In physiologic sweating, the eccrine sweat gland is activated by sympathetic transmission, which causes the hypothalamus to receive retrograde negative input.

Even though the eccrine glands in PHH are normal in size, number, and histologic appearance, the overstimulation of cholinergic receptors on sweat glands and increased efferent transmission are caused by unbalanced sympathetic signaling. Neurosensory dysfunction also causes sensitive skin (SS), which is characterized by cutaneous hyperreactivity to normally harmless stimuli that cannot be linked to an underlying skin problem. An estimated 40% to 70% of people worldwide are thought to have SS, which is characterized by itching, burning, tightening, or stinging feelings. While the pathogenesis of SS is unknown, perspiration, stress, and high temperatures are recognized exacerbators of the condition which indicates the cholinergic activation which may contribute to symptom flares. Thus, this study was to survey PHH patients in order to evaluate the burden of SS and hyperhidrosis (HH).

The International Hyperhidrosis Society distributed a survey exempt from the International Review Board (IRB). Random forest machine learning methods were used to create a predictive classification model for SS. HH and SS severity levels were significantly correlated, with 89% of the 637 respondents with PHH reporting SS. SS happened on both HH-affected and HH-unaffected body locations. Sensitive Scale-10 (SS-10), a validated questionnaire to measure SS severity, was shown to be the most useful in predicting SS in this cohort using predictive modeling.

Overall, these findings suggest and validate a connection between SS and HH. Despite it also happened on unaffected body locations, SS was most common in HH-afflicted sites by indicating that sweat is not the only cause. Cholinergic signaling may be investigated in future to rule out the connection between these disorders.

Reference:

McCormick, E. T., Min Choi , J., Abdel Azim, S., Whiting, C., Pieretti, L., Zhang, L., & Friedman, A. (2024). Primary Hyperhidrosis and Sensitive Skin: Exploring the Link with Predictive Machine Learning-Based Classification Models - JDDonline - Journal of Drugs in Dermatology. 2024. https://doi.org/10.36849/JDD.8461