Ananya Ghosal, MAKAUT(WB)
Understanding anhidrosis:
Anhidrosis is a condition where sweat glands don’t function. The function of sweat glands is to remove heat or cool the body down. It is life-threatening because of heat-related illness. The illness related to heat may occur even during moderate temperatures. Hence, the threat of heatstroke increases. The state of hyperthermia where the body temperature is raised abnormally.
The body normally produces heat resulting in metabolism, which can disappear by evaporation of sweat or by radiation of heat. Heat intolerance may occur due to numerous disorders. Heat intolerance may cause symptoms like fatigue as well as a decrease in the patient’s normal sweating, episodic inability to concentrate in a hot environment or drowsiness are the indication for the diagnosis of the disorder.
Three main causes of anhidrosis:
Peripheral alteration in the eccrine gland, idiopathic, central, or neuropathic disease.
- Peripheral alteration in eccrine gland– Peripheral alteration which causes anhidrosis may be acquired or congenital. The peripheral alteration may occur due to genetic abnormalities like incontinentia pigmenti due to local destruction. For example, the obstruction by an entity like psoriasis or by the tumor.
- Central/ neuropathic disease– Central/neuropathic may occur at any stage of stimulation. The interruption may occur at the sweat gland, the descending neural tract, and the sweating center in the brain. The interruption will result in an absence of sweating. Interruption in the neural input may occur due to a clog or tumor of the hypothalamus, medulla, or pons. The neural tract can be interrupted by injuries, spinal cord tumors, or infarction.
Physiology of anhidrosis:
Central/ neuropathic causes may occur anywhere as well as a neural tract. The patient will have neck anhidrosis or ipsilateral facial if there is the participation of medulla or pontine. Alteration of the spinal cord may lead to anhidrosis of the skin that may be either contralateral or ipsilateral, as the neural tract in the spinal cord is consists of both crossed and uncrossed fibers. The chemical blockade in a selected sympathetic ganglion may lead to regional anhidrosis. The abnormality in the sweat gland causes anhidrosis.
The sweat glands are absent in the males with X-linked hypohidrotic ectodermal dysplasia; however, the female carriers will have reduced sweating or hypohidrosis. Local tissue destruction is the main reason for acquired localized anhidrosis. Radiation therapy, tumors, systematic sclerosis, and burns may distort the normal skin with subsequent anhidrosis. Entities that result in obstruction of the glands are also involved in anhidrosis.
Treatment:
The discontinuation of the distressed agent is the first step for the treatment of anhidrosis. The patient should be moved to the cold place followed by laying them down and raising their feet, providing them with plenty of water. The use of a water spray bottle to reduce the body heat and using cold packs around armpits or necks is very effective. Frequent and gentle exfoliation is useful for clogged sweat glands. When experiencing loss of consciousness, fast breathing, confusion, or no response contact the doctor immediately.
Drugs used for the treatment of anhidrosis:
A few drugs that are used in the treatment of anhidrosis are 5-fluorouracil, Quinacrine, Nicotinic acetylcholine receptor antagonists, Muscarinic acetylcholine receptor antagonists, Calcium channel blockers, Zonisamide, Alpha-adrenergic blockers, Alpha2-adrenergic agonist.
Also read: Biosensors for detection of SARS-CoV-2 infection
Reference:
- Harper, Chelsea D., and Rene Bermudez. ‘Anhidrosis’. StatPearls, StatPearls Publishing, 2021. PubMed, http://www.ncbi.nlm.nih.gov/books/NBK555988/
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