Sweating (Hyperhidrosis): Examination

A comprehensive clinical examination is the basis for selecting further diagnostic steps:

  • General physical examination – including blood pressure, pulse, body temperature, body weight, body height; furthermore:
    • Inspection (viewing).
      • Skin and mucous membranes [Hyperhidrosis (sweating) is:
        • Local or focal, i.e., increased sweating in specific areas of the body (e.g., armpits, hands, feet)
        • Generalized, i.e., increased sweating over the entire body (e.g., as night sweats). Generalized hyperhidrosis usually occurs as an accompanying symptom in the presence of an underlying disease].
    • Auscultation (listening) of the heart.
    • Auscultation of the lungs
    • Palpation (palpation) of the abdomen (abdomen), etc.
  • If necessary, neurological examination [due todifferential diagnoses:
    • Apoplexy (stroke)
    • Epilepsy
    • Parkinson’s syndrome
    • Sleep apnea syndrome
    • Sympathetic nervous system damage – e.g., traumatic damage to the sympathetic nervous system or the sweat center in the hypothalamus; irritation of the sympathetic nervous system by a cervical rib; neck marker disease; paraplegic symptomatology]
  • Psychiatric examination, if necessary [due todifferential diagnoses:
    • Alcohol dependence
    • Nightmares
    • Anxiety disorders
    • Drug withdrawal
    • Gustatory sweating – form of sweating that occurs after eating.
    • Panic attacks
    • Stress]
  • If necessary, rheumatological examination [due todifferential diagnoses:
    • Arteritis temporalis (synonyms: Arteriitis cranialis; Horton’s disease; giant cell arteritis; Horton-Magath-Brown syndrome) – systemic vasculitis (vascular inflammation) affecting the arteriae temporales (temporal arteries), especially in the elderly.
    • Chronic polyarthritis (synonym: rheumatoid arthritis) – chronic inflammatory multisystem disease, which usually manifests itself in the form of synovitis (inflammation of the synovial membrane).
    • Granulomatosis with polyangiitis (GPA), formerly Wegener’s granulomatosis – necrotizing (tissue dying) vasculitis (vascular inflammation) of the small to medium-sized vessels (small vessel vasculitides), which is accompanied by granuloma formation (nodule formation) in the upper respiratory tract (nose, sinuses, middle ear, oropharynx) and the lower respiratory tract (lungs).
    • Scleroderma – (sclero = hard, dermie = skin) – rare autoimmune disease associated with hardening of connective tissue of the skin alone or of the skin and internal organs (especially digestive tract, lungs, heart and kidneys)
    • Sudeck’s syndrome – CRPS (chronic regional pain syndrome, Sudeck’s syndrome) – persistent pain after an injury (for example, after a distal radius fracture – fracture of the radius) caused by a disorder of the autonomic nervous system.
    • Vasculitides (vascular inflammations), unspecified]
  • Health check

Square brackets [ ] indicate possible pathological (pathological) physical findings.