Zusammenfassung
Hintergrund/Ziele: Ausgeprägtes Schwitzen ist ein häufiges und belastendes Symptom. Die Kenntnis der
Differenzialdiagnosen der Hyperhidrose ist für die Wahl der Therapie erforderlich.
Methoden: Literaturüberblick. Ergebnisse: Die physiologische Funktion der Schweißsekretion besteht in der Thermoregulation.
Eine über diese Erfordernisse hinausgehende Schweißneigung kann primär als fokale
Hyperhidrose idiopathisch bedingt oder sekundär als generalisierte Hyperhidrose Nebenwirkung
medikamentöser Therapie oder Ausdruck einer Systemerkrankung sein. Der behandelnde
Arzt braucht Kriterien zur Unterscheidung zwischen der idiopathischen fokalen Hyperhidrose
und einer sekundären Hyperhidrose. Hierzu werden die häufigsten Ursachen einer sekundären
Hyperhidrose differenzialdiagnostisch aufgeführt und ein diagnostisches Schema wird
definiert. Das Spektrum der Therapieformen der primären fokalen Hyperhidrosis reicht
von lokalen Maßnahmen über medikamentöse zu chirurgischen Eingriffen. Schlussfolgerungen: Schwitzen kann durch eine Vielzahl physiologischer und pathologischer Vorgänge bedingt
sein. Oft geben die Anamnese und die körperliche Untersuchung des Patienten schon
maßgebliche Hinweise für die Diagnose.
Abstract
Background/Aims: Increased perspiration is a frequent symptom which is associated with a significant
loss of quality of life. It is necessary to know the differential diagnoses of hyperhidrosis
for choosing the appropriate treatment. Methods: Review of Literature. Results: Sweating is a physiological mechanism to regulate the body temperature. Increased
perspiration beyond the requirements of thermoregulation might be either due to primary
idiopathic focal hyperhidrosis or it might be secondary to medication or symptom of
a systemic disease. The physician requires criteria in order to distinguish between
focal hyperhidrosis and secondary hyperhidrosis. The most common differential diagnoses
of hyperhidrosis are summarized and a diagnostic scheme is provided. Possible treatments
for focal hyperhidrosis range from local treatment to systemic medical treatment and
to surgical procedures. Summary: Sweating might caused by a number of physiological and pathological conditions. A
full medical history and physical examination frequently provide valuable information
guiding to the diagnosis of the underlying condition.
Schlüsselwörter
Hyperhidrosis - Nachtschweiß - Diagnose - Therapie
Key words
hyperhidrosis - night sweats - diagnosis - therapy
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PD Dr. med. Thomas W. Spahn
Klinik für Allgemeine Innere Medizin · Marienhospital Osnabrück
Johannisfreiheit 2-4
49074 Osnabrück
Email: thomas.spahn@mhos.de
