Dermatology
Hyperhidrosis
Distinguish primary (focal — axillae, palms, soles) from secondary (medical cause). Topical → iontophoresis → botox → systemic → surgery.
Source: BAD; NICE CKS
Step 1 of ~2
info
Differentiate Primary vs Secondary
Primary focal hyperhidrosis: bilateral, symmetric, focal (axillae, palms, soles, face), starts childhood / adolescence, family history common, stops during sleep, no underlying cause.
Secondary hyperhidrosis: generalised, asymmetric, nocturnal, adult onset.
Secondary causes — investigate:
• Endocrine: hyperthyroidism, phaeochromocytoma, hypoglycaemia, diabetes, menopause.
• Infection (TB, HIV, infective endocarditis), malignancy (lymphoma).
• Drugs: SSRIs, opioids, antipsychotics.
• Anxiety.
• Rheumatological / neurological.
Workup if secondary suspected: TFTs, glucose, FBC, CRP, HIV, urinary metanephrines, CXR.
Related
Curated clinical cross-links plus same-class fallbacks.
Drugs
- Dapsone · Anti-inflammatory / Antimicrobial
- Chloramphenicol · Amphenicol — Meningitis (Alternative) / Topical Eye Infections
- Medical-Grade Honey (Manuka) · Topical Wound Care Agent
- Silicone Gel / Sheeting (Scar Management) · Medical Device / Topical Scar Treatment
- Dexamethasone (ICU / ARDS) · Systemic Corticosteroid
- Protamine Sulphate (Heparin Reversal) · Heparin Reversal / Cardiac Surgery
Pathways
- Suspicious Pigmented Lesion — Melanoma Pathway · NICE NG14 2015 / BAD
- Cellulitis and Erysipelas · NICE NG141 2019 / CREST
- Psoriasis — Severity Assessment and Step-Up Therapy · NICE NG153 2019 / BAD
- Atopic Eczema — Assessment and Step-Up Therapy · NICE NG95 2023
- Urticaria and Angioedema · BSACI / EAACI Guidelines 2022
- Acne Vulgaris — Grading and Treatment · NICE NG198 2021 / BAD
Decision support only. Always apply local guidelines and clinical judgement.