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Current Problems in Dermatology

Jeong-Beom Lee, Jeong-Ho Kim, Hiroyuki Murota
The sudomotor mechanism, wich contributes to tolerating thermal environments, is affected by not only the body temperature, but also sex, ethnicity, exercise training, region, season, and heat adaptation. Aging attenuates the sudomotor function by the decreased peripheral sensitivity to acetylcholine and demyelination of innervating nerves. Women show less sudomotor activity than men. Heat adaptation with sudomotor modification is induced by repetitive physical and/or thermal training. Short-term heat acclimation increases sweat gland activity...
2016: Current Problems in Dermatology
Takaaki Hiragun, Michihiro Hide
For many years, sweat has been recognized as an exacerbation factor in all age groups of atopic dermatitis (AD) and a trigger of cholinergic urticaria (CholU). Recently, we reported the improvement of AD symptoms by spray with tannic acid, which suppresses basophil histamine release by semipurified sweat antigens in vitro, and showering that removes antigens in sweat from the skin surface. We finally identified MGL_1304 secreted by Malassezia globosa as a major histamine-releasing antigen in human sweat. MGL_1304 is detected as a 17-kDa protein in sweat and exhibits almost the highest histamine-release ability from basophils of patients with AD and CholU among antigens derived from Malassezia species...
2016: Current Problems in Dermatology
Yoshiki Tokura
Cholinergic urticaria (CholU) is characterized by pinpoint-sized, highly pruritic wheals occurring upon sweating. Both direct and indirect theories in the interaction of acetylcholine (ACh) with mast cells have been put forward in the sweating-associated histamine release from mast cells. In the mechanism of indirect involvement of ACh, patients are hypersensitive to sweat antigen(s) and develop wheals in response to sweat substances leaking from the syringeal ducts to the dermis, possibly by obstruction of the ducts...
2016: Current Problems in Dermatology
Tomoko Fujimoto
Primary focal hyperhidrosis is a disease of unknown cause with profuse perspiration of local sites (head, face, palms, soles of feet, and axillae) that adversely affects daily life. Guidelines have been proposed in the USA [<citeref rid="ref1">1</citeref>], Canada [<citeref rid="ref2">2</citeref>], and Japan [<citeref rid="ref3">3</citeref>]. The symptoms impair quality of life, with significant negative effects on daily existence and personal relationships. The current goal in medical practice for patients with hyperhidrosis is to provide guidance and encourage coping skills for a normal daily life, as well as give appropriate advice regarding treatment options...
2016: Current Problems in Dermatology
Aya Nishizawa
Dyshidrotic eczema, also known as dyshidrotic dermatitis or pompholyx, is characterized by pruritic, small tense vesicles mainly on the palmoplantar region and lateral and ventral surfaces of the fingers. While its etiology appears to be related to sweating, as dyshidrotic eczema often occurs in an individual with hyperhidrosis, and the spring allergy season, histologic examination shows an eczematous reaction around the sweat ducts which is not associated with abnormalities of the sweat ducts. More recently, the nomenclature of 'acute and recurrent vesicular hand dermatitis' has been proposed to reflect clinical features of dyshidrotic eczema...
2016: Current Problems in Dermatology
Takahiro Satoh
Acquired idiopathic generalized anhidrosis (AIGA) is a sweating disorder characterized by inadequate sweating in response to heat stimuli such as high temperature, humidity, and physical exercise. Patients exhibit widespread nonsegmental hypohidrosis/anhidrosis without any apparent cause, but the palms, soles, and axillae are rarely affected. Heat stroke readily develops due to increased body temperature. AIGA commonly affects young males. Approximately 30-60% of patients show complications of cholinergic urticaria, also known as idiopathic pure sudomotor failure or hypohidrotic cholinergic urticaria...
2016: Current Problems in Dermatology
Ichiro Katayama
This chapter summarizes recent advances in the pathogenesis and management of Sjögren's syndrome (SS). Major topics are newly described pathomechanisms and cutaneous manifestations of SS, with special references to hypohidrosis and related mucocutaneous manifestations. Although the significance of cutaneous manifestations in SS has been gradually recognized in rheumatologists, sudomotor function has not been fully evaluated and recognized in the diagnosis of SS except by dermatologists. SS is a relatively underestimated collagen disease in contrast to systemic lupus erythematosus, systemic sclerosis, or dermatomyositis, and special care is needed not to misdiagnose SS when we see patients with common skin diseases such as drug eruption, infectious skin disease, or xerosis in daily practice...
2016: Current Problems in Dermatology
Hiroyuki Murota
Sweating disorders are sometimes observed in various systemic diseases that include genetic disorders, organ damage, metabolic impairment, autoimmune diseases, and neuropathic disorders. In these diseases, various symptoms such as autonomic failures, psychopathic disorders, abnormal skin innervation, and sweat gland dysfunction can interact with one another in diverse ways, resulting in impaired sweating. This review focuses on the influence of uremia (with or without hemodialysis) and diabetes mellitus on impaired sweating...
2016: Current Problems in Dermatology
Aya Takahashi, Saki Tani, Hiroyuki Murota, Ichiro Katayama
Many factors such as food or environmental allergens, bacteria, fungi, and mental stress aggravate the condition of atopic dermatitis (AD) eczema. Sweating can also exacerbate AD, and patients are aware of that. In the past, it has been reported that contamination of skin surface antigens by sweat induces acute allergic reactions and that sweating functions of AD patients via axonal reflexes are decreased. Histamine demonstrably inhibits acetylcholine-induced sweating in both mice and humans via histamine H1 receptor-mediated signaling...
2016: Current Problems in Dermatology
Mari Wataya-Kaneda
Sweating is regulated by various neurohormonal mechanisms. A disorder in any part of the sweating regulatory pathways, such as the thermal center, neurotransmitters in the central to peripheral nerve, innervation of periglandular neurotransmission, and sweat secretion in the sweat gland itself, induces dyshidrosis. Therefore, hereditary disorders with dyshidrosis result from a variety of causes. These diseases have characteristic symptoms derived from each pathogenesis besides dyshidrosis. The information in this chapter is useful for the differential diagnosis of representative genetic disorders with dyshidrosis...
2016: Current Problems in Dermatology
Tetsuo Shiohara, Yohei Sato, Yurie Komatsu, Yukiko Ushigome, Yoshiko Mizukawa
Although recent research on the pathogenesis of allergic skin diseases such as atopic dermatitis has focused on defects in skin genes important for maintaining skin barrier function, the fact that excreted sweat has an overwhelmingly great capacity to increase skin surface hydration and contains moisturizing factors has long been ignored: the increase in water loss induced by these gene defects could theoretically be compensated fully by a significant increase in sweating. In this review, the dogma postulating the detrimental role of sweat in these diseases has been challenged on the basis of recent findings on the physiological functions of sweat, newly recognized sweat gland-/duct-related skin diseases, and therapeutic approaches to the management of these diseases...
2016: Current Problems in Dermatology
Hiroyuki Murota
The evaluation of sweating activities contributes to both medical services and social living. There are several old and new approaches for assessing sweating. These methods are mainly composed of adopted techniques that focus on detecting small amounts of water on the skin surface. For many years, the iodine-starch reaction has been applied in various settings to evaluate sweat on the skin surface. However, methodology based on the coloration of sweat is in a constant state of evolution, and multiple advancements have been made...
2016: Current Problems in Dermatology
Risako Inoue
Aquaporin-5 (AQP5) is a member of the water channel protein family. Although AQP5 has been shown to be present in sweat glands, the presence or absence of regulated intracellular translocation of AQP5 in sweat glands remains to be determined. In this article, recent findings on AQP5 in sweat glands are presented. (1) Immunoreactive AQP5 was detected in the apical membranes and the intercellular canaliculi of secretory coils, and in the basolateral membranes of the clear cells in human eccrine sweat glands. (2) AQP5 rapidly concentrated at the apical membranes during sweating in mouse sweat glands...
2016: Current Problems in Dermatology
Yuichiro Ohshima, Yasuhiko Tamada
Hyperhidrosis can be subdivided into generalized hyperhidrosis, with increased sweating over the entire body, and focal hyperhidrosis, in which the excessive sweating is restricted to specific parts of the body. Generalized hyperhidrosis may be either primary (idiopathic) or secondary. Secondary generalized hyperhidrosis may be caused by infections such as tuberculosis, hyperthyroidism, endocrine and metabolic disturbances such as pheochromocytoma, neurological disorders, or drugs. Focal hyperhidrosis may also be primary (idiopathic) or secondary...
2016: Current Problems in Dermatology
Hiroo Yokozeki
This chapter introduces the history of perspiration research and the latest perspiration research findings. Many investigators worldwide, particularly those in Japan, have carried forward globally leading studies on perspiration. This chapter will introduce the history of studies on the physiology of perspiration and perspiration research by classifying it in three stages, namely the early, maturation, and development stages, with a focus on Japanese researchers who have played active roles in each stage. In particular, I will introduce two historical physiologists in detail, Dr...
2016: Current Problems in Dermatology
Tabi Anika Leslie
Itch is a common symptom in the elderly population over 65 years old, and is often a chronic condition lasting more than 6 weeks. As in all age groups, but especially in the elderly, there can be a significant effect on the general health status and quality of life, with impaired daily activities and lack of sleep, which can also lead in some cases to depression or anxiety. The cause of chronic itch in the elderly is often multifactorial due to physiological changes in the aging skin, including impaired skin barrier function, and also due to decline in immunological (immunosenescence), neurological, and psychological changes associated with age...
2016: Current Problems in Dermatology
Regina Fölster-Holst
Itch in children is a very common symptom and is mainly related to a skin disease rather than an underlying systemic disorder. The most common dermatoses include atopic dermatitis, contact dermatitis, insect bites, scabies, and pediculosis capitis. There are specific diagnostic patterns which require the evaluation of a careful history and dermatological examination. For dermatological treatment, we have to consider that children, especially infants, show differences in physiology and pathophysiology, and also in pharmacokinetics and pharmacodynamics compared with adults...
2016: Current Problems in Dermatology
Julien Lambert
Pruritus is common in pregnancy. It deserves an elaborated work-up of the patient. It is frequently a symptom of a dermatosis that coincides by chance with pregnancy or a preexisting dermatosis that can flare during pregnancy. In some cases, it is due to the group of pregnancy-specific dermatoses. Work-up requires a prudent consideration of the diagnostic tests as well as the choice of treatment because of the potential effects on the fetus. This chapter will focus on the specific dermatoses of pregnancy and the local and systemic treatment of pruritus in general during pregnancy...
2016: Current Problems in Dermatology
Toshiya Ebata
Drugs may cause itching as a concomitant symptom of drug-induced skin reactions or in the form of pruritus without skin lesions. Drug-induced itch is defined as generalized itching without skin lesions, caused by a drug. Itching associated with drug-induced cholestasis is among the common dermatologic adverse events (dAEs) that induce itching. Some drugs such as opioids, antimalarials, and hydroxyethyl starch are known to induce itching without skin lesions. The clinical features and underlying proposed mechanisms of itching caused by these drugs have been specifically investigated...
2016: Current Problems in Dermatology
Brandon Rowe, Gil Yosipovitch
Paraneoplastic itch occurs as the result of a systemic reaction to an underlying malignancy. Paraneoplastic itch is most commonly associated with lymphoproliferative malignancies and solid tumors that result in cholestasis. Paraneoplastic itch may occur in the absence of a primary rash or in association with dermatologic conditions such as erythroderma, acanthosis nigricans, dermatomyositis, Grover's disease, and eruptive seborrheic keratosis. Treatment of paraneoplastic itch is centered on targeting the underlying malignancy responsible for the systemic reaction...
2016: Current Problems in Dermatology
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