Endocrine Abstracts

Background: Hyperhidrosis is a debilitating disease that has a significant impact on quality of life. There is limited research and gudelines on the investigations and management of hyperhidrosis.

Aims: To assess if investigations and treatment of hyperhidrosis meets NICE CKS July 2013 guidelines.

Method: The term ‘hyperhidrosis’ was used as a keyword search on an electronic patient record. Letters were restricted to those created by the department of diabetes and endocrinology. The first 50 records were analysed for: relevant investigations completed, treatments initiated and whether treatment was effective.

Results: 50 patients presented with hyperhidroisis to an endocrinology clinic over a period of 3 years and 7 months. 15 were diagnosed with secondary hyperhidrosis (30%) and 34 (68%) with idiopathic hyperhidrosis. 66% of patients referred with hyperhidrosis were female and 34% male. 74% of patients diagnosed with idiopathic hyperhidrosis were female. No patient had all investigations completed. 80%–100% had: Full blood count, Urea & electrolytes, Liver function tests, Thyroid function tests, Glucose/hba1c. 50–80% had: urinary catecholamines, FSH/LH/testosterone and a CRP. 22% had a chest radiograph. 0 patients were tested for HIV or infectious diseases. Aluminium chloride was trialled in 10% of patients and was ineffective, oxybutynin in 48% and effective in 33%, glycopyrolate in 4% and effective in 50%, propantholine in 2% and effective in 100%. Surgical intervention was not offered to any patient. 59% of patients were discharged to their GP following assessment. 10% were referred to dermatology.

Conclusion: 0.01% of all endocrinology referrals are due to hyperhidrosis. The pick up rate for secondary hyperhidrosis is 30%. Females are more likely to present with hyperhidrosis and receive a diagnosis of idiopathic hyperhidrosis.Investigations for hyperhidrosis are haphazard and variably completed despite the need to exclude secondary causes.Treatment for hyperhidrosis is poor and ineffective.