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Kwon HR, Bae DW, An JY. Acquired idiopathic generalized anhidrosis (AIGA) associated with SARS-CoV-2 infection. Acta Neurol Belg 2024:10.1007/s13760-024-02622-w. [PMID: 39133455 DOI: 10.1007/s13760-024-02622-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2024] [Accepted: 08/08/2024] [Indexed: 08/13/2024]
Affiliation(s)
- Hye Ryung Kwon
- Department of Neurology, College of Medicine, St. Vincent's hospital, The Catholic University of Korea, Seoul, 442-723, Republic of Korea
| | - Dae Woong Bae
- Department of Neurology, College of Medicine, St. Vincent's hospital, The Catholic University of Korea, Seoul, 442-723, Republic of Korea
| | - Jae Young An
- Department of Neurology, College of Medicine, St. Vincent's hospital, The Catholic University of Korea, Seoul, 442-723, Republic of Korea.
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Takahagi S, Okamoto M, Ishii K, Tanaka A, Mizuno H, Harada N, Yanagida N, Hide M. Clinical and histological characterization of transient dermal pain triggered by sweating stimuli. Allergol Int 2022; 71:362-372. [PMID: 35272957 DOI: 10.1016/j.alit.2022.01.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2021] [Revised: 01/18/2022] [Accepted: 01/31/2022] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Tingling dermal pain triggered by sweating impairs the lives of patients with cholinergic urticaria and generalized anhidrosis. However, dermal pain evoked by sweating stimuli has been under investigated. METHODS To clarify characteristics of tingling dermal pain on sweating, we retrospectively evaluated clinical and histopathological manifestations in 30 patients having the main problem of dermal pain on sweating, and the efficacy of treatments. RESULTS Dermal pain upon sweating affected mostly young males. It accompanied eruptions upon sweating and/or hypohidrosis in 24 patients, while 6 patients had dermal pain independently of hypohidrosis or eruptions. Dermal pain appeared immediately upon exposure to sweating stimuli, and disappeared within mostly 30 or 10 min. Hypohidrosis was not necessarily generalized but localized or absent. Histological analysis revealed that dermal pain could occur even without morphological changes and inflammation of sweat glands. Hypersensitivity to sweat contents was found only in 26% of patients. Sweat histamine and increase of plasma histamine after thermal induction in patients were significantly higher than those in healthy subjects. Effectiveness of steroid pulse therapy was demonstrated for dermal pain with hypohidrosis. Medications acting on nervous systems and regular sweat-inducing activities for promoting perspiration were also effective. CONCLUSIONS Short-lasting tingling dermal pain appears immediately upon exposure to sweating stimuli, regardless of developing eruptions and/or presence of hypohidrosis, but possibly in association with sweat and plasma histamine.
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Affiliation(s)
- Shunsuke Takahagi
- Department of Dermatology, Institute of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Mayumi Okamoto
- Department of Dermatology, Institute of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Kaori Ishii
- Department of Dermatology, Institute of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Akio Tanaka
- Department of Dermatology, Institute of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Hayato Mizuno
- Department of Dermatology, Institute of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Naoe Harada
- Department of Dermatology, Institute of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Nozomi Yanagida
- Department of Dermatology, Institute of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Michihiro Hide
- Department of Dermatology, Institute of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan.
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Kageyama R, Honda T, Tokura Y. Acquired Idiopathic Generalized Anhidrosis (AIGA) and Its Complications: Implications for AIGA as an Autoimmune Disease. Int J Mol Sci 2021; 22:8389. [PMID: 34445091 PMCID: PMC8395056 DOI: 10.3390/ijms22168389] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 07/22/2021] [Accepted: 07/29/2021] [Indexed: 02/06/2023] Open
Abstract
Acquired idiopathic generalized anhidrosis (AIGA) is a rare disorder in which systemic anhidrosis/hypohidrosis occurs without causative dermatological, metabolic or neurological disorder. Most cases of AIGA have been reported in Asia, especially in Japan, but there have been only a few reports in Europe and the United States. Severe AIGA may result in heatstroke and can reduce quality of life due to restriction of exercise and outdoor works. AIGA is often accompanied by cholinergic urticaria (CholU), and it is thought that AIGA and CholU with anhidrosis/hypohidrosis belong to the same spectrum of the disease. However, the pathophysiology of AIGA has not yet been clarified. Decreased expression of cholinergic receptor M3 on the epithelial cells of eccrine sweat glands is often accompanied by T cell infiltration around eccrine apparatus, suggesting an immunological mechanism of disordered perspiration. AIGA is occasionally associated with various complications indicative of autoimmune disorders. The association of autoimmune complications further suggests that AIGA is an autoimmune disorder. Studies on complications may lead to a better understanding of the pathophysiology of AIGA.
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Affiliation(s)
- Reiko Kageyama
- Department of Dermatology, Hamamatsu University School of Medicine, Hamamatsu 431-3192, Japan;
| | - Tetsuya Honda
- Department of Dermatology, Hamamatsu University School of Medicine, Hamamatsu 431-3192, Japan;
| | - Yoshiki Tokura
- Allergic Disease Research Center and Department of Dermatology, Chutoen General Medical Center, Kakegawa 436-8555, Japan;
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Young AT, Yedidi RS, Raffi J, McCalmont TH, North J, Brinker A, Berger TG, Murase JE. Idiopathic pure sudomotor failure: A review and two cases. Int J Womens Dermatol 2020; 7:276-279. [PMID: 34222583 PMCID: PMC8243128 DOI: 10.1016/j.ijwd.2020.12.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 12/09/2020] [Accepted: 12/15/2020] [Indexed: 12/04/2022] Open
Abstract
Idiopathic pure sudomotor failure (IPSF) is a rare disease characterized by acquired impairment in total body sweating despite exposure to heat or exercise. Its etiology is unknown but thought to involve defective cholinergic receptors on eccrine sweat glands. This article reviews the epidemiology, pathophysiology, presentation, and management of IPSF. Additionally, we report two cases of IPSF treated with multimodal therapy, including stacked antihistamine regimens and omalizumab, resulting in symptom improvement. This is the first report of treatment of IPSF with omalizumab, although its benefit is uncertain and requires further study.
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Affiliation(s)
- Albert T Young
- Department of Dermatology, University of California, San Francisco, San Francisco, CA, United States
| | - Raagini S Yedidi
- Department of Dermatology, University of California, San Francisco, San Francisco, CA, United States
| | - Jodie Raffi
- Department of Dermatology, University of California, San Francisco, San Francisco, CA, United States.,School of Medicine, University of California, Irvine, Irvine, CA, United States
| | - Timothy H McCalmont
- Department of Dermatology, University of California, San Francisco, San Francisco, CA, United States.,Department of Pathology, University of California, San Francisco, San Francisco, CA, United States
| | - Jeffrey North
- Department of Dermatology, University of California, San Francisco, San Francisco, CA, United States.,Department of Pathology, University of California, San Francisco, San Francisco, CA, United States
| | - Alyson Brinker
- Naval Medical Center San Diego, San Diego, CA, United States
| | - Timothy G Berger
- Department of Dermatology, University of California, San Francisco, San Francisco, CA, United States
| | - Jenny E Murase
- Department of Dermatology, University of California, San Francisco, San Francisco, CA, United States.,Department of Dermatology, Palo Alto Foundation Medical Group, Mountain View, CA, United States
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