Anhidrosis

Aka: Anhidrosis, Absent Sweating, Hypohidrosis, Oligohidrosis, Decreased Sweating, Drug-Induced Anhidrosis

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II. Definitions

  1. Anhidrosis
    1. Inability to sweat
  2. Hypohidrosis (Oligohidrosis)
    1. Reduced sweating

III. Causes

  1. Neurologic (central or peripheral)
    1. Cerebrovascular Accident (Hypothalamus, pons, Medulla)
    2. CNS Lesion (Hypothalamus, pons, Medulla, spinal cord)
    3. Degenerative Disorders (e.g. Shy-Drager Syndrome)
    4. Peripheral Neuropathy (e.g. Diabetic Neuropathy, Alcoholic Neuropathy)
    5. Autoimmune Autonomic Neuropathy
    6. Horner Syndrome (symathetic system superior cervical Ganglion lesion with Miosis, Ptosis, anhydrosis)
  2. Medications
    1. Alpha Adrenergic Antagonist (e.g. Phentolamine)
    2. Acetylcholine receptor Antagonists
      1. See Anticholinergic Medications (e.g. Antihistamines such as Diphenhydramine)
      2. Nicotinic Acetylcholine ReceptorAntagonists (Dextromethorphan, Bupropion, Amantadine)
      3. Muscarinic Acetylcholine ReceptorAntagonists (Atropine, Scopolamine, Benztropine, Oxybutynin, Meclizine)
    3. Seizure Medications
      1. Topiramate
      2. Zonisamide (Zonegran)
      3. Carbamazepine
    4. Psychiatric Medications
      1. Tricyclic Antidepressants (e.g. Amitriptyline, Doxepin, Nortriptyline, Imipramine)
      2. Antipsychotics (e.g. Chlorpromazine, Clozapine, Olanzapine, Quetiapine)
    5. Miscellaneous Medications
      1. Clonidine
      2. Quinacrine (Mepacrine)
      3. Opioids (e.g. Oxycodone, Fentanyl, Morphine)
      4. Muscle relaxants (e.g. Cyclobenzaprine, Tizanidine)
  3. Sweat Gland Disorders
    1. Various inherited Sweat Gland disorder (e.g. X-Linked Hypohidrotic ectodermal dysplasia)
    2. Localized Sweat Gland destruction or inflammation (tumors, Radiation Therapy, Sjogren Syndrome)
    3. Sweat Gland obstruction (e.g. Psoriasis, Ichthyosis, Eczematous Dermatitis)

IV. Complications

  1. Heat Illness

V. References

  1. Harper (2020) Anhidrosis, Stat Pearls, accessed 1/3/2021
    1. https://www.ncbi.nlm.nih.gov/books/NBK555988/
  2. Cheshire (2008) Drug Safety 31(2):109-26 [PubMed]

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