Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with chronic, excessive palmar sweating, unresponsive to topical antiperspirants. Symptoms are bilateral, symmetrical, and exacerbated by emotional stress or thermal stimuli. Patient reports significant impairment in daily activities, social interactions, and occupational performance. No history of nocturnal diaphoresis or systemic symptoms suggestive of secondary hyperhidrosis.
Clinical Examination Findings
Physical examination reveals visible moisture and beads of sweat on bilateral palmar surfaces. Skin appears macerated, erythematous, and cool to the touch. No evidence of compensatory hyperhidrosis in other regions. Capillary refill is normal; distal pulses are intact. Grip strength and fine motor function are preserved.
Treatment Protocol
Treatment plan initiated with clinical-grade topical aluminum chloride hexahydrate. If refractory, consider Iontophoresis therapy or intradermal Botulinum toxin type A injections. Surgical intervention via Endoscopic Thoracic Sympathectomy (ETS) discussed as a definitive option for severe cases, with detailed counseling regarding potential compensatory hyperhidrosis.