Introduction Hyperhidrosis is a condition characterized by excessive sweating that can negatively affect quality of life and psychosocial well-being. This study aimed to determine the self-reported prevalence of hyperhidrosis symptoms and the level of awareness among medical students at Gulf Medical University, Ajman, UAE. Methods A cross-sectional study was conducted over six months among students aged ≥18 years across six academic programs. Ethical approval was obtained, and a pilot study was conducted before data collection. A structured self-administered questionnaire developed from a literature review and reviewed by specialists was used to assess sociodemographic characteristics, self-reported excessive sweating symptoms suggestive of hyperhidrosis, awareness, and associated factors. Data were analyzed using descriptive and inferential statistics. Results Out of 600 eligible participants, 480 completed the questionnaire (response rate: 80%). The majority were female (75.4%) and aged 18-21 years. The prevalence of self-reported excessive sweating symptoms suggestive of hyperhidrosis was 36.8% (171/465; 95% CI: 32.4%-41.2%). Among participants reporting excessive sweating symptoms who responded to the relevant items, the axilla was the most commonly affected site, followed by the face and hands. Afternoon was the most frequently reported time of excessive sweating. Awareness of hyperhidrosis was low, with only 31.7% of participants reporting prior knowledge, most commonly through the internet and academic sources. A significantly higher prevalence of self-reported excessive sweating symptoms was observed among males compared to females (p<0.01). Smoking was also significantly associated with self-reported excessive sweating symptoms (p<0.05). No significant associations were observed with age group, body mass index, or diabetes status. A proportion of participants reported a positive family history of similar symptoms. Conclusion Self-reported excessive sweating symptoms suggestive of hyperhidrosis were relatively common among medical students, but awareness remained low. While associations with gender and smoking were observed, the findings should be interpreted cautiously, given the use of self-reported data rather than clinically validated diagnostic criteria. Increased awareness and further studies using validated diagnostic instruments are recommended.

This systematic review and meta-analysis aimed to comprehensively evaluate the efficacy and safety of topical sofpironium bromide in patients with primary axillary hyperhidrosis (PAH) in various published randomized controlled trials (RCTs). The study was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We systematically searched PubMed, Scopus, Web of Science, Embase, and Medline databases through April 30, 2025, using keywords related to sofpironium and PAH. The odds ratio (OR) or mean difference (MD) was calculated using a random effects model with 95% confidence interval (CI). Three RCTs of sofpironium were included in the meta-analysis, with 1,209 patients with PAH. Sofpironium, compared to the vehicle, showed statistically significant improvement in the Hyperhidrosis Disease Severity Measure-Axillary (HDSM-Ax) score (OR=2.35, 95% CI [1.82 to 3.04]), Hyperhidrosis Disease Severity Scale (HDSS) score (OR=2.02, [1.46 to 2.79]), Dermatology Life Quality Index (DLQI) score (MD=-2.75, [-3.58 to -1.92]), and gravimetric sweat production (MD=-26.39, [-44.65 to -8.12]). The incidences of anticholinergic adverse events (AEs) and application site AEs were statistically higher in patients treated with sofpironium. Sofpironium is an effective treatment for PAH associated with significant improvements in sweat reduction and QOL for patients, although the drug also has risks of anticholinergic or application-site AEs.

Numerous exocrine glands play key physiological roles in the body that include tearing, salivation, and lactation, as well as the control of body temperature via sweating. Malfunction of sweat glands can be deeply problematic or-in the case of anhidrosis-life-threatening. The prevalence of sweating disorders is high, affecting millions. The few available therapies are generally of limited effectiveness. Several lines of evidence point to regulation of sweating by the cannabinoid signaling system, an arrangement that would mirror cannabinoid regulation of tearing and salivation. Mice sweat in their paws via glands that closely resemble human eccrine sweat glands, including regulation by muscarinic signaling and by temperature. We applied a galvanic skin response-based assay to investigate cannabinoid regulation of sweating in awake, unanesthetized mice. The muscarinic agonist pilocarpine increased conductance while the antagonist glycopyrrolate reduced conductance, validating the model as a measure of sweating. The cannabinoid receptor agonist CP55940 substantially reduced conductance in wild-type and CB2 but not CB1 receptor knockout mice. The phytocannabinoid tetrahydrocannabinol (THC) also reduced conductance, while the non-psychoactive cannabidiol (CBD) did not. Using immunohistochemistry, we detected CB1 receptors in periglandular cholinergic axons, the anandamide-synthesizing enzyme NAPE-PLD in myoepithelial cells, and the anandamide metabolizing enzyme FAAH in acinar cells. This indicates that a local CB1/anandamide-based circuit is present in mouse walking pads. In summary, we employed a novel galvanic skin response-based assay to determine that cannabinoid CB1 receptors reduce sweating in a mouse model. This may point to a previously unappreciated effect on sweating in cannabis users.

Sofpironium bromide is a recently approved topical anticholinergic agent for primary axillary hyperhidrosis, developed using a retrometabolic approach to limit systemic side effects. However, randomized evidence about its effects has not yet been quantitatively synthesized. This meta-analysis aimed to assess the efficacy and safety of topical sofpironium bromide compared with a vehicle in patients with primary axillary hyperhidrosis. PubMed, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), and ClinicalTrials.gov were searched for randomized controlled trials (RCTs) comparing topical sofpironium bromide with a vehicle. Risk ratios (RRs) and mean differences (MDs) with 95% confidence intervals (CIs) were pooled using random-effects models in Review Manager 7.2.0 (The Cochrane Collaboration, London, UK). Five RCTs, including 1,398 participants, were included, of whom 807 (57.7%) received topical sofpironium bromide. Compared with vehicle, sofpironium bromide significantly reduced gravimetric sweat production (GSP) at the end of treatment (MD -25.27 mg; 95% CI -40.15 to -10.40) and increased the likelihood of achieving at least a two-point improvement in the Hyperhidrosis Disease Severity Scale (HDSS) (RR 3.27; 95% CI 1.57-6.80). Discontinuation due to adverse events was more frequent in the sofpironium bromide group (RR 9.83; 95% CI 1.82-53.17). Adverse events occurred more frequently in the treatment group, including application-site dermatitis (RR 5.26; 95% CI 2.05-13.48), application-site pain (RR 4.63; 95% CI 2.08-10.28), pruritus (RR 5.97; 95% CI 1.98-18.02), and dry mouth (RR 15.45; 95% CI 5.35-44.62). No significant increase in serious adverse events was observed. Overall, this meta-analysis supports the efficacy of sofpironium bromide for primary axillary hyperhidrosis, while treatment decisions should be weighed against potential side effects.

Endoscopic thoracic sympathectomy is an effective treatment of primary palmar hyperhidrosis. Currently, single-port thoracoscopy is the primary surgical approach. Ensuring efficacy and safety, reducing surgical obstacles, minimizing tissue damage, and enhancing cosmesis and aesthetics of the surgical incision are focal in clinical research on endoscopic thoracic sympathectomy. Herein, we report a simple and minimally invasive surgical technique that avoids collisions due to the telescope and endodissector crossing in single-port thoracoscopic surgery. This refers to the application of medical thoracoscopy combined with nonintubation anesthesia and perfusion index monitoring in the treatment of primary palmar hyperhidrosis.

Compensatory hyperhidrosis (CH) is a significant complication following surgery for primary hyperhidrosis, impairing patients' postoperative experience and quality of life. Radiofrequency sympathectomy (RFS) is one of the main minimally invasive surgeries for hyperhidrosis, yet high-risk factors and patient experiences of postoperative CH are rarely reported. This retrospective observational study (Strengthening the Reporting of Observational Studies in Epidemiology compliant) aimed to identify significant risk factors for CH after RFS and to develop a dynamic nomogram for individualized risk prediction. A total of 410 primary hyperhidrosis patients who underwent RFS between January 2018 and March 2023 were enrolled. A CH database was established via systematic follow-up to track postoperative sweating patterns. Detailed clinical assessments included the Numeric Rating Scale (NRS), Hyperhidrosis Disease Severity Scale (HDSS), and Hospital Anxiety and Depression Scale (HADS). Advanced statistical techniques, including logistic regression analysis, were used to identify potential risk factors for CH. Of the 410 patients, 281 (68.5%) developed CH, with 105 (25.6%) reporting moderate-to-severe symptoms. Multivariate analysis revealed 4 significant predictors of CH: male gender (odds ratio [OR] = 1.69); higher NRS scores (OR = 1.16); lower immediate postoperative HDSS (OR = 0.48); higher preoperative HADS scores (OR = 1.11). A dynamic, web-based nomogram was also developed to provide personalized CH risk prediction. Male gender, higher intraoperative NRS scores, lower immediate postoperative HDSS, and higher preoperative HADS scores were identified as independent risk factors. The constructed dynamic nomogram enables individualized risk prediction and supports clinicians in providing personalized preoperative counseling and perioperative management for patients undergoing RFS.

Pourfour du Petit syndrome (PdPS) is a rare oculosympathetic hyperactivity syndrome characterized by ipsilateral mydriasis, eyelid retraction, and hyperhidrosis. We report a case of a 36-year-old female who presented to the emergency department with a chief complaint of a dilated pupil with photosensitivity and blurred vision in the left eye (OS). On examination, the best corrected visual acuity was 20/20 in both eyes (OU). Anisocoria was observed with the right pupil measuring 4 mm in the dark and 2 mm in the light and the larger left pupil measuring 6 mm in the dark with minimal constriction in the light. There was no relative afferent pupillary defect (RAPD). Magnetic resonance angiography (MRA) and digital subtraction angiogram (DSA) of the head showed a 7 mm left paraclinoid ICA aneurysm. Neurovascular neurosurgery placed a flow diverting stent into the left ICA. Repeat DSA demonstrated near-complete resolution of the left ICA ophthalmic segment aneurysm status post-flow diversion. At the last follow-up one year later, the patient was stable clinically and radiographically with no further recurrences. Clinicians should be aware that anisocoria can be a potentially life-threatening presentation of intracranial vascular lesions.