Localized (focal) HH
HH is arbitrarily classified as focal or localized, if it does not exceed an area of 100 cm2, and generalized if it does exceed 100 cm2. Focal HH is also known as primary, idiopathic or essential HH.
Sweating is often triggered by anxiety and fear. Certain substances will also trigger HH like coffee, tea, cola drinks, chocolate and spices. In this type of HH, the armpits, the hands and feet are most often involved, but the forehead, the groins and the perineum could also be affected.
Primary HH is almost always symmetrical. An asymmetrical HH should always raise suspicious of an
underlying pathology. The sweat glands are most active during the day.
Generalized HH occurs following fever, exercise, an increase in air temperature and other triggers such as, anxiety, spicy foods and many drugs.
Sweating, like fever and shivering, is one of the main signs and symptoms that allow us to reach an accurate diagnosis during the assessment of many diseases. Several specialties like internal medicine, endocrinology, neurology, neurosurgery, dermatology and psychiatry to name only a few, are often implicated in its evaluation.
Night sweats are more commonly associated with infection, classically tuberculosis, brucellosis or even a lymphoma. The diagnosis of HH poses no problem as the sweat droplets on the affected area or the staining of the clothing covering that same area are more than enough to confirm it.