ICD-10: L74.5

Focal hyperhidrosis, classified under ICD-10 code L74.5, is a medical condition characterized by excessive sweating in specific areas of the body, such as the palms, soles, underarms, or face. This condition can significantly impact an individual's quality of life, leading to social anxiety, embarrassment, and discomfort.

Clinical Description

Definition

Focal hyperhidrosis is defined as a condition where there is an overactivity of the sweat glands in localized areas, resulting in excessive sweating that is not necessarily related to heat or exercise. This condition is often idiopathic, meaning the exact cause is unknown, although it may be linked to genetic factors or hyperactivity of the sympathetic nervous system.

Symptoms

The primary symptom of focal hyperhidrosis is excessive sweating in specific regions of the body. Commonly affected areas include:
- Palmar Hyperhidrosis: Excessive sweating of the hands.
- Plantar Hyperhidrosis: Excessive sweating of the feet.
- Axillary Hyperhidrosis: Excessive sweating of the underarms.
- Facial Hyperhidrosis: Excessive sweating of the face and scalp.

Patients may experience sweating that occurs spontaneously, without any triggers, and it can be severe enough to soak through clothing or interfere with daily activities.

Diagnosis

Diagnosis of focal hyperhidrosis typically involves:
- Clinical Evaluation: A thorough medical history and physical examination to assess the pattern and severity of sweating.
- Sweat Tests: Tests such as the starch-iodine test or gravimetric measurement can quantify the amount of sweating.
- Exclusion of Secondary Causes: It is essential to rule out secondary causes of hyperhidrosis, such as endocrine disorders, infections, or medications.

Treatment Options

Conservative Management

Initial treatment often includes:
- Antiperspirants: Over-the-counter or prescription-strength aluminum chloride antiperspirants can be effective for mild cases.
- Lifestyle Modifications: Wearing breathable fabrics and practicing good hygiene can help manage symptoms.

Medical Interventions

For more severe cases, various medical treatments may be considered:
- Botulinum Toxin Injections: These injections can temporarily block the nerves that cause sweating.
- Iontophoresis: A procedure that uses electrical currents to reduce sweating, particularly in the hands and feet.
- Medications: Anticholinergic medications may be prescribed to reduce sweating.
- Surgery: In extreme cases, surgical options such as sympathectomy may be considered, which involves cutting nerves that trigger sweating.

Conclusion

Focal hyperhidrosis (ICD-10 code L74.5) is a challenging condition that can significantly affect an individual's daily life. Understanding its clinical features, diagnostic criteria, and treatment options is crucial for effective management. Patients experiencing symptoms should consult healthcare professionals for a tailored approach to treatment, which may include both conservative and advanced medical interventions.

Focal hyperhidrosis, classified under ICD-10 code L74.5, is a condition characterized by excessive sweating in specific areas of the body. This condition can significantly impact a patient's quality of life, leading to social anxiety, embarrassment, and discomfort. Below is a detailed overview of the clinical presentation, signs, symptoms, and patient characteristics associated with focal hyperhidrosis.

Clinical Presentation

Focal hyperhidrosis typically manifests as excessive sweating localized to specific areas, most commonly affecting the:

• Palms of the hands
• Soles of the feet
• Axillary (underarm) regions
• Facial areas, particularly the forehead and scalp

The sweating episodes can occur spontaneously or be triggered by various factors, including heat, stress, or physical activity. Patients often report that the sweating is disproportionate to the environmental conditions or their level of exertion.

Signs and Symptoms

Primary Symptoms

1. Excessive Sweating: The hallmark symptom is excessive sweating in localized areas, which can be observed during physical examinations.
2. Moist Skin: Affected areas may appear visibly moist or wet, even in cool environments.
3. Odor: While the sweating itself is not inherently odorous, excessive moisture can lead to secondary issues such as body odor or skin irritation.

Associated Symptoms

• Social Anxiety: Many patients experience anxiety or embarrassment due to their condition, which can lead to avoidance of social situations.
• Skin Irritation: Prolonged moisture can cause skin irritation, rashes, or fungal infections in affected areas.
• Impact on Daily Activities: Patients may find it challenging to perform daily tasks, such as holding objects, writing, or engaging in physical activities due to discomfort from sweating.

Patient Characteristics

Focal hyperhidrosis can affect individuals of all ages, but certain characteristics are commonly observed:

• Age: It often begins in childhood or adolescence, with many patients reporting symptoms before the age of 25.
• Family History: There is a tendency for focal hyperhidrosis to run in families, suggesting a genetic predisposition.
• Gender: Studies indicate that both males and females are equally affected, although some research suggests that males may experience more severe symptoms.
• Comorbid Conditions: Patients may have comorbid conditions such as anxiety disorders, which can exacerbate the symptoms of hyperhidrosis.

Conclusion

Focal hyperhidrosis, represented by ICD-10 code L74.5, is characterized by excessive sweating in specific body areas, leading to significant psychosocial impacts. Understanding the clinical presentation, signs, symptoms, and patient characteristics is crucial for effective diagnosis and management. Treatment options may include lifestyle modifications, topical agents, oral medications, and advanced therapies such as botulinum toxin injections, which have shown efficacy in managing this condition[1][2][3].

For patients experiencing symptoms of focal hyperhidrosis, it is advisable to consult a healthcare professional for a comprehensive evaluation and tailored treatment plan.

Focal hyperhidrosis, classified under the ICD-10-CM code L74.5, is a condition characterized by excessive sweating in specific areas of the body. This condition can significantly impact the quality of life for those affected. Below are alternative names and related terms associated with focal hyperhidrosis.

Alternative Names for Focal Hyperhidrosis

1. Localized Hyperhidrosis: This term emphasizes that the excessive sweating is confined to specific areas rather than being generalized across the body.

2. Primary Focal Hyperhidrosis: This designation is often used to differentiate cases that are idiopathic (without an identifiable cause) from secondary forms of hyperhidrosis, which may be due to underlying medical conditions.

3. Axillary Hyperhidrosis: Specifically refers to excessive sweating in the armpits, which is one of the most common areas affected by focal hyperhidrosis.

4. Palmar Hyperhidrosis: This term describes excessive sweating of the palms, another frequently reported area of concern.

5. Plantar Hyperhidrosis: Refers to excessive sweating of the feet, which can also be a significant issue for individuals.

6. Craniofacial Hyperhidrosis: This term is used when excessive sweating occurs on the face and scalp.

Related Terms

1. Hyperhidrosis: A broader term that encompasses all forms of excessive sweating, including both focal and generalized hyperhidrosis.

2. Secondary Hyperhidrosis: This term refers to excessive sweating that is a symptom of another medical condition, such as hyperthyroidism or diabetes.

3. Sweating Disorders: A general category that includes various conditions related to abnormal sweating patterns.

4. Botulinum Toxin Treatment: A common treatment for focal hyperhidrosis, where botulinum toxin injections are used to temporarily block the nerves that cause sweating.

5. Surgical Treatment of Hyperhidrosis: Refers to surgical options available for severe cases of focal hyperhidrosis, such as sympathectomy.

Understanding these alternative names and related terms can help in better communication regarding the condition, especially in clinical settings or when seeking treatment options. If you have further questions or need more specific information, feel free to ask!

Focal hyperhidrosis, classified under the ICD-10-CM code L74.5, is characterized by excessive sweating in specific areas of the body, such as the palms, soles, underarms, or face. The diagnosis of focal hyperhidrosis typically involves several criteria to ensure accurate identification and differentiation from other conditions. Here’s a detailed overview of the diagnostic criteria used for this condition:

Diagnostic Criteria for Focal Hyperhidrosis

1. Clinical Presentation

• Localized Sweating: The sweating must be focal, occurring in specific areas rather than generalized across the body. Common sites include the palms, soles, axillae (armpits), and face.
• Excessive Sweating: The sweating is considered excessive when it is beyond what is necessary for thermoregulation and occurs at least once a week.

2. Duration

• Chronic Condition: Symptoms should be present for at least six months to qualify for a diagnosis of focal hyperhidrosis. This duration helps to distinguish it from transient sweating due to other factors, such as heat or anxiety.

3. Impact on Daily Life

• Functional Impairment: The excessive sweating must cause significant distress or impairment in social, occupational, or other important areas of functioning. This can include difficulties in work performance, social interactions, or personal relationships.

4. Exclusion of Secondary Causes

• Rule Out Other Conditions: It is essential to exclude secondary causes of hyperhidrosis, such as endocrine disorders (e.g., hyperthyroidism), infections, or medication side effects. A thorough medical history and physical examination are crucial in this step.

5. Response to Treatment

• Evaluation of Treatment Efficacy: While not a diagnostic criterion, the response to initial treatments (such as topical antiperspirants or botulinum toxin injections) can help confirm the diagnosis. A positive response may indicate that the sweating is indeed focal hyperhidrosis rather than a symptom of another underlying condition.

Conclusion

The diagnosis of focal hyperhidrosis (ICD-10 code L74.5) relies on a combination of clinical presentation, duration of symptoms, impact on daily life, and the exclusion of secondary causes. Proper diagnosis is essential for effective management and treatment, which may include various therapeutic options tailored to the severity and location of the sweating. If you suspect you have this condition, consulting a healthcare professional for a comprehensive evaluation is recommended.

Focal hyperhidrosis, classified under ICD-10 code L74.5, is a condition characterized by excessive sweating in specific areas of the body, such as the palms, soles, underarms, or face. This condition can significantly impact the quality of life, leading to social anxiety and discomfort. Various treatment approaches are available, ranging from conservative measures to more invasive procedures. Below is a comprehensive overview of standard treatment options for focal hyperhidrosis.

1. Topical Treatments

Antiperspirants

The first line of treatment often involves the use of topical antiperspirants containing aluminum chloride. These products work by blocking the sweat glands and are typically applied to the affected areas at night. Over-the-counter options are available, but prescription-strength formulations may be more effective for severe cases[1].

2. Oral Medications

Anticholinergics

Oral medications, particularly anticholinergics, can be prescribed to reduce sweating. These medications work by blocking the neurotransmitters that stimulate sweat glands. Common examples include glycopyrrolate and oxybutynin. However, they may have side effects such as dry mouth, blurred vision, and constipation, which can limit their use[2].

3. Botulinum Toxin Injections

Botulinum toxin (Botox) injections are a well-established treatment for focal hyperhidrosis, particularly for underarm sweating. The toxin temporarily blocks the nerves that cause sweating, providing relief for several months. Patients typically require repeat treatments every 6 to 12 months, depending on individual response[3].

4. Iontophoresis

Iontophoresis is a non-invasive treatment that involves using a device to pass a mild electrical current through water and into the skin's surface. This method is particularly effective for sweating of the hands and feet. Patients usually undergo multiple sessions, and maintenance treatments may be necessary to sustain results[4].

5. Microwave Therapy

Microwave therapy is a newer option that destroys sweat glands using microwave energy. This treatment is typically performed in a clinical setting and can provide long-lasting results. It is particularly effective for underarm hyperhidrosis and may require only one or two sessions[5].

6. Surgical Options

For severe cases of focal hyperhidrosis that do not respond to other treatments, surgical options may be considered. The most common surgical procedure is sympathectomy, which involves cutting nerves that trigger sweating. This approach is generally reserved for patients with significant impairment from their condition and is associated with potential risks and complications, including compensatory sweating in other areas[6].

7. Lifestyle Modifications

In addition to medical treatments, lifestyle modifications can help manage symptoms. These may include wearing loose-fitting clothing, using absorbent pads, and practicing stress-reduction techniques, as stress can exacerbate sweating episodes[7].

Conclusion

Focal hyperhidrosis can be effectively managed through a variety of treatment options tailored to the severity of the condition and the patient's preferences. While topical treatments and oral medications are often the first steps, more advanced therapies like botulinum toxin injections and microwave therapy offer significant relief for many individuals. In cases where conservative measures fail, surgical interventions may be considered. Patients are encouraged to consult with a healthcare provider to determine the most appropriate treatment plan based on their specific symptoms and lifestyle.

By understanding the available options, individuals suffering from focal hyperhidrosis can take proactive steps toward managing their condition and improving their quality of life.