ICD-10: L74.52

Secondary focal hyperhidrosis, classified under ICD-10-CM code L74.52, refers to excessive sweating that occurs in specific areas of the body due to an underlying medical condition or external factors. This condition is distinct from primary hyperhidrosis, which is typically idiopathic and not linked to other health issues.

Clinical Description

Definition

Secondary focal hyperhidrosis is characterized by excessive sweating localized to specific body regions, such as the palms, soles, axillae (armpits), or face. Unlike primary hyperhidrosis, which often has no identifiable cause, secondary hyperhidrosis is a symptom of another medical condition or can be triggered by certain medications or substances.

Etiology

The causes of secondary focal hyperhidrosis can vary widely and may include:

• Medical Conditions: Conditions such as hyperthyroidism, diabetes, infections, or neurological disorders can lead to increased sweating in localized areas[1].
• Medications: Certain drugs, including antidepressants, antipyretics, and some antihypertensives, may induce sweating as a side effect[2].
• Hormonal Changes: Hormonal fluctuations, particularly during menopause or due to endocrine disorders, can also contribute to excessive sweating[3].

Symptoms

Patients with secondary focal hyperhidrosis typically experience:

• Localized Sweating: Excessive sweating in specific areas, which may be more pronounced during physical activity or emotional stress.
• Discomfort and Social Anxiety: The condition can lead to significant discomfort, embarrassment, and social anxiety, impacting the patient's quality of life[4].
• Associated Symptoms: Depending on the underlying cause, patients may experience other symptoms related to their medical condition, such as weight loss in hyperthyroidism or polyuria in diabetes[5].

Diagnosis

Clinical Evaluation

Diagnosis of secondary focal hyperhidrosis involves a thorough clinical evaluation, including:

• Medical History: A detailed history to identify any underlying conditions or medications that may contribute to the sweating.
• Physical Examination: Assessment of the areas affected by excessive sweating and evaluation for signs of underlying diseases[6].
• Diagnostic Tests: Additional tests may be warranted to rule out specific conditions, such as thyroid function tests or blood glucose levels, depending on the clinical suspicion[7].

Treatment Options

Management Strategies

Treatment for secondary focal hyperhidrosis focuses on addressing the underlying cause and may include:

• Medications: Anticholinergic medications can be prescribed to reduce sweating, while treating the underlying condition may alleviate symptoms[8].
• Botulinum Toxin Injections: These can be effective for localized sweating, particularly in the axillary region[9].
• Lifestyle Modifications: Patients may benefit from wearing breathable fabrics and practicing stress-reduction techniques[10].

Referral to Specialists

In cases where the underlying cause is complex or requires specialized treatment, referral to an endocrinologist or dermatologist may be necessary for comprehensive management[11].

Conclusion

ICD-10 code L74.52 for secondary focal hyperhidrosis encapsulates a condition that significantly impacts patients' lives due to excessive localized sweating linked to other medical issues. Understanding the etiology, symptoms, and treatment options is crucial for effective management and improving patient outcomes. If you suspect you have this condition, consulting a healthcare provider for a thorough evaluation and tailored treatment plan is essential.

References

1. Eccrine sweat disorders L74 - ICD-10-CM Codes.
2. Clinical Policy: Hyperhidrosis Treatments.
3. Clinical Policy: Hyperhidrosis Treatments.
4. Clinical Policy: Hyperhidrosis Treatments.
5. Clinical Policy: Hyperhidrosis Treatments.
6. Clinical Policy: Hyperhidrosis Treatments.
7. Clinical Policy: Hyperhidrosis Treatments.
8. Clinical Policy: Hyperhidrosis Treatments.
9. Clinical Policy: Hyperhidrosis Treatments.
10. Clinical Policy: Hyperhidrosis Treatments.
11. Clinical Policy: Hyperhidrosis Treatments.

Secondary focal hyperhidrosis, classified under ICD-10 code L74.52, is characterized by excessive sweating localized to specific areas of the body, which is secondary to an underlying medical condition. Understanding its clinical presentation, signs, symptoms, and patient characteristics is crucial for effective diagnosis and management.

Clinical Presentation

Definition and Etiology

Secondary focal hyperhidrosis occurs when excessive sweating is a symptom of another medical condition, rather than a primary disorder. This condition can be triggered by various factors, including hormonal changes, medications, or systemic diseases such as hyperthyroidism, diabetes, or infections[1][2].

Commonly Affected Areas

The sweating typically occurs in specific regions, including:
- Axillary (underarms)
- Palmar (hands)
- Plantar (feet)
- Craniofacial (face and scalp)

Signs and Symptoms

Excessive Sweating

Patients with secondary focal hyperhidrosis experience:
- Localized sweating: Unlike generalized hyperhidrosis, which affects the entire body, secondary focal hyperhidrosis is confined to specific areas.
- Increased sweating during specific triggers: Patients may notice that sweating worsens with stress, heat, or physical activity.

Associated Symptoms

In addition to excessive sweating, patients may report:
- Skin irritation: Due to constant moisture, affected areas may develop rashes or fungal infections.
- Social and psychological impact: Patients often experience embarrassment, anxiety, or social withdrawal due to their condition[3].

Patient Characteristics

Demographics

• Age: Secondary focal hyperhidrosis can occur at any age but is often reported in young adults and middle-aged individuals.
• Gender: There is no significant gender predisposition, although some studies suggest a slight male predominance[4].

Medical History

Patients may have a history of:
- Underlying medical conditions: Such as hyperthyroidism, diabetes, or infections that can contribute to excessive sweating.
- Medication use: Certain medications, including antidepressants and antipyretics, can induce secondary hyperhidrosis[5].

Lifestyle Factors

• Stress levels: High-stress environments or psychological conditions can exacerbate symptoms.
• Dietary influences: Consumption of spicy foods or caffeine may trigger episodes of sweating in some individuals.

Conclusion

Secondary focal hyperhidrosis, represented by ICD-10 code L74.52, is a condition that requires careful evaluation to identify underlying causes. Clinicians should consider the patient's medical history, associated symptoms, and demographic factors to provide an accurate diagnosis and effective treatment plan. Addressing the underlying condition is essential for managing the symptoms of secondary focal hyperhidrosis effectively.

For further management, healthcare providers may explore various treatment options, including topical agents, oral medications, or even surgical interventions, depending on the severity and impact of the condition on the patient's quality of life[6].

References

1. ICD-10-CM Code for Secondary focal hyperhidrosis L74.52.
2. Hyperhidrosis - Medical Clinical Policy Bulletins.
3. Treatment of Hyperhidrosis.
4. Symptoms, Signs, and Abnormal Clinical and Laboratory Findings.
5. Other Therapies for Hyperhidrosis.
6. Clinical Policy Title: Hyperhidrosis treatment.

When discussing the ICD-10 code L74.52, which refers to Secondary focal hyperhidrosis, it is helpful to understand the alternative names and related terms that are commonly associated with this condition. Below is a detailed overview of these terms.

Alternative Names for Secondary Focal Hyperhidrosis

1. Secondary Hyperhidrosis: This term is often used interchangeably with secondary focal hyperhidrosis, emphasizing that the excessive sweating is a symptom of an underlying condition rather than a primary disorder.

2. Localized Hyperhidrosis: This term can refer to excessive sweating that is confined to specific areas of the body, which is characteristic of focal hyperhidrosis.

3. Sweating Disorders: A broader category that includes various types of hyperhidrosis, including both primary and secondary forms.

4. Excessive Sweating: A general term that describes the condition of sweating more than what is considered normal, applicable to both primary and secondary hyperhidrosis.

Related Terms

1. ICD-10 Codes: Other related ICD-10 codes may include:
   - L74.51: Primary focal hyperhidrosis, which is the primary form of the condition without an underlying cause.
   - R61: Generalized hyperhidrosis, which refers to excessive sweating affecting the entire body.

2. Underlying Conditions: Secondary focal hyperhidrosis can be associated with various medical conditions, such as:
   - Hyperthyroidism: An overactive thyroid can lead to increased sweating.
   - Diabetes: Some individuals with diabetes may experience excessive sweating due to autonomic neuropathy.
   - Obesity: Increased body weight can contribute to higher sweating levels.

3. Botulinum Toxin Injections: A common treatment for hyperhidrosis, particularly for localized areas, often referenced in discussions about management options for secondary focal hyperhidrosis.

4. Surgical Treatment: Procedures such as sympathectomy may be considered for severe cases of hyperhidrosis, including secondary forms.

5. Diagnosis and Assessment: Terms related to the diagnosis of hyperhidrosis, such as hyperhidrosis assessment scales or clinical evaluation, are also relevant when discussing secondary focal hyperhidrosis.

Understanding these alternative names and related terms can enhance communication among healthcare providers and improve patient education regarding the condition. If you have further questions or need more specific information, feel free to ask!

The diagnosis of secondary focal hyperhidrosis, classified under ICD-10 code L74.52, involves specific criteria that healthcare providers must consider to ensure accurate identification and treatment. Here’s a detailed overview of the diagnostic criteria and considerations for this condition.

Understanding Secondary Focal Hyperhidrosis

Secondary focal hyperhidrosis is characterized by excessive sweating in specific areas of the body, such as the palms, soles, or underarms, which is not due to primary hyperhidrosis but rather secondary to an underlying medical condition or medication. This condition can significantly impact a patient's quality of life, leading to social anxiety and discomfort.

Diagnostic Criteria

1. Clinical History

• Symptom Onset: The patient should report a history of excessive sweating that is localized to specific areas of the body. This sweating must occur at least once a week and can be triggered by various factors, including stress, heat, or physical activity.
• Duration: Symptoms should be persistent and not limited to a temporary condition or acute illness.

2. Exclusion of Primary Hyperhidrosis

• Differentiation: It is crucial to differentiate secondary focal hyperhidrosis from primary hyperhidrosis, which is idiopathic and not linked to other medical conditions. A thorough medical history and physical examination are essential to rule out primary causes.

3. Identification of Underlying Causes

• Medical Conditions: Secondary hyperhidrosis can be associated with various medical conditions, such as hyperthyroidism, diabetes, infections, or neurological disorders. A comprehensive evaluation may include blood tests or imaging studies to identify any underlying issues.
• Medications: Certain medications, including antidepressants, antipyretics, and some antihypertensives, can cause excessive sweating. A review of the patient's medication history is necessary to identify potential drug-induced causes.

4. Physical Examination

• Sweating Patterns: A physical examination should document the areas affected by excessive sweating. The clinician may assess the severity and frequency of sweating episodes.
• Skin Assessment: Examination of the skin in the affected areas can help rule out other dermatological conditions that may mimic hyperhidrosis.

5. Impact on Daily Life

• Quality of Life Assessment: Evaluating how the sweating affects the patient's daily activities, social interactions, and emotional well-being is important. Tools such as questionnaires can help quantify the impact of hyperhidrosis on the patient's life.

Conclusion

The diagnosis of secondary focal hyperhidrosis (ICD-10 code L74.52) requires a comprehensive approach that includes a detailed clinical history, exclusion of primary hyperhidrosis, identification of any underlying medical conditions or medications, and a thorough physical examination. By following these criteria, healthcare providers can ensure accurate diagnosis and appropriate management of this condition, ultimately improving the patient's quality of life.

Secondary focal hyperhidrosis, classified under ICD-10 code L74.52, refers to excessive sweating localized to specific areas of the body, which is secondary to an underlying medical condition or medication use. The treatment approaches for this condition can vary based on the underlying cause, but several standard methods are commonly employed.

Understanding Secondary Focal Hyperhidrosis

Secondary focal hyperhidrosis differs from primary hyperhidrosis, which occurs without an identifiable cause. In secondary cases, the excessive sweating is often linked to conditions such as hyperthyroidism, diabetes, or certain medications. Therefore, addressing the underlying condition is crucial in managing symptoms effectively.

Standard Treatment Approaches

1. Addressing Underlying Conditions

The first step in treating secondary focal hyperhidrosis is to identify and manage any underlying medical issues. For instance:

• Hyperthyroidism: Treatment may involve antithyroid medications, radioactive iodine, or surgery.
• Diabetes: Proper management of blood sugar levels can help alleviate symptoms.
• Medications: If a specific medication is causing excessive sweating, a healthcare provider may adjust the dosage or switch to an alternative drug.

2. Topical Treatments

Topical antiperspirants containing aluminum chloride are often the first line of treatment for localized sweating. These products work by blocking the sweat glands and can be effective for mild cases of secondary hyperhidrosis. They are typically applied to the affected areas before bedtime and washed off in the morning.

3. Oral Medications

Anticholinergic medications, such as glycopyrrolate, can be prescribed to reduce sweating. These medications work by inhibiting the neurotransmitters that stimulate sweat glands. However, they may have side effects, including dry mouth and blurred vision, which should be discussed with a healthcare provider.

4. Botulinum Toxin Injections

Botulinum toxin (Botox) injections are a well-established treatment for focal hyperhidrosis. The toxin temporarily blocks the nerves that cause sweating in the treated areas. This method is particularly effective for areas like the palms, feet, and underarms, providing relief for several months before repeat treatments are necessary.

5. Iontophoresis

Iontophoresis is a non-invasive treatment that uses electrical currents to reduce sweating, particularly in the hands and feet. Patients typically undergo multiple sessions, and while it can be effective, the results may vary.

6. Microwave Therapy

Microwave therapy is a more recent option that destroys sweat glands using microwave energy. This treatment is typically performed in a clinical setting and can provide long-lasting results.

7. Surgical Options

In severe cases where other treatments have failed, surgical options may be considered. Procedures such as sympathectomy, which involves cutting nerves that trigger sweating, can be effective but come with risks and potential complications.

Conclusion

Managing secondary focal hyperhidrosis involves a multifaceted approach that includes treating any underlying conditions, utilizing topical and oral medications, and considering advanced therapies like Botox or surgical options when necessary. Patients experiencing symptoms should consult with a healthcare provider to determine the most appropriate treatment plan tailored to their specific situation. Regular follow-ups are essential to monitor the effectiveness of the chosen treatment and make adjustments as needed.