Are you, or anyone in your family or friend circle, suffering from excessive sweating without any apparent cause? It might be an abnormal condition known as Diaphoresis that you are having. Read on and find out all about this disease, including its causes, symptoms, treatment options, prognosis and more.
It refers to a medical condition characterized by excessive or profuse sweating in sufferers. It is usually linked with medical emergency conditions, such as circulatory shocks. Its scope is broad and includes all types of heavy perspiration.
In a medical setting, this is a condition unassociated to the normal stimuli of human beings. The occurrence of the disorder varies with age. This is because sweat glands function in an immature manner in infants and in a less active fashion in older adults.
Diaphoresis ICD 9 Code
The ICD 9 Code for this disorder is 780.8.
What Happens in Diaphoresis?
A body temperature of around 98.6º Fahrenheit (37º Celsius) is ideal. The internal temperature of the body is closely monitored by the hypothalamus. If the temperature rises to a great extent, it can threaten to compromise the homeostasis (metabolic equilibrium of the physical system). The hypothalamus would try to avoid the situation by triggering off the sweat mechanism. Thus, sweating is the natural response of the body to high temperature. It is the method of temperature regulation within the body. If the external temperature is very high, people would sweat more and vice versa.
In individuals suffering from Diaphoresis, the sweat mechanism is triggered by apparently unrecognizable factors.
The various causes of this condition include:
These include remembrance of traumatic events of the past, fear and other strong emotions. These also comprise of physical agents like physical exertion, fever and menopause as well as external factors like spicy foods and excessively high temperature. In menopausal women, hot flashes may be responsible for heavy perspiration.
These involve possibility of association with health abnormalities like shock or hyperthyroidism. The condition may also arise in diabetic individuals who rely on oral medications or insulin shots for reducing blood sugar level.
The pathological causes for excessive sweating can also be associated to use of medications like:
- Antipsychotic drugs
- Acetylcholinesterase inhibitors, such as certain pesticides
- Narcotic painkillers
- Sympathetic nervous system stimulants, in the range of amphetamines or cocaine
The condition may also arise due to use of morphine, caffeine and alcohol. Excessive toxicity due to intake of mercury may also lead to the development of this disease.
Lifting heavy objects, working out, athletic activities and being exposed to hot weather conditions can also cause sweating. These are normal causes for severe perspiration and do not generally need any medical treatment. However, people who sweat due to no apparent reason should consult a professional healthcare giver and seek proper medical treatment. In any case, medical attention is important to attend to health issues that occur due to unexplained factors.
The condition may also develop due to the presence of one or more of the following disorders:
- Alcohol and Opioid withdrawal
- Autonomic hyperreflexia
- Cardiogenic, anaphylactic, hypovolemic, septic or neurogenic shock
- Circulatory shock
- Heart failure
- Infantile acrodynia (mercury poisoning during childhood)
- Parkinson’s disease
- Pheochromocytoma (caused by ectopic catecholamine)
- Sudden febrile illness, resulting from infection
- Various medications as well as certain antipsychotics and caffeine
As aforementioned, excessive sweating or perspiration is the primary characteristic of this disorder. The secondary symptoms include:
Foul odor in the body develops due to the micro-organisms like yeast that naturally reside inside the skin. The odor emanates as the skin gets moist and gets mixed with these organisms. It is also believed that stress causes the tubules of the apocrine gland to contract. The sweat contained in them is pushed to the skin floor. Drugs used for the treatment of various conditions, as well as disorders like Diabetic ketoacidosis and kidney failure, may have an effect on the odor.
Altered appearance of skin
Areas producing sweat generally appear white or pink. In severe cases, however, they may appear soft, scaly or cracked.
It should be noted that Diaphoresis is itself a symptom of several other diseases.
Hyperhidrosis vs Diaphoresis
Hyperhidrosis is a medical term used for Diaphoresis that occurs without any apparent cause. In such cases, affected individuals may perspire even when relaxed or in cool weather conditions. Some individuals may have sweaty hands (Palmar hyperhidrosis) or sweaty underarms (Axillary hyperhidrosis). Both types of hyperhidrosis can cause embarrassment, mental distress and other social problems.
Diaphoresis is characterized by severe perspiration that sometimes amounts to over 1 liter every hour. The condition is differentiated from Hyperhidrosis by the fact that individuals affected by the former disease suffer from “clammy” skin or “cold sweat.” The condition arises all of a sudden and might be associated to other signals of the autonomic nervous system such as tachycardia and elevated blood pressure.
The diagnosis of this condition should depend on the basis of accounting all the signs and symptoms exhibited by an affected individual. Physicians should ask patients and know about all the symptoms being experienced before confirming the presence of this condition. When possible environmental and pathological factors are ruled out by doctors, the condition can definitely be confirmed to be Hyperhidrosis or Diaphoresis.
Physicians usually diagnose this disease with the aid of examinations like paper test. In this exam, physicians use a strip of special paper to soak up sweat of affected individuals and weight it. The weight of the paper gives them an idea of the amount of sweat that has been accumulated. The heavier the paper, the more the sweat accumulation is found to be.
In some cases, X-rays or thyroid function tests might also be performed to detect the presence of other underlying medical causes.
If physicians suspect hyperhidrosis, they may perform a starch-iodine test for diagnosis. This includes application of an iodine solution to the affected region. Once it dries, starch is sprinkled over the area. The combination of starch and iodine gives rise to a dark-blue color in case of excessive sweat.
Diaphoresis Differential Diagnosis
The differential diagnosis or this disorder involves taking into account and ensuring the absence of symptoms of other conditions like:
- Any vagal episodes
- Injury or damage to the central nervous system
- Acute respiratory distress
- Myocardial Infarction, along with elevation of ST
The treatment of this condition is not actually possible. This is mainly because Diaphoresis is not a disorder; rather it is a symptom of other conditions. Due to this reason, healthcare professionals tend to focus on curing the main factors responsible for heavy perspiration.
Medical Treatment for Diaphoresis
If pathological factors are responsible for the occurrence of the disease, they should be cured first in order to eliminate Diaphoresis completely. If menopause results in this problem, estrogen replacement therapy can help improve the symptoms.
In case psychological factors like stress or anxiety are responsible, relaxation techniques like medication or yoga can be helpful. A proper diet and regular workouts may also yield benefits.
Certain patients can manage their bad body odor with the aid of powerful antiperspirants, particularly one that contains aluminum hydroxide.
Anti-cholinergic medications help stop excessive sweating temporarily. Unfortunately, however, the dosages necessary to decrease sweating also result in side effects. These include problems like:
- Bladder and bowel dysfunction
Home Treatment for Diaphoresis
Home treatment for this condition mostly begins with the use of over-the-counter antiperspirants. These have compounds which lower the amount of sweat that can reach the skin by clogging sweat pores. Deodorants, although effective in eliminating body odor, are incapable of blocking sweat pores unlike antiperspirants. Deodorants act by making the skin and pores acidic in nature, which is not conducive to the growth of micro-organisms like bacteria.
Non-surgical treatment for Diaphoresis
If over-the-counter remedial measures are not effective, physicians can prescribe remedies that mainly depend on factors like:
- Age of sufferers
- Complete well-being of patients
- Severity of the disorder
- Trigger for the disorder
- Tolerance level of affected individuals
Remedial measures prescribed by physicians include inserting topical solutions or use of iontophoresis or Botox. The last two options require greater tolerance. Botox injections help reduce nerve impulses. Botox (Botulinum toxin A) is directly injected into the area that is most affected by perspiration. Iontophoresis involves passing electrical currents into the region.
Certain oral drugs, called anticholinergics, have been found to yield effective results by reducing the amount of perspiration in sufferers.
Surgical treatment for Diaphoresis
If non-operative techniques fail to work as per the expectations of affected individuals, a surgical process known as sympathectomy might be needed as a remedial measure. The method can be used to regulate the amount of sweating on the arms and feet of sufferers. It also acts by destroying sections of the nerve supply to the glands of sweat in these regions. To put simply, this operative method switches off the sweat synthesis receptors in the body.
The condition can be prevented by the use of antiperspirants, bathing and adopting relaxation techniques that calm the mind as well as the body.
The outcome of this disorder depends on the underlying factor. Early management of the responsible factor and its successful cure helps determine whether or not this condition can be completely cured.
The condition is not known to give rise to any serious side effects. In the absence of timely management, however, the disorder can result in electrolyte imbalance and worsen the underlying disorder responsible for its occurrence.
Patients or their family members should consult professional medical caregivers in case of sweating arising along with other problems like respiratory shortness, fever, unexplained loss of weight or chest discomfort. Untimely diagnosis and cure can lead to worsening of the disease and add to the discomfort of sufferers. Naturally, it is important to seek medical treatment on a timely basis and avoid the risk of all future complications.