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Disorders of eccrine sweating can occur for many different reasons, including dysfunction of the thermoregulatory centers in the brain's central autonomic network, changes in the spinal sympathetic preganglionic, ganglionic, or postganglionic neurons/axons or in the muscarinic (M3) cholinergic synapse on sweat glands. Abnormalities of eccrine sweat formation by the secretory coil and sweat ductal cells may occur or ductal disruption or occlusion may develop, preventing delivery of sweat to the skin surface.
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A review of the normal anatomy and physiology of eccrine sweat glands and sweating may be found in Chapter 83. This chapter focuses on neurologic and dermatologic disorders that cause focal or generalized abnormalities of sweating, highlighting an exciting interface where disorders are better understood, diagnosed, and treated based on recognition of the integrated function of nerves, skin, and the immune system (Fig. 84-1). There are a variety of techniques that can be used clinically and in research of sweating that are discussed online. Table 84-1 is a comprehensive table based on disorders with increased or decreased sweating—some diseases are discussed in this text–the others are discussed online. Many are disorders related to nervous system structural, functional and inherited disorders; therefore any patient with a sweating disorder should be evaluated carefully for internal medicine diseases and neurologically by consultants in some cases.
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