From the Guidelines
Unilateral axillary hyperhidrosis can be caused by various conditions, including breast cancer, which is the most common cause of axillary lymph node metastasis, as stated in the study by Le-Petross et al 1. The most common causes of unilateral axillary hyperhidrosis include:
- Primary focal hyperhidrosis, which is often idiopathic and may affect one side more than the other
- Neurological disorders such as stroke, spinal cord injury, or nerve damage
- Certain medications like antidepressants or opioids
- Endocrine disorders including hyperthyroidism, diabetes, or pheochromocytoma
- Infections like tuberculosis
- Rarely, certain tumors, with breast cancer being a significant concern, as noted in the study by Le-Petross et al 1 and the ESMO clinical practice guideline for diagnosis, treatment, and follow-up of early breast cancer 1.
According to the ESMO clinical practice guideline for diagnosis, treatment, and follow-up of early breast cancer 1, sentinel lymph node biopsy (SLNB) is the standard staging approach for clinically negative axillary lymph nodes (ALNs) at diagnosis or after neoadjuvant chemotherapy. The identification of axillary lymph node metastasis is crucial, as it can significantly impact treatment and prognosis, as highlighted in the study by Le-Petross et al 1 and the ESMO guideline 1.
Treatment for unilateral axillary hyperhidrosis depends on the underlying cause but may include:
- Topical antiperspirants containing aluminum chloride
- Oral anticholinergics like glycopyrrolate
- Botulinum toxin injections
- Iontophoresis
- Microwave thermolysis (miraDry)
- For severe cases unresponsive to these treatments, thoracic sympathectomy may be considered as a surgical option, as noted in the example answer.
It is essential to seek medical evaluation for unilateral hyperhidrosis, as it could signal an underlying condition requiring specific treatment, especially when it appears suddenly or is accompanied by other symptoms, as emphasized in the example answer and supported by the studies by Le-Petross et al 1 and the ESMO guideline 1.
From the Research
Unilateral Axillary Hyperthyroid Causes
- Hyperthyroidism is a potential cause of unilateral axillary hyperhidrosis, as it can lead to an overproduction of sweat by the exocrine sweat glands 2.
- Secondary hyperhidrosis, which can be caused by an underlying medical condition, may also result in unilateral axillary hyperhidrosis 3, 4.
- Other potential causes of hyperhidrosis, such as phaeochromocytoma, may also contribute to unilateral axillary hyperhidrosis 2.
- It is essential to note that primary hyperhidrosis is typically bilaterally symmetric, whereas secondary hyperhidrosis can be unilateral or asymmetric 3, 4.
- The diagnosis of unilateral axillary hyperhidrosis should involve excluding underlying medical conditions that may be causing the hyperhidrosis 4.