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Sweat lead levels in persons with high blood lead levels: experimental elevation of blood lead by ingestion of lead chloride.

Blood lead levels were experimentally elevated in two subjects by ingestion of single oral doses of lead as lead chloride. Serial samples of blood, urine and sweat were collected subsequently. Sweat samples were collected in polythene armbags while subjects cycled on a bicycle ergometer in a hot chamber. In spite of increases in blood and urinary lead levels, no increases in sweat lead levels were recorded. Possible reasons for this observation are discussed.

Administration, Oral↗

Effects of calcitonin gene-related peptide and vasoactive intestinal peptide on nicotine-induced sweating in man.

The effects of two neuropeptides, calcitonin gene-related peptide and vasoactive intestinal peptide on nicotine-induced sweating in human skin were investigated. Intradermal injection of nicotine induced local sweating and each peptide, administered together with nicotine, inhibited these responses in a concentration-dependent manner. The concentration of calcitonin gene-related peptide for threshold and half-maximum inhibition were about 10(-10) M and 10(-8) M, respectively, while those of vasoactive intestinal peptide were approximately 10(-9) M and 10(-7) M, respectively. The results suggest that calcitonin gene-related peptide and vasoactive intestinal peptide have inhibitory effects on the nicotinic action, and release of endogenous calcitonin gene-related peptide and/or vasoactive intestinal peptide may influence sweating in human skin under physiological conditions in vivo.

Adult↗

Somatostatin-like immunoreactivity is found in dendritic guard cells of human sweat ducts.

Somatostatin is reported in a new population of human sweat duct cells. The epithelial content of somatostatin-like immunoreactivity in normal human skin from various sites of the body was investigated using indirect immunofluorescence. With this methodology we found round-to-oval somatostatin-immunoreactive cells situated outside the lining sweat duct cells at the level of the stratum spinosum. The cells had processes that were clearly directed towards the duct lumen, passing between the lining duct cells. This finding raises new questions and ideas about somatostatin's role in the skin, and could point to a possible involvement of somatostatin in immune defense, sweat secretion modification, antiproliferation, or other actions.

Dendritic Cells↗

Blood typing of blood stains on sweat stains by the isoagglutinins detection method.

When a blood typing is made for mixed stains of sweat and blood, erroneous results may be obtained. The reason is that the blood group substance in the sweat is detected at the same time as that in the blood. In this paper the typing of the blood stain on the sweat stain is carried out by the detection of isoagglutinins which may give additional information to the forensic serologist.

ABO Blood-Group System↗

Acquisition of cholinergic and peptidergic properties by sympathetic innervation of rat sweat glands requires interaction with normal target.

The sweat glands, a target of cholinergic sympathetic neurons, were replaced with parotid gland, a target of noradrenergic sympathetic neurons, in neonatal rats. This transplantation paradigm allowed sympathetic neurons that would normally innervate the sweat glands and develop a cholinergic phenotype to innervate the parotid gland instead. The innervation of the transplanted parotid gland did not develop a cholinergic phenotype, as assessed by choline acetyltransferase activity and acetylcholinesterase immunoreactivity, but continued to express intense catecholamine fluorescence. In addition, immunoreactivity for vasoactive intestinal peptide, normally expressed by the sympathetic innervation of the sweat glands but not the parotid, was observed in only a small percentage of the parotid-associated fibers. These results suggest that cellular interactions between neurons and their targets play an important role in the differentiation of mature neurotransmitter and neuropeptide phenotypes in vivo.

Animals↗

An investigation into the effect of axillary surgery on ipsilateral axillary sweating--a pleasing 'complication' or a potential treatment for hyperhidrosis?

Although there had not been complaints of excessive sweating pre-operatively, it was noticed incidentally that a large proportion of patients who had undergone axillary lymph node sampling or clearance for breast carcinoma seemed to report ipsilateral sweat loss as a pleasing 'complication'. We interviewed 65 consecutive patients who had all had axillary dissections performed by the same surgeon's technique; the interviews were held 2-102 months after their operations. In 36 cases, patients reported no change in axillary sweating (mean 35 months), whereas 29 patients reported a decrease (mean 50 months). This result was statistically significant at the 95% confidence interval (p=0.022).

Adult↗

Detection of cocaine and cocaethylene in sweat by solid-phase microextraction and gas chromatography/mass spectrometry.

In the present work, a semi-quantitative method was developed to detect simultaneously cocaine (COC) and cocaethylene (CE) (transesterification product of the coingestion of COC with ethanol) in sweat. Sweat samples were collected by means of a non-occlusive sweat patch device supplied by PharmChek. The method was based on the dissolution of COC and CE incorporated into the patch, with 0.2 M sodium acetate buffer (pH 5.0) and the extraction of the analytes by solid-phase microextraction (SPME). Gas chromatography/mass spectrometry (GC-MS) was used to detect the analytes in selected ion monitoring mode (SIM). The method showed to be very simple, rapid and sensitive. The limits of detection were 5 ng/ml for COC and CE (12.5 ng/patch). Good inter and intra-assay precision was also observed (coefficient of variation <8%) with the use of deuterated internal standards.

Cocaine↗

Tibolone relieves climacteric symptoms in highly symptomatic women with at least seven hot flushes and sweats per day.

OBJECTIVE: To establish the potency of four dose levels of tibolone, a tissue selective estrogenic activity regulator (STEAR), to relieve climacteric symptoms in a subgroup of highly symptomatic women experiencing a minimum of seven hot flushes and sweats per day. METHODS: In a group of 770 women receiving tibolone 0.625, 1.25, 2.5 or 5.0 mg or placebo for 12 weeks, a total of 317 women experienced at least seven hot flushes and sweats per day. Frequency and intensity of climacteric symptoms were assessed at baseline and after 4, 8 and 12 weeks of treatment. Vaginal bleeding/spotting was studied using diary cards. Occurrence of adverse events was determined by active questioning. RESULTS: Tibolone induced a decrease in the frequency and intensity of climacteric symptoms, leading to statistically significant differences compared to placebo for dose levels of 1.25 mg and higher. The incidence of vaginal bleeding/spotting and of drug-related adverse events was similar in all tibolone dose groups, except for the 5.0 mg group, where the incidence was about twice as high. Dropout rate due to insufficient therapeutic effect is substantially higher in the 0.625 and 1.25 mg group (about 10%) compared to the 2.5 and 5.0 mg group (about 1%). These results are consistent with what occurred in the total study population published previously. CONCLUSION: The effects of tibolone in highly symptomatic women experiencing at least seven hot flushes and sweats per day do not differ much from that in the total study population. A daily dose of 2.5 mg is the optimal dose for both the total study population and the subgroup of highly symptomatic women. However, in order to optimise individual treatment, the 1.25 mg dose might also be taken into consideration.

Climacteric↗

Topical botulinum toxin to treat hyperhidrosis? No sweat!

Palmar, plantar and axillary hyperhidrosis, though benign, may be burdensome and occupationally restrictive, even hazardous. Treatment modalities range from topical antiperspirants, iontophoresis, systemic medications such as anticholinergics and benzodiazepines and injections of botulinum toxin, to thoracic sympathectomy. Intradermal injections of botulinum toxin (BTX), though effective, are painful especially when multiple injections are required. Iontophoretic administration of BTX has been described, the BTX entering the eccrine sweat glands via the sweat pores and through the sweat ducts. We postulate that BTX can be administered topically, either unassisted or assisted by application of an electrical gradient, low-frequency ultrasound or excipients such as dimethylsulfoxide. We examine the rationale and feasibility for such a treatment modality and route of administration.

Administration, Topical↗

Gustatory facial sweating subsequent to upper thoracic sympathectomy.

Gustatory facial sweating has been described as a consequence of upper thoracic sympathectomy. Patients may also develop compensatory hyperhidrosis, sensory deficits, nipple hypersensitivity, and Horner's syndrome. In this article, we have reviewed three patients with reflex sympathetic dystrophy who developed gustatory facial sweating subsequent to endoscopic T2 and T3 ganglionectomy. This article also discusses the possible mechanisms of gustatory facial sweating.

Adult↗

Sweat testing for the diagnosis of cystic fibrosis: practical considerations.

Most pediatricians eventually encounter a patient with a clinical presentation that warrants the consideration of a sweat test to rule out of confirm the diagnosis of cystic fibrosis. This article discusses, in a series of questions and answers, the currently available sweat testing methods and describes the various methods' reliability, limitations, and frequency of use. In addition, sweat testing utilization and the interpretation and evaluation of test results are discussed so that the clinician can critically analyze the laboratory data.

Arm↗

Thermoregulatory sweating abnormalities in diabetes mellitus.

A properly performed thermoregulatory sweat test (TST) can be informative in patients with diabetic neuropathy. Of 51 patients suspected of having neuropathy on the basis of a clinical examination, 48 (94%) had unequivocal abnormalities on the TST. Pathologic loss of sweating occurred distally in 65%, segmentally in 25%, and only in isolated dermatomes in 25%; 78% of patients had a combination of two or more patterns. Global anhidrosis was noted in eight patients (16%), all of whom had profound autonomic neuropathy, and in the entire group, the percentage of body surface anhidrosis correlated with the degree of clinical dysautonomia (rank correlation coefficient = 0.77; P less than 0.01). Discrete zones of anhidrosis on the thorax and abdomen were noted in patients with painful diabetic radiculopathy, and they correlated highly with thoracic paraspinal muscle fibrillation potentials. Distal loss of sweating detected on the TST was always associated with a subnormal quantitative sudomotor axon reflex response or abnormal electromyographic findings, an indication of a distal axonal neuropathy. The TST provides reliable information about the distribution of diabetic neuropathic involvement and can be especially useful in the diagnosis of truncal radiculopathy and clinically significant autonomic neuropathy.

Adult↗

Cold-induced profuse sweating on back and chest. A new genetic entity?

Two sisters whose parents shared a grandfather had cold-induced sweating. Since childhood they had sweated profusely from the back and chest when exposed to environmental temperatures of 18 degrees to 7 degrees C. They had additional abnormalities--e.g., high palate and inability fully to extend the elbows--which neither their parents nor their sibs shared. The cold-induced sweating, which could not be stopped by a beta-adrenergic blocking agent, was abolished by postganglionic blockade with atropine sulphate. This indicates the possibility of a peripheral mechanism.

Administration, Oral↗

Signet ring cell carcinoma of the eccrine sweat glands in the eyelid.

BACKGROUND: Signet ring cell carcinoma of the eyelid is a rare variant of eccrine sweat gland carcinoma and has been reported previously in only five patients. METHODS: The authors report the clinical findings of a 55-year-old man with a signet ring cell carcinoma in the left eyelid as well as a clinical follow-up of 4.5 years. Several biopsies and the exenteration specimen were analyzed by routine light microscopy, electron microscopy, and comprehensive immunohistochemical stains on paraffin sections. RESULTS: Histologically, the tumor was shown to be a rare type of eccrine sweat gland carcinoma with signet ring cells and Indian file growth pattern reminiscent of invasive lobular carcinoma of the breast. Estrogen and progesterone receptors were identified immunohistochemically. On electron microscopy, intracytoplasmic pseudolumina with microvilli were positive for anti-human milk fat globulin and the lectin peanut agglutinin. Clinically, the tumor followed a malignant course with orbital invasion and lymph node metastases. CONCLUSIONS: Histologic recognition of this variant of eccrine sweat gland carcinoma is important because of its aggressive and malignant behavior and the wide range of differential diagnoses. Primarily, metastatic mammary carcinoma must be excluded. The treatment is primary excision with histologic control of the excision margins. In more advanced stages, radiation therapy, neck dissection, and anti-estrogen therapy should be considered.

Biomarkers, Tumor↗

Sympathetic skin responses recorded from non-palmar and non-plantar skin sites: their role in the evaluation of thermal sweating.

OBJECTIVE: To characterize the sympathetic skin responses (SSRs) recorded from non-palmar and non-plantar (non-Pa/P1) skin sites and to evaluate their clinical usefulness. METHODS: SSRs were recorded from 6 non-Pa/P1 sites as well as palmar and plantar (Pa/P1) sites using magnetic neck stimulation in 33 normal subjects, 17 neurological patients with dysautonomia and one patient with lumbar sympathectomy. A conventional thermoregulatory sweat test (TST) was also carried out in 3 patients. RESULTS: Clear and reproducible SSRs were obtained from all recording sites in all of the normal subjects when the skin temperatures of the subjects were maintained above 34 degrees C and the subjects drank 100-200 ml of hot water. The distribution of absent SSRs was closely correlated with that of anhidrosis or a sweating delay shown by the TST in the patients. Nine of the 17 neurological patients (53%) showed normal responses at Pa/P1 sites, and abnormal responses at non-Pa/P1 sites. CONCLUSIONS: Recording SSRs from multiple skin sites including non-Pa/P1 sites after magnetic stimulation is more sensitive in detecting sudomotor dysfunction than is the conventional method of recording SSRs from only Pa/P1 sites. In addition, this new method is very useful for the objective clinical evaluation of thermal sweating.

Adrenoleukodystrophy↗

Expression of a glycoprotein of the carcinoembryonic antigen family in normal and neoplastic sebaceous glands. Limited role of carcinoembryonic antigen as a sweat gland marker.

BACKGROUND: Carcinoembryonic antigen (CEA) is a well-known marker for sweat gland differentiation in adnexal neoplasms. OBJECTIVE: The aim of this study was to examine the expression of glycoproteins of the CEA family, that is, CEA-180, nonspecific cross-reacting antigens (NCAs), and biliary glycoprotein (BGP), in sebaceous glands and in neoplasms with sebaceous differentiation. METHODS: Normal adult and fetal skin, hyperplasias, hamartomas, and neoplasms with sebaceous or follicular differentiation were stained immunohistochemically with a panel of polyclonal and monoclonal antibodies highly specific for CEA-180, NCAs, and BGP. Double immunostaining was performed to correlate the CEA expression with that of epithelial membrane antigen (EMA), a glycoprotein consistently found in differentiating sebocytes. RESULTS: Whereas sweat glands coexpressed CEA, NCAs, BGP, and EMA, sebaceous glands were exclusively labeled with the antibodies recognizing BGP or EMA. Staining of the sebaceous glands was restricted to mature sebocytes, sparing immature cells. At the ultrastructural level immunoreactivity for BGP and EMA was demonstrable in the golgi area, in small vesicles, and along the cell membranes. During fetal development BGP was not found until the sebaceous glands matured. The expression of BGP and EMA was highly conserved in reactive, hamartomatous, and neoplastic proliferations of adnexal structures with sebaceous differentiation. CONCLUSION: The expression of BGP, a CEA glycoprotein, in differentiating sebocytes accounts for the reactivity of many anti-CEA antibodies with sebaceous glands and thus disqualifies the CEA family as a monospecific marker for sweat gland differentiation.

Adolescent↗

Gustatory sweating and diabetes.

Gustatory sweating as a feature of autonomic neuropathy is an unusual phenomenon in diabetes mellitus. We describe a patient with type 1 diabetes mellitus complicated by retinopathy, nephropathy and neuropathy. This patient presented with bilateral diffuse facial sweating during eating. She was treated with the antimuscarine agent oxybutynine, which provided a striking relief from the gustatory sweating.

Adult↗

Development of emotional sweating in preterms measured by skin conductance changes.

Skin conductance shows the emotional state, as reflected in changes in the sympathetic nervous system. Skin conductance changes (number and amplitude of the waves, as well as mean skin conductance level) were measured in connection with heel prick from 29 weeks gestational age. The purposes of this study were to examine the development of emotional sweating in preterm infants, and to correlate the changes in emotional sweating with the changes in behavioural state. Fifty infants' behavioural state and skin conductance changes were measured for 2 min before, 2 min during, and 2 min after heel prick. Half of the infants were between 29 and 31 weeks gestational age. They were divided into three sub-groups; 0-10, 11-20 and 21-30 days postnatal age. The other half of the infants were between 32 and 34 weeks gestational age and they were divided into three similar sub-groups. They changed their behavioural state 114 times. Infants from 29 weeks gestational age and more than 10 days old showed emotional sweating as measured by the number and amplitude of the waves that were lowest in sleep and highest during crying (p<0.05). The mean skin conductance level mirrored the behavioural state from 34 weeks gestational age (p<0.05).To conclude, skin conductance changes increased with the level of behavioural state from 29 weeks gestational age and more than 10 days postnatal age.

Birth Weight↗