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      Clinical Analysis and Management of Acquired Idiopathic Generalized Anhidrosis

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      Current Problems in Dermatology

      S. Karger AG

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          Acquired idiopathic generalized anhidrosis (AIGA) is a sweating disorder characterized by inadequate sweating in response to heat stimuli such as high temperature, humidity, and physical exercise. Patients exhibit widespread nonsegmental hypohidrosis/anhidrosis without any apparent cause, but the palms, soles, and axillae are rarely affected. Heat stroke readily develops due to increased body temperature. AIGA commonly affects young males. Approximately 30-60% of patients show complications of cholinergic urticaria, also known as idiopathic pure sudomotor failure or hypohidrotic cholinergic urticaria. Systemic corticosteroids are the most effective therapy, although recurrence is not uncommon.

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          Most cited references 12

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          Dynamic analysis of histamine-mediated attenuation of acetylcholine-induced sweating via GSK3β activation.

          Sweating has been associated with the exacerbation of atopic dermatitis (AD) in diverse ways. Acetylcholine (ACh)-mediated sweating is known to be attenuated in AD, but its cause remains obscure. To address this issue, the impact of histamine on ACh-induced sweating was evaluated. Sweating was measured by counting the number of active sweat pores by the starch-iodine reaction and dynamic optical coherence tomography; sweat was visualized using two-photon excitation fluorescence microscopy in mice and the quantitative sudomotor axon reflex test in humans. Both histamine receptor antagonists and H1 receptor (H1R)-knockout (KO) mice were used to determine methodological specificity. Histamine demonstrably inhibited ACh-induced sweating in both mice and humans via H1R-mediated signaling. In sweat glands, ACh inactivated glycogen synthase kinase 3β (GSK3β), a kinase involved in endocytosis and secretion, whereas simultaneous stimulation with histamine activated GSK3β. Results of two-photon excitation fluorescence microscopy confirmed the dynamic motion of sweat and sweat glands after ACh treatment, showing that simultaneous stimulation with histamine altered their dynamic properties. These results indicate that histamine inhibits sweat gland secretions by blocking ACh-induced inactivation of GSK3β. Histamine-mediated hypohidrosis might be involved in the mechanism of abnormal skin dryness in patients with AD.
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            Cholinergic urticaria: studies on the muscarinic cholinergic receptor M3 in anhidrotic and hypohidrotic skin.

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              Decreased expression of acetylcholine esterase in cholinergic urticaria with hypohidrosis or anhidrosis.


                Author and article information

                Curr Probl Dermatol
                Current Problems in Dermatology
                Curr Probl Dermatol
                S. Karger AG (Basel, Switzerland karger@ )
                September 2016
                30 August 2016
                : 51
                : Perspiration Research
                : 75-79
                Department of Dermatology, National Defense Medical College, Tokorozawa, Japan
                CPD2016051075 Yokozeki H, Murota H, Katayama I (eds): Perspiration Research. Curr Probl Dermatol. Basel, Karger, 2016, vol 51, pp 75-79
                © 2016 S. Karger AG, Basel

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                Page count
                Figures: 3, References: 13, Pages: 5

                Medicine, General social science


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