RESEARCH ARTICLE Diagnosis of palmar hyperhidrosis via questionnaire without physical examination

Objectives In order to determine the reliability of a self-administered instrument to diagnose excessive sweating conditions, including palmar hyperhidrosis (PH), we designed two successive questionnaires and compared responses with physical examination and sweat measure-ment in normal volunteers and a cohort of patients with documented PH. The reliable diagnosis of PH via ques-tionnaire would enable molecular epidemiological studies without the need for physical examination or direct sweat measurement. Methods Subjects self identified as either normal or affected by PH. Each completed one or both questionnaires and underwent physical examination. Sweat production from the thenar eminence and forehead was measured at rest and following mental/emotional stress. Correlation among sweat measurement, physical examination, and questionnaire score was assessed. Results Forty-seven subjects enrolled in the study, 29 of whom underwent sweat measurements. The partici-pants ’ perception of whether they were affected agreed with the examiner’s visual and tactile observation of PH in all cases (P \ 0.0005). The mean peak sweat rate for those participants with PH was 1.59 mg/cm2/min, while that of the normal cohort was 0.37 mg/cm2/min (P = 0.001). The mean questionnaire #1 and #2 scores for those participants with PH and the normal cohort was 7.10 versus 0.36 (P = 0.0005) and 5.145 versus 0.045 (P = 0.0005), respectively. Peak sweat rate cor-related with questionnaire score (Pearson correlation coefficient = 0.723). Interpretation Palmar hyperhidrosis can be accurately diagnosed via questionnaire. Molecular epidemiological studies of PH may be reliably conducted without the need for direct physical examination