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Gepubliceerd in: Huisarts en wetenschap 9/2015

01-09-2015 | Nascholing

‘Dokter, ik zweet te veel’: hyperhidrose in de praktijk

Auteur: Roel Genders

Gepubliceerd in: Huisarts en wetenschap | Uitgave 9/2015

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Samenvatting

Genders R. ‘Dokter, ik zweet te veel’: hyperhidrose in de praktijk Huisarts Wet 2015;58(9):492-5.
Er zijn twee soorten zweetklieren: eccriene zweetklieren zorgen voor de thermoregulatie en bevinden zich overal op het lichaam, apocriene zweetklieren produceren vooral geurstoffen en bevinden zich in de oksels, rond de tepels en bij de geslachtsorganen. Overmatig zweten kan leiden tot schaamte, verminderd zelfvertrouwen en psychische klachten. Ongeveer 1-3% van de algemene bevolking heeft last van hyperhidrose, bij ongeveer eenderde van hen zijn de klachten zodanig dat ze bij de huisarts komen.
Een belangrijk onderscheid is dat tussen primaire en secundaire hyperhidrose. Primaire hyperhidrose is meestal lokaal (handen, voeten, oksels, liezen of gelaat), secundaire hyperhidrose is doorgaans gegeneraliseerd. Bekende oorzaken van secundaire hyperhidrose zijn overgewicht, metabole, endocriene en neurologische aandoeningen, druggebruik en medicatie.
Er is een scala van behandelingen voor primaire hyperhidrose, variërend van topicale of orale medicatie, iontoforese, botulinetoxine-injecties en microgolfbehandeling tot chirurgische ingrepen zoals excisie, curettage of sympathectomie. De niet-invasieve microgolftechniek ter behandeling van axillaire hyperhidrose is nieuw en veelbelovend.
De huisarts speelt een belangrijke rol in de diagnostiek en verwijzing. Welke behandeling hij kiest bij primaire hyperhidrose is sterk afhankelijk van de wensen en verwachtingen van de patiënt, en van de ernst en lokalisatie van de aandoening. Bij secundaire hyperhidrose zal hij uiteraard eerst de onderliggende aandoening aanpakken.
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Metagegevens
Titel
‘Dokter, ik zweet te veel’: hyperhidrose in de praktijk
Auteur
Roel Genders
Publicatiedatum
01-09-2015
Uitgeverij
Bohn Stafleu van Loghum
Gepubliceerd in
Huisarts en wetenschap / Uitgave 9/2015
Print ISSN: 0018-7070
Elektronisch ISSN: 1876-5912
DOI
https://doi.org/10.1007/s12445-015-0258-3

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