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Primary focal hyperhidrosis severely affects many aspects of daily life including emotional well-being, interpersonal relationships, leisure activities, personal hygiene, work and productivity, and self-esteem.
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For evaluation of its impact on patients, disease-specific questionnaires, such as the Hyperhidrosis Disease Severity Scale, the Clinical Protocol for Quality of Life, and the comprehensive Hyperhidrosis Impact Questionnaire, have been developed.
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Limitations of hyperhidrosis as a
Impact of Hyperhidrosis on Quality of Life and its Assessment
Section snippets
Key points
Hyperhidrosis Disease Severity Scale
The Hyperhidrosis Disease Severity Scale (HDSS) is a single-item question allowing 4 gradations of the tolerability of sweating and its interference with daily activities (Table 1). This simple, validated diagnostic tool offers a quick way to estimate the impairment of QoL caused by sweating. A score of 3 or 4 indicates severe hyperhidrosis, a score of 2 moderate hyperhidrosis, and a score of 1 absence of hyperhidrosis.
The HDSS was introduced in 2004 to determine the prevalence of hyperhidrosis
Dermatology Life Quality Index
The Dermatology Life Quality Index (DLQI) developed by Finlay and Khan66 in 1994 is the most frequently used instrument to measure the effects of dermatologic diseases on QoL. The simple, validated questionnaire consists of 10 items covering 6 domains: symptoms and feelings, daily activities, leisure, work and school, personal relationships, and treatment. Each item has 4 gradations (3, very much; 2, a lot; 1, a little; 0, not at all/not relevant). Total scores range from 0 to 30, with higher
Short Form Health Survey (36 Item and 12 Item)
The 36-item Short Form Health Survey (SF-36) and an abbreviated variant of it, the 12-item Short Form Health Survey (SF-12), are valid and reliable patient-reported tools widely used for evaluation of the health-related QoL of an individual.77 The SF-36 consists of multiple-choice questions on 8 health domains (vitality, physical functioning, bodily pain, general health perceptions, physical role functioning, emotional role functioning, social role functioning, mental health). Answers are
Assessment of special impairments
Anxiety, depression, and social phobia profiles were repeatedly assessed in patients with hyperhidrosis.31, 49, 76, 84, 87 Weber and colleagues76 applied the State-Trait Anxiety Inventory G Form X2 (STAI), the Social Phobia Scale (SPS), the Symptom Checklist 90R (SCL-90-R) of Derogatis, and the Hospital Anxiety and Depression Scale (HADS-D) to 70 patients with different types of PFH. Only the mean value for SPS was slightly greater than the normal range, but values of all instruments
Summary
Hyperhidrosis in general, and PFH in particular as the most important entity within its scope, are common conditions that are often detrimental to patients’ social, psychological, professional, and physical well-being. Beyond objective measurement of increased sweat production and demarcation of affected sites and areas, the real impact of the disease can only be recognized by assessment of the reduction in QoL. Significant progress in treatment of PFH has been achieved by the introduction of
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Disclosure Statement: The author has been investigator in clinical trials sponsored by Allergan Co, United Kingdom, and Ipsen Pharma GmbH, Germany. He has received grants from Allergan Co for hyperhidrosis research and has been a consultant for Pharm-Allergan GmbH, Germany. He has received speaker’s honoraria from Allergan and from the International Hyperhidrosis Society.