Background: Hypohidrosis is a risk factor for developing heat-related illnesses. Objective: To determine the prevalence of hypohidrosis in heat injury. Methods: Soldiers from the Singapore Armed Forces who developed heat injury between January 1, 2012 and December 31, 2013 were invited to participate in the study. Subjects were induced to sweat through exercising in a temperature- and humidity-regulated room, and then atomized starch-iodine powder was administered over their whole body to detect hypohidrosis. If this was found to be present, investigations to elucidate the cause of anhidrosis were performed. Results: Out of 65 males, 30 consented to participation. One was excluded because an exogenous cause resulted in heat injury. Nine (31%) demonstrated hypohidrosis. Of these, 1 (11%) had miliaria profunda, 2 (22%) had acquired idiopathic generalized anhidrosis and 6 (67%) manifested a new phenotype which we termed acquired symmetrical hypohidrosis (ASH). Conclusion: Thirty-one percent of healthy soldiers who developed heat injury had hypohidrosis. Concurrently, a new clinical phenotype of ASH was identified.

Lee-Chiong TL Jr, Stitt JT: Heatstroke and other heat-related illnesses. The maladies of summer. Postgrad Med 1995;98:26-28, 31-33, 36.
Simon HB: Current concepts: hyperthermia. N Engl J Med 1993;329:483-487.
Lugo-Amador NM, Rothenhaus T, Moyer P: Heat-related illness. Emerg Med Clin North Am 2004;22:315-327.
Sandor RP: Heat illness: on-site diagnosis and cooling. Phys Sportsmed 1997;25:35-40.
Yaqub B, Al Deeb S: Heat strokes: aetiopathogenesis, neurological characteristics, treatment and outcome. J Neurol Sci 1998;156:144-151.
Narins R (ed): Maxwell and Kleeman's Clinical Disorders of Fluid and Electrolyte metabolism. New York, McGraw-Hill, 1994.
Pang HN: Management of heat injuries; in: Proceedings of the International Congress on Emergency Medicine (ICEM 2010) 2010, p 128.
Sulzberger MB, Harris DR: Miliaria and anhidrosis. Arch Dermatol 1972;105:845-850.
Burns T, Breathnach S, Cox N, Griffiths C (eds): Rook's Textbook of Dermatology. Oxford, Blackwell Science, 2004.
Dann EJ, Berkman N: Chronic idiopathic anhydrosis - a rare cause of heat stroke. Postgrad Med J 1992;68:750-752.
Thami GP, Kaur S, Kanwar AJ: Acquired idiopathic generalized anhidrosis: a rare cause of heat intolerance. Clin Exp Dermatol 2003;28:262-264.
Narita K, Sakamoto S, Mizushige K, Senda S, Matsuo H: Development and evaluation of a new target heart rate formula for the adequate exercise training level in healthy subjects. J Cardiol 1999;33:265-272.
Sato KT, Richarson A, Timm DE, Sato L: One-step iodine starch method for direct visualisation of sweating. Am J Med Sci 1988;295:528-531.
Wallace AB: The exposure treatment of burns. Lancet 1951;1:501-504.
Seth P, Juliana P: Exertional heat stroke in a marathon runner with extensive healed deep burns: a case report. Int J Emerg Med 2011;4:12.
Roskind JL, Petrofsky J, Lind AR, Paletta FX: Quantification of thermoregulatory impairment in patients with healed burns. Ann Plast Surg 1978;1:172-176.
O'Brien JP: A study of miliaria, tropical anhidrosis and anhidrotic asthenia. Br J Dermatol Syph 1947;59:125-158.
Kirk JF, Wilson BB, Chun W, Cooper PH: Miliaria profunda. J Am Acad Dermatol 1996;35:854-856.
Tey HL, Tay EY, Cao TG: In vivo imaging of miliaria profunda using high-definition optical coherence tomography: diagnosis, pathogenesis and treatment. JAMA Dermatol 2015;151:346-348.
Murakami K, Sobue G, Terao S, Mitsuma T: Acquired idiopathic generalized anhidrosis: a distinctive clinical syndrome. J Neurol 1998;235:428-431.
Chen YC, Wu CS, Chen GS, Khor GT, Chen CH, Huang P: Identification of subgroups of acquired idiopathic generalized anhidrosis. Neurologist 2008;14:318-320.
Nakazato Y, Tamura N, Ohkuma A, Yoshimaru K, Shimazu K: Idiopathic pure sudomotor failure: anhidrosis due to deficits in cholinergic transmission. Neurology 2004;63:1476-1480.
Chung TS, Lee SH: Idiopathic acquired anhidrosis: reversible generalized anhidrosis after sunstroke. J Dermatol 1999;26:615-618.
Dann EJ, Berkman N: Chronic idiopathic anhydrosis - a rare cause of heat stroke. Postgrad Med J 1992;68:750-752.
Chia KY, Tey HL: Approach to hypohidrosis. J Eur Acad Dermatol Venereol 2013;27:799-804.
Ando Y, Fujii S, Sakashita N, et al: Acquired idiopathic generalised anhidrosis: clinical manifestations and histochemical studies. J Neurol Sci 1995;132:80-83.
Muramaki K, Sobue G, Iwase S, Mitsuma T, Mano T: Skin sympathetic nerve activity in acquired idiopathic generalized anhidrosis. Neurology 1993;43:1137-1140.
Yoritaka A, Hishima T, Akagi K, Kishida S: Successful steroid treatment of acquired idiopathic partial hypohidrosis. J Dermatol 2006;33:265-267.
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.