UNILATERAL LOCALIZED HYPERHIDROSIS WITH IMMUNOHISTOCHEMICAL EVIDENCE OF VIPERGIC DYSREGULATION

We report the case of a woman affected by idiopathic, circumscribed hyperhidrosis of the right side of the thorax. No associated systemic abnormalities, or histologic evidence of sweat gland alterations present. Immunohistochemical investigation of skin specimens using neuronal general (protein gene product 9.5, neuron-specific enolase) and neuropeptide markers (substance P, calcitonin gene-related peptide, neuropeptide tyrosine and vasoactive intestinal peptide - VIP) showed marked reduction of periglandular VIP-immunoreactive fibers at the affected side, as compared to contralateral normal skin. We suggest that a localized functional hyperactivity of autonomic VIP-containing fibers may be implanted in the pathogenesis of idiopathic, circumscribed hyperhidrosis.