Probability diagnosis Common infections, esp. respiratory, other infections (viral, urinary), tension/anxiety, menopause, intense pain Not to be missed Severe infection, e.g. tropical, HIV, TB, endocarditis, sepsis Malignancy, e.g. lymphoma, leukaemia, cerebal, lung Vasoactive tumours: carcinoid syndrome, phaeochromocytoma Masquerades Drugs: e.g. antidepressants, NSAIDs, hormone therapy, caffeine, alcohol, opioid withdrawal, PDE5 inhibitors—tadalafil, etc. Endocrine—hyperthyroidism, hypoglycaemia, pituitary Note: Perspiration is usually idiopathic. Treatment See also  72 Use an antiperspirant deodorant or aluminium chloride hexahydrate 20% solution or spray (e.g. Driclor) (also good for palms and soles) Reduce caffeine intake Avoid known aggravating factors Consider referral for axillary wedge resection or botulinum toxin if axillary hyperhidrosis Iontophoresis |