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"etiology": "<p>Различают общий и локализованный гипергидроз: </p>\r\n<ul>\r\n<li>Общий гипергидроз наблюдается при воздействии высокой температуры окружающей среды, физических и эмоциональных напряжениях (физиологический гипергидроз), а также при ряде болезней (туберкулёз, поражения нервной системы, резком падении уровня глюкозы в сыворотке крови). </li>\r\n<li>Наиболее частые формы локализованного гипергидроза — ладонно-подошвенный гипергидроз и гипергидроз крупных складок. Нередко эти формы являются проявлением вегетососудистой дистонии, а также результатом несоблюдения личной гигиены, плоскостопия, использования тесной, резиновой обуви, одежды из синтетических тканей и т.д.</li>\r\n</ul>",
"pathogenesis": "<p>Терморегуляционныйгипергидроз. Потоотделение – один из важнейших путей терморегуляции наряду c излучением тепла, теплопроводностью и конвекцией. Утрата тепла путём испарения находится под контролем главного механизма регуляции потоотделения в организме – гипоталамуса, и осуществляется в автономном режиме. Данный процесс является основным способом охлаждения при повышении температуры тела человека. На интенсивность терморегуляционного потоотделения влияют многочисленные факторы – температура окружающего воздуха и тела, влажность и интенсивность движения воздуха, физическое напряжение, теплоизоляционные свойства одежды, площадь поверхности тела, количество функционирующих потовых желез, прямое и отражённое излучение и т.д. </p>\r\n<p><br />Психогенный гипергидроз.Психогенный (эмоциональный) гипергидроз возникает в результате эмоционального и психического напряжения (тревога, гнев, страх, боль). Повышение потоотделения может иметь при этом различную интенсивность, усиливаться как на ограниченных участках (преимущественно на ладонях и подошвах), так и на всей поверхности тела.</p>\r\n<p><br />Пищевой гипергидроз.Пищевой гипергидроз может наблюдаться после еды, богатой экстрактивными веществами (острых блюд, алкоголя), и связан с наличием нейронных связей в стволе мозга между слюноотделительными ядрами и симпатическими путями. Бывает локализованным (преимущественно в области лица) и генерализованным (по всему телу).</p>\r\n<p><br />Спонтанный гипергидроз.Спонтанный гипергидроз возникает внезапно и обусловлен психогенными факторами.<br />Фармакологический гипергидроз.Вызывается приёмом лекарственных препаратов, воздействующих преимущественно на парасимпатический отдел вегетативной нервной системы.</p>",
"diagnostics": "<p>Диагноз устанавливается на основании жалоб больного и показании йодно-крахмальная проба Минора. Суть ее состоит в следующем: на обследуемые участки тела пациента наносят раствор йода, после высыхания которого притрушивают пятно крахмалом и следят за реакцией. При выделении пота йод растворяется и вступает в реакцию с крахмалом, от чего места, на которых выделился пот, чернеют. По размерам почерневшего пятна врачи определяют зону повышенного потоотделения и соответственно объемы предстоящего лечения. </p>",
"treatment": "<p>Современная медицина располагает различными методами лечения гипергидроза: </p>\r\n<ul>\r\n<li>безоперационными – применение медицинских антиперспирантов, ионофорез; </li>\r\n<li>малоинвазивными – инъекции ботулотоксина; </li>\r\n<li>инвазивными – симпатэктомия, кюретаж, лечение лазером. </li>\r\n</ul>\r\n<p>Начинают лечение обычно с наименее инвазивных способов – антиперспирантов и ионофореза. И только если они не дают желаемого результата, проводят инъекции ботоксом или оперативное вмешательство. </p>\r\n<p>МЕДИЦИНСКИЕ АНТИПЕРСПИРАНТЫ </p>\r\n<p>Эти средства могут использоваться для области подмышек, рук, стоп и даже лица. По своему действию они похожи на косметические антиперспиранты, однако концентрация активных веществ (обычно солей алюминия) в них намного выше. </p>\r\n<p>ИОНОФОРЕЗ </p>\r\n<p>Ионофорез – это достаточно эффективный и безопасный метод лечения гипергидроза. Суть данного метода заключается в том, что токи и ионизирующие вещества, проходя через кожу, «выключают» потовые железы. </p>\r\n<p>ЛЕЧЕНИЕ БОТУЛОТОКСИНОМ </p>\r\n<p>Инъекции ботокса, широко используемые для омоложения, применяются и для лечения гипергидроза. При внутрикожном введении ботулотоксин блокирует передачу нервных импульсов от нервов к потовым железам и тем самым уменьшает выделение пота. Особенно эффективен этот метод при аксиллярном (подмышечном) гипергидрозе. Эффект от применения данного метода лечения сохраняется 6-8 месяцев. </p>\r\n<p>ИНВАЗИВНЫЕ МЕТОДЫ ЛЕЧЕНИЯ ГИПЕРГИДРОЗА </p>\r\n<p>Кюретаж – хирургический метод лечения аксиллярного гипергидроза. Суть заключается в механическом разрушении потовых желез с помощью специального приспособления – кюретки. Проводится данная процедура под местной анестезией, для введения кюретки на коже делается небольшой разрез. Эффект после кюретажа сохраняется 4-6 месяцев, потом появляются новые потовые железы, однако такой повышенной потливости, как до операции, как правило уже не наблюдается. Побочным действием применения кюретажа является временное нарушение чувствительности под мышками из-за повреждения нервных волокон. </p>\r\n<p>Самый современный метод лечения гипергидроза – это применение лазера. Во время операции под кожу аксиллярной области через небольшой разрез вводится световод, после чего лазерный луч разрушает потовые железы. Восстановление после такой операции проходит намного быстрее, чем после обычного кюретажа. </p>\r\n<p>Симпатэктомия – еще один метод лечения гипергидроза, заключающийся в пересечении или клипировании симпатических нервных волокон. При повышенной потливости ладоней проводится эндоскопическая торакальная симпатэктомия, а при гипергидрозе стоп – поясничная симпатэктомия. Осуществляются эти операции под общим наркозом. </p>",
"prevention": "<p>Главными методами профилактики в борьбе с гипергидрозом должно стать тщательное соблюдение правил личной гигиены: следует ежедневно принимать душ, делать теплые ванночки для ладоней и стоп (лучше с настоем ромашки или дубовой коры), делать обтирания. Для уничтожения запаха пота рекомендуется пользоваться дезодорантами. Не рекомендуется носить одежду, особенно нижнее белье и носки, из синтетических тканей, поскольку они воздухонепроницаемы. Менять белье, носки, колготки следует как можно чаще. Обувь должна быть удобной, легкой со специальными стельками-вкладышами, а летом – открытой. Необходимо ограничить, а по возможности и исключить из рациона совсем, слишком горячую, острую пищу, алкоголь, никотин, кофе. Усиливают неприятный запах пота такие продукты, как лук и чеснок, специи.</p>",
"clinical_picture": "<p>Гипергидроз подмышек </p>\r\n<p>Повышенная потливость подмышек — наиболее распространенная форма гипергидроза. У человека заметны: </p>\r\n<ul>\r\n<li>Огромные мокрые следы в подмышечных впадинах; </li>\r\n<li>При высыхании пот оставляет следы на одежде желтоватого, красного и фиолетового цвета; </li>\r\n<li>Резкий запах, заметный для окружающих даже при использовании дезодоранта. </li>\r\n</ul>\r\n<p>Гипергидроз стопы </p>\r\n<p>Неприятный запах от ног, быстро возникающий после мытья, обусловлен изменением кислотности кожи. При этом на «вечно мокрых от пота» ногах быстро развивается грибок, что еще более усугубляет внешние проявления гипергидроза. </p>\r\n<p>Гипергидроз ладоней </p>\r\n<p>Мокрые, всегда холодные ладони — в большинстве случаев признак неустойчивой нервной системы и высокой эмоциональности. Даже минимальное переживание может спровоцировать моментальное потение ладоней. Человек стесняется при рукопожатии и общении с другими людьми. </p>\r\n<p>Гипергидроз ног </p>\r\n<p>В этом случае потеют не только стопы, мокрой испариной покрывается вся кожа ног. Капли пота стекают от паховой области, вызывая потертости на внутренней поверхности бедер и раздражая наиболее нежную кожу подколенных ямок. </p>\r\n<p>Другие признаки гипергидроза </p>\r\n<p>Гипергидроз может локализоваться и на других участках кожи. Несколько реже встречается общий гипергидроз тела. При этом появляется: </p>\r\n<ul>\r\n<li>Покраснение и блеск лица, капли пота на лбу (человек постоянно вытирает лицо салфеткой); </li>\r\n<li>Потертости под грудью у женщин; </li>\r\n<li>Мацерация кожи в паху; </li>\r\n<li>Стекающие ручейки пота по позвоночнику; </li>\r\n<li>Мокрое нижнее белье — в таких случаях человек говорит: «мокрый, хоть выжимай». </li>\r\n</ul>",
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"lead": "Повышенная постоянная потливость рук с липким субстратом свидетельствует о серьезной внутренней патологии, болезни. Предвестником отказа почек и нижних конечностей, потери обоняния и зрения, инфаркта может стать вязкий пот. Это может быть проявлением инфекционных заболевания, эндокринных нарушений,онкологии, диабета. При этом запах пота становится зловонным. При локальном эссенциальном гипергидрозе, гидрадените становится вязким этот секрет кожных желез. Это также повод посетить гастроэнтеролога, нужна консультация невролога. Если у человека появился липкий пот, поход к врачу откладывать нельзя.",
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