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Advisor(s)
Abstract(s)
Introdução: Hiperidrose, ou de forma coloquial o excesso de sudorese, é uma
condição que afeta um grande nĂșmero de pessoas a nĂvel mundial, causando stress e
diminuindo a qualidade de vida de quem sofre dela. Apesar de a hiperidrose poder ocorrer
de forma isolada, pode tambĂ©m aparecer como consequĂȘncia de outras patologias. Neste
trabalho iremos focar-nos nas causas tiroideias.
As anomalias tiroideias são alteraçÔes endócrinas comuns que afetam a função secretora
da glùndula tiroideia. Tanto o hipertiroidismo (um aumento da produção das hormonas
tiroideias) como o hipotiroidismo (uma diminuição da produção da produção das hormonas
tiroideias) causam um leque de sintomas, os quais incluem a hiperidrose. Estes sintomas
podem manifestar-se de uma forma muito dĂspar caso a caso, desde afeção palmar, plantar,
axilar, virilhas, costas entre outras.
Apesar da potencial ligação entre a hiperidrose e as anomalias tiroideias, a sua ligação
ainda não é muito bem compreendida. Nesta tese, iremos explorar a relação entre estas duas
entidades, com um principal foco no processo, desde o seu diagnóstico, até ao tratamento
da hiperidrose como consequĂȘncia de anomalias tiroideias.
Objetivos: O nosso principal objetivo Ă© providenciar um guia compreensivo para o
diagnĂłstico e tratamento baseado na literatura mais recente, existente. Primeiro teremos
em conta os processos patofisiolĂłgicos presentes, incluindo os mecanismos que poderĂŁo
correlacionar as duas condiçÔes. Posteriormente iremos rever os critérios de diagnóstico
bem como os métodos que podem ser utilizados. Por fim, iremos explorar as vårias opçÔes
de tratamento existentes, discutindo os seus benefĂcios e contraindicaçÔes.
Metodologia: Foram usadas as bases de dados eletrĂłnicas da pubmed-medeline, web
of science, science direce scopus, focando-nos nos artigos posteriores a 2000 escritos em
Espanhol, InglĂȘs ou FrancĂȘs, tendo sido selecionados a partir do seu titulo e resumo. As
palavras-chave usadas na pesquisa foram: hiperhidrose; Tiroide; anomalias da tiroide,
excesso de sudorese, hipertiroidismo
DiscussĂŁo: A hiperhidrose Ă© um fenĂłmeno mais comum do que possa ser pensado,
afetando um nĂșmero considerĂĄvel de pessoas em todo o mundo. No entanto, nĂŁo sĂŁo
conhecidos os valores certos da sua prevalĂȘncia, uma vez que os dados existentes levam a
pensar que a sua incidĂȘncia Ă© muito inferior ao possĂvel valor real: nĂŁo sĂł por ser um
diagnóstico muito subjetivo, mas também por ser uma patologia muito constrangedora,
quer para o paciente, quer para o médico responsåvel.
O maior consenso atinge-se na importĂąncia da temĂĄtica: Ă© sem dĂșvida uma situação que
provoca muito impacto no dia a dia de quem a sofre, nĂŁo existindo uma resposta suficiente para estes casos. Outros pontos concordantes sĂŁo: quer o tratamento, quer a forma de
diagnĂłstico, que jĂĄ foram amplamente estudados e investigados.
Por seu lado, as anomalias da tiroide, nomeadamente o hipertiroidismo, por si sĂł, jĂĄ
foram alvo de muitos estudos, estando bem documentados, do seu diagnĂłstico ao
tratamento.
No entanto, a relação entre estas duas patologias não foi, ainda, alvo de uma avaliação
tĂŁo pormenorizada, havendo, mesmo assim, dados para concluir que as anomalias da
tiroide, nomeadamente as causas de hipertiroidismo podem originar uma situação de
hiperhidrose, sendo uma das causas mais comuns de hiperhidrose secundĂĄria encontradas
nas investigaçÔes encontradas.
Parece tambĂ©m, que nestas situaçÔes a clĂnica tende a ser uma situação mais
generalizada e simĂ©trica, mas devido ao reduzido nĂșmero de casos avaliados, Ă© preciso uma
maior investigação para haver uma relação forte entre esta distribuição corporal e esta causa
secundĂĄria.
O diagnóstico de uma situação de hiperidrose secundåria a anomalias da tiroide passa
por uma boa avaliação clĂnica e uma avaliação analĂtica das hormonas da tiroide, podendo
ser usados alguns mĂ©todos de diagnĂłstico especĂficos que serĂŁo referidos. O seu tratamento
passa pelo tratamento e controlo da causa principal da anomalia tiroideia, no entanto pode
ser preciso o uso de terapias coadjuvantes de hiperhidrose, que irĂŁo ser referidas neste
trabalho, como formas de tratamento sintomĂĄtico.
Conclusão: A Hipehidrose é uma situação relativamente comum com um grande
impacto diĂĄrio. A hiperhidrose secundĂĄria Ă© mais rara, tende a ser mais generalizada e as
anomalias da tiroide, nomeadamente as causas de hipertiroidismo, sĂŁo uma das causas
secundårias mais comummente encontradas, tendo sido encontrada uma relação forte entre
estes dois tópicos. No entanto são necessårios mais estudos para uma descrição mais
pormenorizada desta relação e a confirmação de achados clĂnicos tĂpicos desta situação.
Introduction: Hyperhidrosis, or colloquially, excessive sweating, is a condition that affects a great number of people worldwide, causing stress and affecting the quality of life for those who suffer from it. Although hyperhidrosis can occur in isolation, it can also appear as a result of other pathologies. In this work, we will focus on thyroid-related causes. Thyroid abnormalities are common endocrine changes that affect the secretory function of the thyroid gland. Both hyperthyroidism (an increase in the production of thyroid hormones) and hypothyroidism (a decrease in the production of thyroid hormones) cause a range of symptoms, including hyperhidrosis. These symptoms can manifest in various ways, such as palmar, plantar, axillary, inguinal, back, among others. Despite the potential connection between hyperhidrosis and thyroid abnormalities, their link is not yet well understood. In this thesis, we will explore the relationship between these two entities, with a focus on the process from diagnosis, to the treatment of hyperhidrosis as a consequence of thyroid abnormalities. Objectives: Our main objective is to provide a comprehensive guide to diagnosis and treatment based on the latest existing literature. First, we will consider the present pathophysiological processes, including the mechanisms that may correlate the two conditions. Subsequently, we will review the diagnostic criteria as well as the methods that can be used. Finally, we will explore various existing treatment options, discussing their benefits and contraindications. Methodology: Electronic databases such as PubMed-Medline, Web of Science, Science Direct, Scopus were used, focusing on articles written in Spanish, English, or French and published after 2000. Selection was based on titles and abstracts. The keywords used in the search were: hyperhidrosis; Thyroid; Thyroid abnormalities, excessive sweating, hyperthyroidism. Discussion: Hyperhidrosis is a more common phenomenon than one might think, affecting a considerable number of people worldwide. However, the exact prevalence values are unknown since existing data suggests that its incidence is much lower thanthe true value: not only due to being a highly subjective diagnosis, but also because it is a very embarrassing condition, for the patient and the responsible physician. The greatest consensus is reached on the importance of the topic: it is undoubtedly a situation that has a significant impact on the daily lives of those who suffer from it, and there is no sufficient answer for these cases. Other concurring points are that both the treatment and the diagnostic approach have been extensively studied and investigated. On the other hand, thyroid abnormalities, especially hyperthyroidism, have already been the subject of many studies, with their diagnosis and treatment well documented. However, the relationship between these two pathologies has not yet been subject to a detailed evaluation, although there are data suggesting that thyroid abnormalities, especially the causes of hyperthyroidism, can lead to a situation of hyperhidrosis, being one of the most common causes of secondary hyperhidrosis found in the investigations. It also seems that, in these situations, the clinical presentation tends to be more generalized and symmetrical. Still, due to the limited number of cases evaluated, further research is needed to establish a strong relationship between this body distribution and this secondary cause. The diagnosis of secondary hyperhidrosis due to thyroid abnormalities involves a thorough clinical evaluation and an analytical assessment of thyroid hormones, with specific diagnostic methods that will be mentioned. Its treatment involves addressing and controlling the underlying cause of thyroid abnormality; however, the use of adjunctive hyperhidrosis therapies may be necessary, which will be discussed in this work as forms of symptomatic treatment. Conclusion: Hyperhidrosis is a relatively common situation with a significant daily impact. Secondary hyperhidrosis is rarer, tends to be more generalized, and thyroid abnormalities, especially the causes of hyperthyroidism, are one of the most commonly found secondary causes, with a strong relationship found between these two topics. However, more studies are needed for a more detailed description of this relationship and the confirmation of typical clinical findings in this situation.
Introduction: Hyperhidrosis, or colloquially, excessive sweating, is a condition that affects a great number of people worldwide, causing stress and affecting the quality of life for those who suffer from it. Although hyperhidrosis can occur in isolation, it can also appear as a result of other pathologies. In this work, we will focus on thyroid-related causes. Thyroid abnormalities are common endocrine changes that affect the secretory function of the thyroid gland. Both hyperthyroidism (an increase in the production of thyroid hormones) and hypothyroidism (a decrease in the production of thyroid hormones) cause a range of symptoms, including hyperhidrosis. These symptoms can manifest in various ways, such as palmar, plantar, axillary, inguinal, back, among others. Despite the potential connection between hyperhidrosis and thyroid abnormalities, their link is not yet well understood. In this thesis, we will explore the relationship between these two entities, with a focus on the process from diagnosis, to the treatment of hyperhidrosis as a consequence of thyroid abnormalities. Objectives: Our main objective is to provide a comprehensive guide to diagnosis and treatment based on the latest existing literature. First, we will consider the present pathophysiological processes, including the mechanisms that may correlate the two conditions. Subsequently, we will review the diagnostic criteria as well as the methods that can be used. Finally, we will explore various existing treatment options, discussing their benefits and contraindications. Methodology: Electronic databases such as PubMed-Medline, Web of Science, Science Direct, Scopus were used, focusing on articles written in Spanish, English, or French and published after 2000. Selection was based on titles and abstracts. The keywords used in the search were: hyperhidrosis; Thyroid; Thyroid abnormalities, excessive sweating, hyperthyroidism. Discussion: Hyperhidrosis is a more common phenomenon than one might think, affecting a considerable number of people worldwide. However, the exact prevalence values are unknown since existing data suggests that its incidence is much lower thanthe true value: not only due to being a highly subjective diagnosis, but also because it is a very embarrassing condition, for the patient and the responsible physician. The greatest consensus is reached on the importance of the topic: it is undoubtedly a situation that has a significant impact on the daily lives of those who suffer from it, and there is no sufficient answer for these cases. Other concurring points are that both the treatment and the diagnostic approach have been extensively studied and investigated. On the other hand, thyroid abnormalities, especially hyperthyroidism, have already been the subject of many studies, with their diagnosis and treatment well documented. However, the relationship between these two pathologies has not yet been subject to a detailed evaluation, although there are data suggesting that thyroid abnormalities, especially the causes of hyperthyroidism, can lead to a situation of hyperhidrosis, being one of the most common causes of secondary hyperhidrosis found in the investigations. It also seems that, in these situations, the clinical presentation tends to be more generalized and symmetrical. Still, due to the limited number of cases evaluated, further research is needed to establish a strong relationship between this body distribution and this secondary cause. The diagnosis of secondary hyperhidrosis due to thyroid abnormalities involves a thorough clinical evaluation and an analytical assessment of thyroid hormones, with specific diagnostic methods that will be mentioned. Its treatment involves addressing and controlling the underlying cause of thyroid abnormality; however, the use of adjunctive hyperhidrosis therapies may be necessary, which will be discussed in this work as forms of symptomatic treatment. Conclusion: Hyperhidrosis is a relatively common situation with a significant daily impact. Secondary hyperhidrosis is rarer, tends to be more generalized, and thyroid abnormalities, especially the causes of hyperthyroidism, are one of the most commonly found secondary causes, with a strong relationship found between these two topics. However, more studies are needed for a more detailed description of this relationship and the confirmation of typical clinical findings in this situation.
Description
Keywords
Anomalias da Tiroide Excesso de Sudorese Hiperhidrose Hipertiroidismo Tiroide