STOP THE CAUSE, KEEP THE PATIENT COOL (RECOGNITION & REFERRAL)
Reduced or absent sweating - uncommon as a presenting complaint and dangerous in Egypt's heat. The management is causal and physical, not pharmacological. Treating whatever underlies it is the cornerstone, the article's own example being a lung carcinoma that has produced a Horner syndrome and with it the anhidrosis. Where no offending agent can be stopped, it warns that there may be little else to offer, and that keeping the patient in a cool environment has to be pressed hard. The practical measures it gives are a water spray bottle for cooling, and - where the sweat glands are blocked - exfoliating often and gently. Review the drug list for an anticholinergic cause, and refer for the neurological or dermatological cause. - Refer, with advice
Children follow the same pathway: recognise and refer. No primary-care medicine is implied.
No dose - referral pathway, no medicine given in primary care
Reduced or absent sweating - uncommon as a presenting complaint and dangerous in Egypt's heat. The management is causal and physical, not pharmacological. Treating whatever underlies it is the cornerstone, the article's own example being a lung carcinoma that has produced a Horner syndrome and with it the anhidrosis. Where no offending agent can be stopped, it warns that there may be little else to offer, and that keeping the patient in a cool environment has to be pressed hard. The practical measures it gives are a water spray bottle for cooling, and - where the sweat glands are blocked - exfoliating often and gently. Review the drug list for an anticholinergic cause, and refer for the neurological or dermatological cause.
- Heat intolerance and risk of heat stroke in a hot climate; generalised anhidrosis needs urgent evaluation to prevent hyperthermia.
- RED FLAG - Children with anhidrosis are at particularly higher risk of heat-related illness because their core body temperature rises faster and their heat-loss mechanisms are less efficient.
- No drug row is listed here. The article names exactly one drug class, for one rare subtype, with no drug, no dose and an explicit caveat about the evidence: it acknowledges that nothing substantial supports corticosteroids, while noting that many case reports still advise giving them early in AIGA. (AIGA is acquired idiopathic generalised anhidrosis, a dermatology diagnosis.) And the window closes - once treatment is delayed, or the sweat glands have already been destroyed, corticosteroids may then be of no benefit. That decision belongs to the dermatologist who makes the AIGA diagnosis.