Pityriasis rubra pilaris: a retrospective analysis of 43 patients.

head and neck or parotid disease, physical examination revealed no neurological signs, no associated Horner's syndrome or other autonomic dysfunction was observed and magnetic resonance imaging of the brain and brainstem were normal. There are few reports demonstrating the presence of enlarged sweat glands in the affected skin of patients with localized hyperhidrosis and the lesions have been considered as variants of the pure anatomical eccrine naevi or as functional naevi which showed secondary hypertrophy of the glandular elements (1, 9, 10). But this ®nding has not been reported in most of the patients with localized hyperhidrosis, and skin biopsies in our patient failed to reveal such ®ndings. According to some authors (4), localized hyperhidrosis may be caused by a non-demonstrable disturbance of autonomic nervous system, but the reason for this rare condition remains to be elucitated. Because of the limited number of cases reported, there is no standard therapy for idiopathic unilateral localized hyperhidrosis and the condition often proves resistant to therapy. Sweating may partially be controlled by treatments with anticholinergic drugs, sedatives, tranquillizers, calcium-channel blockers, astringents, topical antiperspirants, iontophoresis and surgical sympathectomy. However, these treatments have various side-effects and topical therapies tend to cause contact dermatitis (1, 5, 10). In our patient treatment with amitryptiline in a dosage of 20 mg daily combined with topical aluminium chloride cream 20% was not found to be effective. REFERENCES