Hyperhidrosis Prevalence and Demographical Characteristics in Dermatology Outpatients in Shanghai and Vancouver

BackgroundThere is a wide variation in the reported prevalence of primary hyperhidrosis in the literature. Further, it is unknown if primary hyperhidrosis is a lifelong condition, or if demographical factors influence hyperhidrosis prevalence.ObjectivesThis study aims to examine the prevalence of hyperhidrosis in multiple ethnic groups from two ethnically diverse cities and to determine if the prevalence of primary hyperhidrosis changes according to age, gender, ethnicity, body mass index, and geographical locations.MethodsIn total, 1010 consecutive subjects attending dermatology outpatient clinics in Shanghai Skin Disease Hospital and 1018 subjects in Skin Care Center of Vancouver General Hospital were invited to fill out a questionnaire on their presenting concerns, demographical information, and sweating symptoms. The subjects were then classified to have primary hyperhidrosis using the criteria of International Hyperhidrosis Society, late-onset hyperhidrosis, or no-hyperhidrosis. The prevalence of primary HH and late-onset HH was calculated for the entire study population and in subgroups stratified according to age of examination, sex, ethnicity, presenting diagnosis, body mass index, and specific study cities. Multivariate logistic regression analyses were performed to assess the impact of these factors on HH prevalence.ResultsThe prevalence of primary hyperhidrosis is very similar in Shanghai and in Vancouver, at 14.5% and 12.3% respectively. In addition, 4.0% of subjects in Shanghai and 4.4% subjects in Vancouver suffer from late-onset HH. Primary HH has highest prevalence in those younger than 30 years of age, decreasing dramatically in later years. Caucasian subjects are at least 2.5 times more likely to develop axillary hyperhidrosis compared to Chinese subjects. Obesity does not have much influence on primary HH presentation, although it does increase significantly the development of late-onset HH. Finally, there is no major difference of hyperhidrosis between Chinese subjects in Shanghai and Vancouver.LimitationsThe data were gathered according to patients’ self-reports only and the sample size was relatively small in some groups after stratification for gender, ethnicity and age.ConclusionPrevalence of primary HH and late-onset HH is similar in dermatology outpatients independent of geographical locations. However, certain specific HH subtypes can show great variations according to ethnicity, age, body mass index and sex.背景 目前文献中报道的原发性多汗症（primary hyperhidrosis）患病率存在较大差异。此外，原发性多汗症是否为终身性疾病，以及人口统计学因素是否会影响多汗症患病率，目前尚不明确。 目的 本研究旨在调查两座种族多元城市中不同族群人群的多汗症患病率，并明确原发性多汗症（primary hyperhidrosis）患病率是否会随年龄、性别、族群、体质量指数（body mass index）及地理位置发生变化。 方法 本研究共连续纳入上海皮肤病医院皮肤科门诊的1010名受试者，以及温哥华总医院（Vancouver General Hospital）皮肤护理中心的1018名受试者，邀请其填写涵盖就诊主诉、人口统计学信息及出汗症状的调查问卷。随后依据国际多汗症学会（International Hyperhidrosis Society）的诊断标准，将受试者分为原发性多汗症（primary hyperhidrosis，以下简称HH）组、迟发性多汗症（late-onset HH）组及非多汗症组。本研究计算了全部研究人群及按就诊年龄、性别、族群、就诊诊断、体质量指数、研究城市分层后的亚组中，原发性HH与迟发性HH的患病率。同时采用多因素logistic回归分析（multivariate logistic regression analyses），评估上述因素对多汗症（HH）患病率的影响。 结果 上海与温哥华两地的原发性多汗症患病率极为相近，分别为14.5%与12.3%。此外，上海地区有4.0%的受试者、温哥华地区有4.4%的受试者罹患迟发性HH。原发性HH的患病率在30岁以下人群中最高，随后随年龄增长显著下降。与中国受试者相比，白种人受试者发生腋部多汗症（axillary hyperhidrosis）的风险至少高出2.5倍。肥胖对原发性HH的发病无显著影响，但可显著增加迟发性HH的发生风险。最后，上海与温哥华的中国受试者之间，多汗症患病率无显著差异。 局限性 本研究的数据仅来源于受试者的自我报告，且按性别、族群与年龄分层后的部分亚组样本量相对较小。 结论 皮肤科门诊患者中，原发性HH与迟发性HH的患病率不受地理位置影响，二者均较为稳定。但特定亚型的HH患病率会随族群、年龄、体质量指数及性别出现显著差异。