Pressure and postural hyperhidrosis is the sweating response to pressure on one side of the body during position changes and lateral recumbency. It is a manifestation of hyperhidrosis. Hyperhidrosis is a disorder in which excessive sweat gland secretion is caused by sympathetic hyperexcitation. The sympathetic nerve governs sweating throughout the body. Under normal circumstances, the sympathetic nerve regulates body temperature by controlling sweating and heat dissipation. In hyperhidrosis, however, sweating and facial flushing are completely out of control. Hyperhidrosis and facial flushing leave the patient in a daily state of helplessness, agitation or panic. How do you check for stress and postural hyperhidrosis? Hyperhidrosis is usually not difficult to diagnose based primarily on a history of excessive sweating, typical clinical manifestations, and a combination of objective examinations. 1, according to the sweating situation is divided into: (1) limited hyperhidrosis often begins in childhood or adolescence, can occur in both sexes, some have a family history, can last several years, to 25 years of age after a natural tendency to reduce. The most common sites of restrictive hyperhidrosis are the palmoplantar and friction surfaces, such as the axillae, groin, and perineum. This is followed by the forehead, tip of the nose, and chest. The palmoplantar hyperhidrosis can be persistent or transient, caused by mood swings, without seasonal differences, often with chills or even cyanosis of the hands and feet, which can be accompanied by keratinization of the hands and feet over time. Axillary sweating can be triggered by heat or mental activity. Axillary sweating is caused by excessive activity of the small sweat glands, unlike axillary odor which is mainly caused by the sweat glands. (2) Generalized hyperhidrosis is caused by generalized sweating mainly due to other diseases, such as infectious hyperthermia, due to nervous system regulation or oral antipyretics to dissipate heat by sweating. Others like damage to the central nervous system including the cortex and basal ganglia, spinal cord or peripheral nerves can cause generalized hyperhidrosis. 2, according to the different reasons for producing excessive sweating is divided into: (1) neurological hyperhidrosis ① cortical hyperhidrosis: A. emotional hyperhidrosis: due to emotional stimulation, acetylcholine secretion increases and produces excessive sweating, cortical or emotional sweating that occurs after simultaneous sexual stimulation is a special type. B. palmar-plantar hyperhidrosis: seen in various ethnic groups, no significant gender differences, most patients have a positive family history. The onset of palmar-plantar hyperhidrosis often begins in infancy or childhood. Palmar-plantar hyperhidrosis does not occur during sleep or quiet and is not stimulated by heat sources. C. axillaryhyperhidrosis: axillary hyperhidrosis is not stimulated by heat sources, but by emotional stimuli and excessive sweating. otherdiseasewithcorticalhyperhidrosis): palmoplantar keratosis, congenital thick nail syndrome, recessive hereditary herpetic epidermolysis bullosa, congenital ichthyosis-like erythroderma, and nail-patellar syndrome can all present with cortical hyperhidrosis. It often occurs after excitement or eating, but can sometimes develop with heat stimuli, indicating that the subcortical centers are particularly hot (the hypothalamus also plays a role). Hypothalamic hyperhidrosis: The hypothalamus is the main autonomic center of the central nervous system and controls the regulation of sweating. Hypothalamic hyperhidrosis can be seen in the following diseases: A. Hodgkin’s disease (Hodgkinrsquo;disease): characterized by a triad of fever, night sweats and weight loss, with night sweats early in the disease, a sudden drop in body temperature during sleep with profuse night sweats, and fluctuating fever later. b. Diabetic hyperhidrosis (diabetesmellitus): there are three types; severe C. pressureandposturalhyperhidrosis: is a sweating response to pressure on one side of the body during postural changes and lateral recumbency. Idiopathicunilateralcircumscribedhyperhidrosis: is an episode of restricted sweating commonly found on the face or upper extremities. Heat, mental and gustatory stimuli can all contribute, but the former is more common, and the mechanism of sweating is unknown. (3) Medullary hyperhidrosis: Medullary hyperhidrosis (medullaryhyperhidrosis) is also known as gustatorysweating because the efferent stimuli often involve gustatory receptors, and can be divided into two types: physiological and pathological medullary hyperhidrosis. (2) Non-neural hyperhidrosis (non-neuralhyperhidrosis) is not innervated by the sympathetic nervous system, but is a dominant sweating of glands sensitive to heat; and cholinergic, adrenergic and other drugs directly stimulate sweat glands and cause dominant sweating, as well as some organoidnevus and nevus-like hemangioma damage, Maffucci syndrome, actinic nevus, Hippdl-Trenaunay syndrome, hemangioblastoma, and blue rubber nevus syndrome, can present with localized sweating, which may be related to the hemangioma at the site of involvement. In addition, colderythema occurs in patients with limited erythema of the skin after cold stimulation, severe pain and sweating in the central area, vascular atrophy and muscle atrophy, and the disease may be caused by the release of 5-hydroxytryptamine from platelets. (3) Compensatory hyperhidrosis (compensatoryhyperhidrosis) occurs when the sweat glands in one part of the body suffer from a certain factor and then compensate for the sweat glands in another part to maintain body temperature. The following diseases are common: ① Diabetes mellitus: compensatory hyperhidrosis occurs in the lower body secondary to diabetic peripheral neuropathy with an absence of sweating or hypohidrosis. Heat-stimulated hyperhidrosis of the upper body (trunk mainly), with nocturnal sweating common. Gustatory hyperhidrosis of the face and neck. (ii) Pathological, gustatory hyperhidrosis occurs after sympathectomy in the neck and thoracic sympathectomy. ③Nocturnal sweating, in addition to the above-mentioned causes that can lead to hyperhidrosis, can also occur due to cardiovascular endocarditis, lymphoma, hyperthyroidism, systemic vasculitis, pheochromocytoma, carcinoid syndrome, withdrawal reaction, uncontrolled autonomic function state, and other chronic infectious diseases.