Sudomotor testing can be a valuable diagnostic tool for the early detection of small fiber neuropathies.
Sudo meaning medical skin#
The gold standard for diagnosis of small fiber neuropathies is Intraepidermal Nerve Fiber Density (IENFD) measured from punch skin biopsies, but this procedure is invasive and inappropriate for long term follow-up. In some cases, it may be the only detectable neurologic manifestation. Sudomotor dysfunction is one of the most common and earliest neurophysiological manifestations of small fiber neuropathies. Depending on the severity of dyshidrosis, it may result in hyperkeratosis, rhagades, ulcerations, and poor wound healing due to altered epidermal moisturization. Excessive sweating can cause social embarrassment, while insufficient sweating can result in heat intolerance and dry skin. Both patterns have the potential to affect an individual’s quality of life.
Sudomotor dysfunction can manifest as increased or decreased sweating patterns. Impaired sudomotor function can occur in any disorder that directly and/or indirectly affects the autonomic nervous system, including diabetes mellitus, amyloidosis, infections, neurodegenerative diseases, multiple system atrophy, and pure autonomic failure.
This triggers the release of intracellular calcium storages and an influx of extracellular calcium which ultimately results in the movement of chloride ion Cl −, and water into the duct lumen. When the action potential reaches the axon terminal of the postganglionic neuron, acetylcholine is released which binds and activates muscarinic M3 receptors on the basolateral membrane of the clear cells in the secretory coil of the eccrine gland. The preganglionic neurons synapse with postganglionic cholinergic sudomotor (and to a lesser extent adrenergic) neurons in the paravertebral sympathetic ganglia. Efferent pathways then descend ipsilaterally from the hypothalamus through the pons and medulla to preganglionic sympathetic cholinergic neurons in the intermediolateral column of the spinal cord. In addition, there are warm-sensitive neurons located within the preoptic nucleus that detect increases in core body temperature. Increases in body and skin temperature are detected by visceral and peripheral thermoreceptors, which send signals via class C and Aδ-fiber afferent somatic neurons through the lateral spinothalamic tract to the preoptic nucleus of the hypothalamus for processing. Eccrine glands are primarily innervated by small-diameter, unmyelinated class C-fibers from postganglionic sympathetic cholinergic neurons. Įccrine sweat is secreted in response to both emotional and thermal stimulation. They are located within the reticular dermal layer of the skin and distributed across nearly the entire surface of the body with the largest numbers occurring in the palms and soles. Eccrine glands are the predominant sweat gland in the human body with numbers totaling up to 4 million.
Eccrine glands open directly onto the surface of the skin, while apocrine glands open into hair follicles. Human sweat glands are primarily classified as either eccrine or apocrine glands. In addition, sweat plays key roles in grip, microbial defense, and wound healing. Sweat production is a vital thermoregulatory mechanism used by the body to prevent heat-related illness as the evaporation of sweat is the body’s most effective method of heat reduction and the only cooling method available when the air temperature rises above skin temperature.
Sudomotor function refers to the autonomic nervous system control of sweat gland activity in response to various environmental and individual factors. Autonomic nervous system control of sweat gland activity MHRA 'SUDO', All Acronyms, 7 June 2023, Bluebook All Acronyms, SUDO (Jun. SUDO, All Acronyms, viewed June 7, 2023, MLA All Acronyms. Retrieved June 7, 2023, from Chicago All Acronyms. Facebook Twitter Linkedin Quote Copy APA All Acronyms.
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