Disorders of sweating and thermoregulation

The autonomic nervous system strictly maintains internal body temperature within a narrow margin of 37°C. Diseases and the drugs used to treat them can impair thermoregulation at many levels, including afferent thermoreception, the hypothalamus, descending vasomotor and sudomotor pathways, spinal intermediolateral cells, sympathetic ganglia, peripheral autonomic nerves, and the neuroeccrine junction. The brain, which is especially vulnerable to the physiologic stresses of hypothermia and hyperthermia, coordinates the vasomotor and sudomotor responses that retain or dissipate bodily heat. Numerous disorders are associated with hyperhidrosis and hypohidrosis. Some disrupt thermoregulation, and others are socially troubling, while most provide informative diagnostic clues.