June 2025 - Week 3 - Does Hyperhidrosis Cause Most Skin Pathologies?
Sweat today, skin rash tomorrow
Hyperhidrosis is unique as it’s both it’s own condition and symptom of other pathologies. But is it the cause of most foot pathologies? Or to put it another way - how much does sweating influence all foot dermatoses?
To answer that, we have to delve into the uniqueness of the foot’s local environment.
Tasty TOFU:
Back last decade when I was writing my Master’s thesis, I used a simple concept to explain biomechanics to a non-Podiatry audience. My thesis was “The Clinical Considerations of Foot Orthoses in Diabetes - An Evidence-Based Review”. As riveting as that sounds, the basis of the research was essentially exploring how Diabetic musculoskeletal tissue changes alter foot function and therefore those changes can necessitate the need for orthotics.
Sounds simple enough, but orthotics are influenced by various factors such as the shoes that they are housed in, and the foot that is placed on them. The interactions between different parts, form the basis of a simplified model, which I called The Total Foot Unit (TOFU). What I didn’t realise at the time, was this model doesn’t just help explain biomechanics, but it also helps in Podiatric Dermatology.
Natural in an unnatural environment:
As the adage goes - ‘anatomy determines physiology’. The foot is supposed to sweat because it has more sweat glands than anywhere else. That’s not an accidental evolutionary outcome. Sweaty feet (and hands) offer better grip and dexterity. Not to mention they can cool you off on a hot day. But put that appendage into an unnatural environment and things start to go wrong.
