Generalised excessive sweating can occur over most of the body and may be caused by underlying infections, malignancies or hormonal imbalances. In contrast, apart from some known trigger factors such as emotional challenges,3 the reasons for localised (focal) sweating are not readily apparent. It is therefore described as idiopathic. Idiopathic sweating seams to have a genetic background as patients with focal hyperhidrosis often report a family history of hyperhidrosis. In a study on the effects of sympathectomy, 54% of 91 patients were found to have a positive family history.4

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