CLINICAL PRESENTATION AND QUALITY OF LIFE BURDEN ASSOCIATED WITH HYPERHIDROSIS IN CHILDREN AND ADOLESCENTS

Purpose: Primary focal hyperhidrosis affects an estimated 4.8% of the total U.S. population and approximately 2% of those under the age of 18 and is associated with a significant quality of life burden. Though it typically has a childhood/adolescent onset, there are little data on the awareness or impact of the disease in these patients, their families or among clinicians and researchers. A quantitative survey was conducted in collaboration with the International Hyperhidrosis Society (IHhS) and sought to understand clinical characteristics of hyperhidrosis in a pediatric and adolescent population, a patient subset that has not been adequately studied to date. In addition, findings from an earlier focus group in children and adolescents describe the impact of hyperhidrosis across life domains (physical, functional, social, emotional and financial). Methods: The quantitative survey design was informed by the earlier focus group data and was approved by an institutional review board. Survey topics covered participant characteristics, quality of life burden, including mental health measures (GAD for anxiety and PHQ-9 for depression), and disease awareness. For the focus group, respondents were recruited through a third-party market research panel and the IHhS. Participants were identified via targeted screening criteria to establish presence of excessive sweating. A deductive qualitative design with in-depth, in-person interviews (children and caregivers); as well as, in-person small focus groups (adolescents and young adults) was used. Results: Survey responses were collected for 539 children and adolescents aged 6-17 years (Grades 1-3, n=126; Grades 4-5, n=124; Grades 6-8, n=142, High school, n=147) with caregivers providing responses for those aged 6-11 years. Slightly more than half (57.6%) were female, and most (84%) reported their excessive sweating as 'moderate* or 'severe/ Areas affected included axillary (82.2%), palmar (73.1), plantar (54.2%), craniofacial (54.0%), inguinal (51.2%) and back (32.8%), suggesting potential differences in focal distribution in children relative to adults (e.g., higher percentages of pediatric and adolescent patients experiencing excessive sweating in craniofacial, palmar, and plantar regions compared with what has been reported in the current literature for adults). The focus group and interview data (n=40) revealed age-specific trends on quality of life burden, with stigma and social impact increasing with age. Female