# A multi-center, cross-sectional questionnaire survey in Japan (KOBE study) exploring factors associated with primary focal hyperhidrosis

**Authors:** Takeshi Fukumoto, Marie Ohata, Yukari Matsumoto, Masashi Ashida, Tetsuya Ikeda, Yusuke Inoue, Satoshi Ogawa, Shuntaro Oniki, Tsuneyoshi Kamo, Takeshi Kozaru, Daisuke Sakai, Masanobu Sakagachi, Yoshihito Sasaki, Hirofumi Sato, Haruki Jimbo, Shingo Tamura, Tsuyoshi Numata, Kazuhito Hayashibe, Susumu Harada, Toshinori Bito, Ayako Fukumoto, Tatsuya Horikawa, Chihiro Honda, Junji Yamashita, Atsushi Yamamoto, Hiromichi Okatsu, Takashi Hashimoto, Hiroshi Miyama, Akiharu Kubo

PMC · DOI: 10.3389/fmed.2026.1739715 · Frontiers in Medicine · 2026-02-09

## TL;DR

This study in Japan identifies factors linked to primary focal hyperhidrosis to help detect and treat patients who may not seek medical care.

## Contribution

The study provides new insights into factors associated with primary focal hyperhidrosis in a large Japanese population.

## Key findings

- The prevalence of primary focal hyperhidrosis was 15.0% among 3,617 participants.
- Axillary osmidrosis had the highest odds ratio (5.440) for being associated with primary focal hyperhidrosis.
- A HADS-A score of 6 was identified as the optimal cutoff for suspecting the condition.

## Abstract

Primary focal hyperhidrosis (PFH) is defined as a condition characterized by excessive sweating in localized areas, which causes patients to experience difficulties in daily life, regardless of temperature or psychological stress. Previous surveys in Japan have revealed that the majority of patients with PFH may not visit medical institutions. Identifying the factors potentially associated with PFH is useful for detecting unmedicated patients and providing appropriate medical interventions. In this study, we explored factors associated with PFH in a multi-center, cross-sectional questionnaire survey (KOBE study).

This study enrolled patients aged 5–64 years who visited 1 of the 24 dermatological institutions in Japan between April and July 2024 and completed a questionnaire (registered at the Japan Registry of Clinical Trials: jRCT1050250083). A combination of univariate and multivariate logistic regression analyses was performed to explore the associated factors.

A total of 3,617 participants were included in the analysis. The prevalence of PFH was 15.0% (544 of 3,617 participants). Among the potential associated factors, the odds ratios (ORs) were higher in order of axillary osmidrosis (OR = 5.440), psoriasis (OR = 1.830), wet earwax (OR = 1.780), a definite Hospital Anxiety and Depression Scale-Anxiety (HADS-A) score (OR = 1.780), a doubtful HADS-A score (OR = 1.460), and smoking (OR = 1.450). Receiver operating characteristic (ROC) curve analysis indicated that a HADS-A score of 6 was the optimal cutoff value for suspecting PFH.

These findings may aid in detecting unmedicated potential patients in routine clinical practice and promoting active intervention for the disease, ultimately improving the quality of life and well-being of patients with PFH.

## Linked entities

- **Diseases:** psoriasis (MONDO:0005083)

## Full-text entities

- **Diseases:** anxiety disorder (MESH:D001008), Basedow's disease (MESH:D006111), back and lower back pain (MESH:D017116), fever (MESH:D005334), psoriasis (MESH:D011565), dandruff (MESH:D063807), diarrhea (MESH:D003967), nausea (MESH:D009325), skin cancer (MESH:D012878), obesity (MESH:D009765), bronchial asthma (MESH:D001249), Anxiety (MESH:D001007), work impairment (MESH:D000073397), vitiligo (MESH:D014820), neck and shoulder pain (MESH:D020069), cancer (MESH:D009369), tinnitus (MESH:D014012), irritability (MESH:D001523), PFH (MESH:D006945), shortness of breath (MESH:D004417), rosacea (MESH:D012393), Parkinson's disease (MESH:D010300), skin disease (MESH:D012871), verruca vulgaris (MESH:D014860), dyslipidemia (MESH:D050171), gastroesophageal reflux disease (MESH:D005764), tinea infections (MESH:D014005), inflammatory (MESH:D007249), headache (MESH:D006261), alopecia areata (MESH:D000506), coma (MESH:D003128), acne (MESH:D000152), sleep apnea syndrome (MESH:D012891), migraine (MESH:D008881), pheochromocytoma (MESH:D010673), atopic dermatitis (MESH:D003876), panic attacks (MESH:D016584), menopausal disorders (MESH:D008594), dementia (MESH:D003704), constipation (MESH:D003248), palpitations (MESH:D006331), contact dermatitis (MESH:D003877), carcinoid tumors (MESH:D002276), Depression (MESH:D003866), type 2 diabetes mellitus (MESH:D003924), thyroid dysfunction (MESH:D013959), erectile dysfunction (MESH:D007172), dizziness (MESH:D004244), dry skin (MESH:D015352), numbness in (MESH:D006987), psychological disorder (MESH:D000067073), cerebral infarction (MESH:D002544), primary (MESH:D010538), hypoglycemia (MESH:D007003), viral infection (MESH:D014777), acromegaly (MESH:D000172), stiffness (MESH:C566112), hypertension (MESH:D006973), seborrheic dermatitis (MESH:D012628), body, foot, and nail (MESH:D009260)
- **Chemicals:** alcohol (MESH:D000438), PFH (-)
- **Species:** Homo sapiens (human, species) [taxon 9606], Trichoderma sp. SK (species) [taxon 1585744]

## Full text

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## Figures

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## References

43 references — full list in the complete paper: https://tomesphere.com/paper/PMC12927475/full.md

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Source: https://tomesphere.com/paper/PMC12927475