{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T11:17:41Z","timestamp":1770722261930,"version":"3.49.0"},"reference-count":43,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,2,9]],"date-time":"2026-02-09T00:00:00Z","timestamp":1770595200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Background\/aim<\/jats:title>\n                    <jats:p>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).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This study enrolled patients aged 5\u201364\u202fyears 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>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\u202f=\u202f5.440), psoriasis (OR\u202f=\u202f1.830), wet earwax (OR\u202f=\u202f1.780), a definite Hospital Anxiety and Depression Scale-Anxiety (HADS-A) score (OR\u202f=\u202f1.780), a doubtful HADS-A score (OR\u202f=\u202f1.460), and smoking (OR\u202f=\u202f1.450). Receiver operating characteristic (ROC) curve analysis indicated that a HADS-A score of 6 was the optimal cutoff value for suspecting PFH.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1739715","type":"journal-article","created":{"date-parts":[[2026,2,9]],"date-time":"2026-02-09T15:19:57Z","timestamp":1770650397000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["A multi-center, cross-sectional questionnaire survey in Japan (KOBE study) exploring factors associated with primary focal hyperhidrosis"],"prefix":"10.3389","volume":"13","author":[{"given":"Takeshi","family":"Fukumoto","sequence":"first","affiliation":[{"name":"Division of Dermatology, Department of Internal Related, Kobe University Graduate School of Medicine","place":["Kobe, Japan"]},{"name":"Department of Dermatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine","place":["Kyoto, Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marie","family":"Ohata","sequence":"additional","affiliation":[{"name":"Division of Dermatology, Department of Internal Related, Kobe University Graduate School of Medicine","place":["Kobe, Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yukari","family":"Matsumoto","sequence":"additional","affiliation":[{"name":"Division of Dermatology, Department of Internal Related, Kobe University Graduate School of Medicine","place":["Kobe, Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masashi","family":"Ashida","sequence":"additional","affiliation":[{"name":"Ashida Skin Clinic","place":["Sasayama, Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tetsuya","family":"Ikeda","sequence":"additional","affiliation":[{"name":"Ikeda Skin Clinic","place":["Kobe, Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yusuke","family":"Inoue","sequence":"additional","affiliation":[{"name":"Inoue Dermatology Clinic","place":["Himeji, Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Satoshi","family":"Ogawa","sequence":"additional","affiliation":[{"name":"Ogawa Skin Clinic","place":["Kakogawa, Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shuntaro","family":"Oniki","sequence":"additional","affiliation":[{"name":"Oniki Dermatological Clinic","place":["Akashi, Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tsuneyoshi","family":"Kamo","sequence":"additional","affiliation":[{"name":"Kamo Skin Clinic","place":["Kobe, Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takeshi","family":"Kozaru","sequence":"additional","affiliation":[{"name":"Kozaru Skin Clinic","place":["Kato, Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daisuke","family":"Sakai","sequence":"additional","affiliation":[{"name":"Sakai Dermatology Clinic","place":["Miki, Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masanobu","family":"Sakagachi","sequence":"additional","affiliation":[{"name":"Sakaguchi Skin Clinic","place":["Ibaraki, Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yoshihito","family":"Sasaki","sequence":"additional","affiliation":[{"name":"Nishiakashi Sasaki Dermatology","place":["Akashi, Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hirofumi","family":"Sato","sequence":"additional","affiliation":[{"name":"Sato Skin Clinic","place":["Tamba, Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Haruki","family":"Jimbo","sequence":"additional","affiliation":[{"name":"Jimbo Dermatology Clinic","place":["Kobe, Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shingo","family":"Tamura","sequence":"additional","affiliation":[{"name":"Tamura Skin Clinic","place":["Kobe, Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tsuyoshi","family":"Numata","sequence":"additional","affiliation":[{"name":"Numata Skin Clinic","place":["Kobe, Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kazuhito","family":"Hayashibe","sequence":"additional","affiliation":[{"name":"Hayashibe Dermatology Clinic","place":["Sanda, Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Susumu","family":"Harada","sequence":"additional","affiliation":[{"name":"Harada Skin Clinic","place":["Nishinomiya, Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Toshinori","family":"Bito","sequence":"additional","affiliation":[{"name":"Bito Dermatology Clinic","place":["Kobe, Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ayako","family":"Fukumoto","sequence":"additional","affiliation":[{"name":"Honda Dermatological Clinic","place":["Kobe, Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tatsuya","family":"Horikawa","sequence":"additional","affiliation":[{"name":"Ueda Hifuka Clinic","place":["Kakogun, Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chihiro","family":"Honda","sequence":"additional","affiliation":[{"name":"Honda Dermatological Clinic","place":["Kobe, Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Junji","family":"Yamashita","sequence":"additional","affiliation":[{"name":"Pure Skin Clinic","place":["Kobe, Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Atsushi","family":"Yamamoto","sequence":"additional","affiliation":[{"name":"Yamamoto Hifuka Kampo Clinic","place":["Himeji, Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiromichi","family":"Okatsu","sequence":"additional","affiliation":[{"name":"Kaken Pharmaceutical Co., Ltd.","place":["Tokyo, Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takashi","family":"Hashimoto","sequence":"additional","affiliation":[{"name":"Kaken Pharmaceutical Co., Ltd.","place":["Tokyo, Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiroshi","family":"Miyama","sequence":"additional","affiliation":[{"name":"Kaken Pharmaceutical Co., Ltd.","place":["Tokyo, Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Akiharu","family":"Kubo","sequence":"additional","affiliation":[{"name":"Division of Dermatology, Department of Internal Related, Kobe University Graduate School of Medicine","place":["Kobe, Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,2,9]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"157","DOI":"10.14924\/dermatol.133.157","article-title":"Guidelines of the Japanese dermatological association, clinical guidelines for primary focal hyperhidrosis (revised edition in 2023)","volume":"133","author":"Fujimoto","year":"2023","journal-title":"Jpn J Dermatol"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"409","DOI":"10.1007\/s00403-022-02365-9","article-title":"Questionnaire-based epidemiological survey of primary focal hyperhidrosis and survey on current medical management of primary axillary hyperhidrosis in Japan","volume":"315","author":"Fujimoto","year":"2023","journal-title":"Arch Dermatol Res"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"467","DOI":"10.1016\/j.det.2014.06.004","article-title":"Impact of hyperhidrosis on quality of life and its assessment","volume":"32","author":"Hamm","year":"2014","journal-title":"Dermatol Clin"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"251","DOI":"10.5114\/ada.2022.115887","article-title":"Hyperhidrosis: disease aetiology, classification and management in the light of modern treatment modalities","volume":"39","author":"Kisielnicka","year":"2022","journal-title":"Postepy Dermatol Alergol"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"1493","DOI":"10.1111\/jdv.17110","article-title":"Stigma in visible skin diseases\u2014a literature review and development of a conceptual model","volume":"35","author":"Germain","year":"2021","journal-title":"J Eur Acad Dermatol Venereol"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"1482","DOI":"10.1111\/1346-8138.16050","article-title":"Cost-of-illness study for axillary hyperhidrosis in Japan","volume":"48","author":"Murota","year":"2021","journal-title":"J Dermatol"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"431","DOI":"10.3812\/jocd.39.431","article-title":"Survey on awareness of axillary hyperhidrosis: results of internet questionnaire survey in 608 individuals","volume":"39","author":"Fujimoto","year":"2022","journal-title":"J Japan Organ Clin Dermatol"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"10","DOI":"10.1159\/000351292","article-title":"Prevalence and disease burden of hyperhidrosis in the adult population","volume":"227","author":"Augustin","year":"2013","journal-title":"Dermatology"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"743","DOI":"10.1007\/s00403-016-1697-9","article-title":"Hyperhidrosis: an update on prevalence and severity in the United States","volume":"308","author":"Doolittle","year":"2016","journal-title":"Arch Dermatol Res"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"1126","DOI":"10.1016\/j.jaad.2016.07.001","article-title":"The prevalence of anxiety and depression in patients with or without hyperhidrosis (HH)","volume":"75","author":"Bahar","year":"2016","journal-title":"J Am Acad Dermatol"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"adv00656","DOI":"10.2340\/actadv.v102.1061","article-title":"Hyperhidrosis comorbidities and treatments: a register-based study among 511 subjects","volume":"102","author":"Heiskanen","year":"2022","journal-title":"Acta Derm Venereol"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"628","DOI":"10.1111\/j.1346-8138.2009.00732.x","article-title":"Analysis of family history of palmoplantar hyperhidrosis in Japan","volume":"36","author":"Yamashita","year":"2009","journal-title":"J Dermatol"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"274","DOI":"10.1016\/j.jaad.2003.12.029","article-title":"Recognition, diagnosis, and treatment of primary focal hyperhidrosis","volume":"51","author":"Hornberger","year":"2004","journal-title":"J Am Acad Dermatol"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"361","DOI":"10.1111\/j.1600-0447.1983.tb09716.x","article-title":"The hospital anxiety and depression scale","volume":"67","author":"Zigmond","year":"1983","journal-title":"Acta Psychiatr Scand"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"145","DOI":"10.1016\/j.jad.2022.01.011","article-title":"Impact of physical exercise on depression and anxiety in adolescent inpatients: a randomized controlled trial","volume":"301","author":"Philippot","year":"2022","journal-title":"J Affect Disord"},{"key":"ref16","volume-title":"Standard health checkup and health guidance program","year":""},{"key":"ref17","year":""},{"key":"ref18","doi-asserted-by":"publisher","first-page":"886","DOI":"10.1111\/1346-8138.12258","article-title":"Epidemiological study and considerations of primary focal hyperhidrosis in Japan: from questionnaire analysis","volume":"40","author":"Fujimoto","year":"2013","journal-title":"J Dermatol"},{"key":"ref19","first-page":"627","article-title":"Receiver operating characteristic (ROC) curve analysis for medical diagnostic test evaluation","volume":"4","author":"Hajian-Tilaki","year":"2013","journal-title":"Caspian J Intern Med"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"364","DOI":"10.1111\/1346-8138.16617","article-title":"Association of primary focal hyperhidrosis with anxiety induced by sweating: a cross-sectional study of Japanese university students focusing on the severity of hyperhidrosis and site of sweating","volume":"50","author":"Ogawa","year":"2023","journal-title":"J Dermatol"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"384","DOI":"10.1111\/1346-8138.12115","article-title":"Clinical features of axillary osmidrosis: a retrospective chart review of 723 Japanese patients","volume":"40","author":"Morioka","year":"2013","journal-title":"J Dermatol"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"284","DOI":"10.1111\/ced.14105","article-title":"Influence of stress on the development of psoriasis","volume":"45","author":"Yang","year":"2020","journal-title":"Clin Exp Dermatol"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"e92412","DOI":"10.1371\/journal.pone.0092412","article-title":"Elevated social stress levels and depressive symptoms in primary hyperhidrosis","volume":"9","author":"Gross","year":"2014","journal-title":"PLoS One"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"453","DOI":"10.1007\/s13555-022-00885-w","article-title":"Hyperhidrosis: a central nervous dysfunction of sweat secretion","volume":"13","author":"Wohlrab","year":"2023","journal-title":"Dermatol Ther (Heidelb)"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"187","DOI":"10.1007\/s40257-022-00743-7","article-title":"The impact of hyperhidrosis on quality of life: a review of the literature","volume":"24","author":"Parashar","year":"2023","journal-title":"Am J Clin Dermatol"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"230","DOI":"10.1590\/abd1806-4841.20142189","article-title":"Evaluation of anxiety and depression prevalence in patients with primary severe hyperhidrosis","volume":"89","author":"Bragan\u00e7a","year":"2014","journal-title":"An Bras Dermatol"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"1299","DOI":"10.1007\/s13555-020-00439-y","article-title":"Treatment patterns, depression, and anxiety among US patients diagnosed with hyperhidrosis: a retrospective cohort study","volume":"10","author":"Klein","year":"2020","journal-title":"Dermatol Ther (Heidelb)"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"adv00240","DOI":"10.2340\/00015555-3598","article-title":"Anxiety and depression in primary hyperhidrosis: an observational study of 95 consecutive Swedish outpatients","volume":"100","author":"Kristensen","year":"2020","journal-title":"Acta Derm Venereol"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"1181","DOI":"10.1016\/j.comppsych.2012.04.009","article-title":"Social anxiety and functional impairment in patients seeking surgical evaluation for hyperhidrosis","volume":"53","author":"Schneier","year":"2012","journal-title":"Compr Psychiatry"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"1576","DOI":"10.1111\/jdv.19151","article-title":"The prevalence of anxiety disorders in dermatology outpatients: a systematic review and meta-analysis","volume":"37","author":"Storer","year":"2023","journal-title":"J Eur Acad Dermatol Venereol"},{"key":"ref31","doi-asserted-by":"publisher","first-page":"245","DOI":"10.1113\/EP085916","article-title":"Nicotinic receptor activation augments muscarinic receptor-mediated eccrine sweating but not cutaneous vasodilatation in young males","volume":"102","author":"Fujii","year":"2017","journal-title":"Exp Physiol"},{"key":"ref32","doi-asserted-by":"publisher","first-page":"2483","DOI":"10.1111\/jdv.12846","article-title":"Smoking is associated with combined allergic and irritant hand eczema, contact allergies and hyperhidrosis","volume":"29","author":"Molin","year":"2015","journal-title":"J Eur Acad Dermatol Venereol"},{"key":"ref33","doi-asserted-by":"publisher","first-page":"adv00435","DOI":"10.2340\/00015555-3790","article-title":"Epidemiology of hyperhidrosis in Danish blood donors","volume":"101","author":"Henning","year":"2021","journal-title":"Acta Derm Venereol"},{"key":"ref34","doi-asserted-by":"publisher","first-page":"699","DOI":"10.1016\/j.ad.2015.06.002","article-title":"The emotional impact of skin diseases","volume":"106","author":"Guerra-Tapia","year":"2015","journal-title":"Actas Dermosifiliogr"},{"key":"ref35","doi-asserted-by":"publisher","first-page":"llaf471","DOI":"10.1093\/ced\/llaf471","article-title":"The impact of facial vitiligo on social appearance anxiety: a case\u2013control study","author":"Kurhan","year":"2025","journal-title":"Clin Exp Dermatol"},{"key":"ref36","doi-asserted-by":"publisher","first-page":"216","DOI":"10.14744\/nci.2025.26928","article-title":"Exploring the phenomenon of social appearance anxiety in individuals suffering from seborrheic dermatitis: comprehensive insights derived from a case-control study","volume":"12","author":"Tumturk","year":"2025","journal-title":"North Clin Istanb"},{"key":"ref37","doi-asserted-by":"publisher","first-page":"13591053251383649","DOI":"10.1177\/13591053251383649","article-title":"The hidden burden of visibility: social appearance anxiety in patients with alopecia areata\u2014a comparative cross-sectional study","author":"Kurhan","year":"2025","journal-title":"J Health Psychol"},{"key":"ref38","doi-asserted-by":"publisher","first-page":"145","DOI":"10.4274\/tjd.galenos.2025.19870","article-title":"Social appearance anxiety and its impact on patients with verruca vulgaris: a comparative study with healthy controls","volume":"19","author":"T\u00fcmt\u00fcrk","year":"2025","journal-title":"Turk J Dermatol"},{"key":"ref39","doi-asserted-by":"publisher","first-page":"234","DOI":"10.4274\/haseki.galenos.2021.7183","article-title":"Social appearance anxiety in patients with acne vulgaris: a cross-sectional controlled study","volume":"59","author":"Kurhan","year":"2021","journal-title":"Med Bull Haseki"},{"key":"ref40","doi-asserted-by":"publisher","first-page":"589","DOI":"10.5505\/ejm.2021.52280","article-title":"Social appearance anxiety in patients with contact dermatitis","volume":"26","author":"Kurhan","year":"2021","journal-title":"East J Med"},{"key":"ref41","doi-asserted-by":"publisher","first-page":"1075672","DOI":"10.3389\/fmed.2023.1075672","article-title":"A network analysis of psychological flexibility, coping, and stigma in dermatology patients","volume":"10","author":"Vasiliou","year":"2023","journal-title":"Front Med (Lausanne)"},{"key":"ref42","doi-asserted-by":"publisher","first-page":"48","DOI":"10.1177\/1073191107306673","article-title":"Development and examination of the social appearance anxiety scale","volume":"15","author":"Hart","year":"2008","journal-title":"Assess"},{"key":"ref43","first-page":"371","article-title":"Japanese translation of hospital anxiety and depression scale","volume":"4","author":"Kitamura","year":"1993","journal-title":"Arch Psychiatric Diag Clin Eval"}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2026.1739715\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,9]],"date-time":"2026-02-09T15:19:58Z","timestamp":1770650398000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2026.1739715\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,9]]},"references-count":43,"alternative-id":["10.3389\/fmed.2026.1739715"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2026.1739715","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,9]]},"article-number":"1739715"}}