PAI-1 and CHRNA1—A new molecular axis and therapeutic target in primary focal hyperhidrosis

Primary focal hyperhidrosis (PFH, OMIM no. 144110), affecting 1%–6.1% of the population,1 is characterized by excessive and localized sweating, typically on the palms, soles, underarms, face, or scalp. Current treatments focus largely on topical blocking of sweating, although other strategies exist, such as local treatments (iontophoresis and intradermal injections), systemic medication, and local surgical procedures to remove the sweat glands.2 While these approaches are effective, they are symptomatic, urging a mechanical understanding of PFH pathogenesis and the development of better adapted therapeutic options.