* Anhidrotic asthenia (heatstroke). A life-threatening disorder, anhidrotic asthenia causes acute, generalized anhidrosis. In early stages, sweating may still occur and the patient may be rational, but his rectal temperature may already exceed 102.2° F (39° C). Associated signs and symptoms include severe headache and muscle cramps, which later disappear; fatigue; nausea and vomiting; dizziness; palpitations; substernal tightness; and elevated blood pressure followed by hypotension. Within minutes, anhidrosis and hot, flushed skin develop, accompanied by tachycardia, tachypnea, and confusion progressing to seizure or loss of consciousness.

* Burns. Depending on their severity, burns may cause permanent anhidrosis in affected areas as well as blistering, edema, and increased pain or loss of sensation.

* Miliaria crystallina. This usually innocuous form of miliaria causes anhidrosis and tiny, clear, fragile blisters, usually under the arms and breasts.

* Miliaria profunda. If severe and extensive, miliaria profunda can progress to life-threatening anhidrotic asthenia. Typically, it produces localized anhidrosis with compensatory facial hyperhidrosis. Whitish papules appear mostly on the trunk but also on the extremities. Associated signs and symptoms include inguinal and axillary lymphadenopathy, weakness, shortness of breath, palpitations, and fever.

* Miliaria rubra (prickly heat). Miliaria rubra typically produces localized anhidrosis, and can also progress to life-threatening anhidrotic asthenia if it becomes severe and extensive; however, this is a rare occurrence. Small, erythematous papules with centrally placed blisters appear on the trunk and neck and rarely on the face, palms, or soles. Pustules may also appear in extensive and chronic miliaria. Related symptoms include paroxysmal itching and paresthesia.

* Peripheral neuropathy. Anhidrosis over the legs usually appears with compensatory hyperhidrosis over the head and neck. Associated findings mainly involve extremities and include glossy red skin; paresthesia, hyperesthesia, or anesthesia in the hands and feet; diminished or absent deep tendon reflexes; flaccid paralysis and muscle wasting; footdrop; and burning pain.

* Shy-Drager syndrome. A degenerative neurologic syndrome, Shy-Drager syndrome causes ascending anhidrosis in the legs. Other signs and symptoms include severe orthostatic hypotension, loss of leg hair, impotence, constipation, urine retention or urgency, decreased salivation and tearing, mydriasis, and impaired visual accommodation. Eventually, focal neurologic signs — such as leg tremors, incoordination, and muscle wasting and fasciculation — may appear.

* Spinal cord lesions. Anhidrosis may occur symmetrically below the level of the lesion, with compensatory hyperhidrosis in adjacent areas. Other findings depend on the site and extent of the lesion but may include partial or total loss of motor and sensory function below the lesion as well as impaired cardiovascular and respiratory function.

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Prognosis of Insensitivity to pain with anhidrosis: poor.The \'prognosis\' of Insensitivity to pain with anhidrosis usually refers to the likely outcome of Insensitivity to pain with anhidrosis. The prognosis of Insensitivity to pain with anhidrosis may include the duration of Insensitivity to pain with anhidrosis, chances of complications of Insensitivity to pain with anhidrosis, probable outcomes, prospects for recovery, recovery period for Insensitivity to pain with anhidrosis, survival rates, death rates, and other outcome possibilities in the overall prognosis of Insensitivity to pain with anhidrosis. Naturally, such forecast issues are by their nature unpredictable.

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