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Hyperhidrosis can either be generalized or localized to specific parts of the body. Hands, feet, armpits, and the groin area are among the most active regions of perspiration due to the relatively high concentration of sweat glands; however, any part of the body may be affected. Hyperhidrosis can also be classified depending on if it is a congenital or acquired trait. Primary hyperhidrosis is found to start during adolescence or even before and seems to be inherited as an autosomal dominant genetic trait. Primary hyperhidrosis must be distinguished from secondary hyperhidrosis, which can start at any point in life. The latter form may be due to a disorder of the thyroid or pituitary gland, diabetes mellitus, tumors, gout, menopause, certain drugs, or mercury poisoning. Hyperhidrosis may be also divided into palmoplantar (symptomatic sweating of primarily the hands or feet), gustatory or generalized hyperhidrosis. Alternatively, hyperhydrosis may be classified according to the amount of skin that is affected and its possible causes.:700 In this approach, excessive sweating in an area that is greater than 100 cm2 (up to generalized sweating of the entire body) is differentiated from sweating that affects only a small area. Further information: diaphoresis The cause of primary hyperhidrosis is unknown, although some surgeons claim that it is caused by sympathetic overactivity. Anxiety can exacerbate the situation for many sufferers. A common complaint of patients is that they get nervous because they sweat, then sweat more because they are nervous. Other factors can play a role; certain foods and drinks, nicotine, caffeine, and smells can trigger a response.