Peripheral Neuropathy and Hyperhidrosis?

My daughter (7) has for the last 3 years suffered with tingling fingers and toes.  The affected areas are the fingertips on both hands although the little finger does not seem affected.  She has recently started with tingling sensastions on the palms (large pad below the little finger and above the wrist).  It would appear more so that the fingertips have a numb sensation which irritates her and she has to press her fingers against something hard in order to 'tingle' them or get feeling back in them.  It's difficult for her to describe and me to interpret, so I hope I'm putting the effect over properly.  Hands are warm and clammy and they sweat to the point of dripping if held or if she gets too warm.  The skin peels on the fingertips and the palm pad leaving red dry cracked skin.  No other area on her hands peels.  The problem is similar with her toes with only the little toe not affected.  The skin peels around her toes and she constantly has to scrunch her toes up to relieve this feeling she has in them. We have been to children's outpatient who ran various tests although I'm not sure if diabete's was one of them.  We were referred to a dermatologist wh didn't mention the hyperhidrosis and put it down to peripheral neurpathy brought on by anxiety. My worry is that she's not an anxious child, although I admit these things can be underlying.  I worry about the hyperhidrosis and whether it will spread during puberty or whether it is secondary to the peripheral neuropathy and I worry that the peripheral neuropathy will spread and become painful as she grows older.  We were pretty much sent away with a smile and not told anything.  I only learned of the diagnosis via letter with no explanation as to what it is, how it can be treated, nothing. So I'm at a lose end now.  I don't want to just abandon the issue - what if it gets worse and can't be treated at a later stage.  As her mother I need to fight her corner and make sure I've done everything I can to help.  

[Christopher R Newey, DO]

Thanks for using the forum. I am happy to address your questions, and my answer will be based on the information you provided here. Please make sure you recognize that this forum is for educational purposes only, and it does not substitute for a formal office visit with a doctor.

Without the ability to examine and obtain a history, I can not tell you what the exact cause of the symptoms is. However I will try to provide you with some useful information.

I would recommend that your daughter be evaluated by a pediatric neurologist. She may need additional testing such as diabetes screen, thyroid, rheumatologic panels, and perhaps autonomic testing. These tests will guide further workup. Many times, there may be an underlying genetic/hereditary component to these diagnoses. Do you or husband have any neurological symptoms or in the family?

It would be best that your daughter be seen by a pediatric neurologist to sort out the “neuropathy”.

Thank you for this opportunity to answer your questions, I hope you find the information I have provided useful, good luck.