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A young, healthy patient with primary palmarplantar hyperhidrosis in resting conditions at room temperature. A, The mixture of starch, alizarin red, and sodium carbonate is placed on the anterior body surface, including the palms, and the resting palmar sweating changes the indicator color from light orange to purple. B, Test is repeated in the same patient under the same conditions 2 months after successful endoscopic thoracic sympathotomy, and no resting palmar sweat is visible. Reprinted with permission from Eisenach JH, Atkinson JLD, Fealey RD. Hyperhidrosis: evolving therapies for a well-established phenomenon. Mayo Clin Proc 2005;80:657-666.