A 24-year-old university student presents to the clinic with a four-year history of excessive sweating, primarily affecting his palms, soles, and underarms. He reports that the sweating occurs even in cool environments and is not related to physical activity or emotional stress. He finds it embarrassing, as his hands are often too damp to shake hands or write without smudging his papers.

He denies any history of fever, weight loss, or medication use. There is no family history of similar symptoms, but he mentions that his symptoms started during his teenage years.

On physical examination, his palms and soles appear visibly moist, with noticeable sweat droplets forming during the exam. No other systemic abnormalities are noted. The starch-iodine test confirms excessive sweating in the affected areas.

Based on the findings, he is diagnosed with primary focal hyperhidrosis, a condition caused by overactivity of the sympathetic nervous system. He is started on topical aluminum chloride (antiperspirant) and advised on additional treatments, including iontophoresis and botulinum toxin injections if symptoms persist.