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Shayesteh A, Janlert U, Nylander E. Hyperhidrosis - Sweating Sites Matter: Quality of Life in Primary Hyperhidrosis according to the Sweating Sites Measured by SF-36. Dermatology 2018; 233:441-445. [PMID: 29502112 DOI: 10.1159/000486713] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2017] [Accepted: 12/19/2017] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Primary hyperhidrosis has negative impacts on quality of life. The aim of this study was to investigate whether the impacts of primary hyperhidrosis on quality of life are different depending on the localisation of the sweating. METHOD We compiled background data, Hyperhidrosis Disease Severity Scale (HDSS), and Short-Form Health Survey (SF-36) post hoc results from 2 previous studies. Cases who described only 1 site as their most problematic area of sweating were included (n = 160/188) while individuals with multifocal primary sites of hyperhidrosis were excluded (n = 28/188). RESULTS Individuals included were 11-62 years old with a mean age of 30.2 ± 10.4 years, and axillary hyperhidrosis (65.6%) was the most common type of hyperhidrosis. Comorbidities were more common when hyperhidrosis was reported in other than the axillary, palmar, and plantar regions. Excluding comorbidities showed the lowest SF-36 mental component summary scores for axillary (41.6 ± 11.6), palmar (40.0 ± 9.4), and plantar hyperhidrosis (41.1 ± 13.7). The HDSS showed the highest proportion of severe cases in axillary (60.6%) and palmar (51.5%) hyperhidrosis (p < 0.01) while mild cases were more often observed in plantar (60%), facial (83.3%), and other sites (85.7%) in primary hyperhidrosis (p < 0.01). CONCLUSION Our results indicate that impairments in quality of life can be different depending on the manifestation of primary hyperhidrosis on the body. This can have an influence on how patients with hyperhidrosis could be prioritised in health care. Subgroup samples affected by facial hyperhidrosis and other sites of primary hyperhidrosis were however small, and more research is required to verify our findings.
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Affiliation(s)
- Alexander Shayesteh
- Department of Public Health and Clinical Medicine, Dermatology and Venereology, Umeå University, Umeå, Sweden
| | - Urban Janlert
- Department of Public Health and Clinical Medicine, Epidemiology and Global Health, Umeå University, Umeå, Sweden
| | - Elisabet Nylander
- Department of Public Health and Clinical Medicine, Dermatology and Venereology, Umeå University, Umeå, Sweden
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Ricchetti-Masterson K, Symons JM, Aldridge M, Patel A, Maskell J, Logie J, Yamaguchi Y, Cook SF. Epidemiology of hyperhidrosis in 2 population-based health care databases. J Am Acad Dermatol 2018; 78:358-362. [DOI: 10.1016/j.jaad.2017.10.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2017] [Revised: 09/29/2017] [Accepted: 10/03/2017] [Indexed: 10/18/2022]
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Effectiveness, success rates, and complications of different thoracoscopic sympathectomy techniques in patients with palmar hyperhidrosis. TURK GOGUS KALP DAMAR CERRAHISI DERGISI-TURKISH JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY 2018; 26:86-92. [PMID: 32082716 DOI: 10.5606/tgkdc.dergisi.2018.14686] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2017] [Accepted: 07/08/2017] [Indexed: 11/21/2022]
Abstract
Background This study aims to investigate the effectiveness, success and complication rates of three different video-assisted thoracoscopic sympathectomy procedures performed for the treatment of primary focal hyperhidrosis; excision, cauterization and clipping. Methods We retrospectively evaluated the records of 60 patients (33 males, 27 females; mean age 25.1±6.4 years; range 16 to 43 years) with primary focal hyperhidrosis and treated with videoassisted thoracoscopic sympathectomy between January 2010 and December 2013. The patients were treated bilaterally at the same session: the sympathetic chain and ganglia were excised from the spinal cord segments of T2-T4 in 20 patients (group 1), cauterized in 20 patients (group 2), and clipped in 20 patients (group 3). The procedural success and complication rates were compared among the groups. Results Sympathectomy was successfully performed in all patients. The mean operation time was found to be significantly shorter in group 2 (42.5±7.1 min) and group 3 (36.9±7.8 min), compared to group 1 (51.1±8.4 min) (p<0.05). Compensatory hyperhidrosis developed in 17 patients (28.3%) and was comparable among all groups (p<0.05). Conclusion Our study results suggest that excision, cauterization, and clipping are effective and reliable in the treatment of primary focal hyperhidrosis. Based on our experience, we believe that sympathectomy with video-assisted excision may be preferable for the treatment of primary focal hyperhidrosis.
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104
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Eustace K, Wilson NJ. Postmenopausal craniofacial hyperhidrosis. Clin Exp Dermatol 2017; 43:180-182. [DOI: 10.1111/ced.13310] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/13/2017] [Indexed: 12/01/2022]
Affiliation(s)
- K. Eustace
- Department of Dermatology; St Helens and Knowsley Teaching Hospitals NHS Trust; St Helens Hospital; St Helens UK
| | - N. J. Wilson
- Department of Dermatology; Royal Liverpool and Broadgreen University Hospitals NHS Trust; Broadgreen Hospital; Liverpool UK
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105
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Retroperitoneoscopic lumbar sympathectomy for plantar hyperhidrosis. J Vasc Surg 2017; 66:1806-1813. [PMID: 29169540 DOI: 10.1016/j.jvs.2017.05.126] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2016] [Accepted: 05/18/2017] [Indexed: 11/22/2022]
Abstract
OBJECTIVE The objective of this study was to assess the reduction in quality of life (QoL) caused by the persistence of primary plantar hyperhidrosis (PPH) symptoms and the level of satisfaction in PPH patients after retroperitoneoscopic lumbar sympathectomy (RLS). The efficacy, safety, and procedure of bilateral RLS in both sexes are also described in this study. METHODS This is a longitudinal study of consecutive patients who sought specific treatment from a private practitioner for severe PPH as classified on the Hyperhidrosis Disease Severity Scale (HDSS) from October 2005 to October 2014. The patients were asked to report the symptoms of PPH experienced in the immediate preoperative period and to complete a standardized QoL questionnaire developed by de Campos at least 12 months after RLS. Disease outcomes, recurrence of symptoms, and any adverse effects of surgery were evaluated after 30 days and at least 12 months after RLS. RESULTS Lumbar sympathectomy was performed 116 times in 58 patients; 30 days after surgery, PPH was resolved in all patients. Three patients (5.2%) reported transient thigh neuralgia, and 19 (32.7%) reported transient paresthesia in the lower limbs. There were no reports of retrograde ejaculation. At a minimum of 12 months after RLS, 49 of the 58 patients had fully and correctly answered the follow-up questionnaire and noted a mild (HDSS 2) to moderate (HDSS 3) increase in pre-existing compensatory sweating. One patient had a PPH relapse within 6 months. Improvement in QoL due to the resolution of PPH was reported in 98% of the 49 patients. None of the operations necessitated a change in the laparotomy approach, and none of the patients died. CONCLUSIONS RLS is safe and effective for the treatment of severe PPH in both sexes. There were no reports of retrograde ejaculation after resection of L3 and L4 ganglia. There was a mild to moderate increase in compensatory sweating in about half of the patients, but without any regret or dissatisfaction for having undergone the surgery because of a significant improvement in QoL.
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106
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Nasir A, Bissonnette R, Maari C, DuBois J, Pene Dumitrescu T, Haddad J, Yamaguchi Y, Dalessandro M. A phase 2a randomized controlled study to evaluate the pharmacokinetic, safety, tolerability and clinical effect of topically applied Umeclidinium in subjects with primary axillary hyperhidrosis. J Eur Acad Dermatol Venereol 2017; 32:145-151. [DOI: 10.1111/jdv.14651] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2017] [Accepted: 10/02/2017] [Indexed: 11/29/2022]
Affiliation(s)
- A. Nasir
- Wake Research Institute; Raleigh NC USA
| | | | - C. Maari
- Innovaderm Research Inc.; Montreal QC Canada
| | | | - T. Pene Dumitrescu
- Clinical Pharmacology Modeling and Simulation; GlaxoSmithKline Upper Merion PA USA
| | - J. Haddad
- Dermatology Therapeutic Area Unit; GlaxoSmithKline; Collegeville PA USA
| | - Y. Yamaguchi
- Dermatology Therapeutic Area Unit; GlaxoSmithKline; Collegeville PA USA
| | - M. Dalessandro
- Dermatology Therapeutic Area Unit; GlaxoSmithKline; Collegeville PA USA
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Negaard M, Anthony C, Bonthius D, Jepson M, Marcussen B, Pelzer D, Peterson A. A case report: Glycopyrrolate for treatment of exercise-induced hyperhidrosis. SAGE Open Med Case Rep 2017; 5:2050313X17721601. [PMID: 28835822 PMCID: PMC5557159 DOI: 10.1177/2050313x17721601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2017] [Accepted: 06/21/2017] [Indexed: 11/30/2022] Open
Abstract
Objective: Hyperhidrosis can cause dehydration and exercise intolerance. There are several case reports of extremely high sweat rates in athletes. We present as case report of a 17-year-old male with the highest sweat rate recorded in the literature (5.8 L/h). Our goal was to determine if glycopyrrolate, an anticholinergic medication with primarily anti-muscarinic effects that is known to decrease sweat production, would reduce the sweat rate of our subject in a controlled exercise setting. Methods: Our patient and a control subject were subjected to an exercise protocol consisting of running on a treadmill (5.4–6.7 mile/h at 1° of incline) in a warm climate-controlled chamber after receiving 0, 2, or 4 mg of glycopyrrolate. Core temperature, heart rate, rater of perceived exertion, and sweat rate were monitored in both subjects. Results: Glycopyrrolate dose was not significantly correlated with decreased sweat rate and maximal core temperature. However, the clinical effect of reducing the sweat rate was very strong. The improvement of the subject’s sweat rate allowed him to successfully return to sport. Conclusion: Our findings suggest that low-dose glycopyrrolate may be a safe and effective method of controlling exertional hyperhidrosis.
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Affiliation(s)
- Matthew Negaard
- Department of Emergency Medicine, University of Iowa Hospitals and Clinics, Iowa City, IA, USA
| | - Christopher Anthony
- Department of Orthopedic Surgery, University of Iowa Hospitals and Clinics, Iowa City, IA, USA
| | - Daniel Bonthius
- College of Medicine, Medical University of South Carolina, Charleston, SC, USA
| | - Matthew Jepson
- Department of Family Medicine, University of Iowa Hospitals and Clinics, Iowa City, IA, USA
| | - Britt Marcussen
- Department of Family Medicine, University of Iowa Hospitals and Clinics, Iowa City, IA, USA
| | - Daniel Pelzer
- Department of Pediatrics, University of Iowa Hospitals and Clinics, Iowa City, IA, USA
| | - Andrew Peterson
- Sports Medicine Clinic, University of Iowa Hospitals and Clinics, Iowa City, IA, USA
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Yetim TD. AYNI SEANSTA BİLATERAL UNİPORT SEMPATEKTOMİ; BİR GÜNDE EVDESİNİZ. MUSTAFA KEMAL ÜNIVERSITESI TIP DERGISI 2017. [DOI: 10.17944/mkutfd.323339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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109
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Affiliation(s)
- Jason E. Sammons
- Department of Clinical Medicine, Avalon University School of Medicine, Willemstad, CW, USA
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110
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Sasaki S, Watanabe J, Ohtaki H, Matsumoto M, Murai N, Nakamachi T, Hannibal J, Fahrenkrug J, Hashimoto H, Watanabe H, Sueki H, Honda K, Miyazaki A, Shioda S. Pituitary adenylate cyclase‐activating polypeptide promotes eccrine gland sweat secretion. Br J Dermatol 2017; 176:413-422. [DOI: 10.1111/bjd.14885] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/13/2016] [Indexed: 11/29/2022]
Affiliation(s)
- S. Sasaki
- Department of Biochemistry Showa University School of Medicine Tokyo Japan
- Department of Dermatology Showa University School of Medicine Tokyo Japan
| | - J. Watanabe
- Centre for Biotechnology Showa University Tokyo Japan
| | - H. Ohtaki
- Department of Anatomy Showa University School of Medicine Tokyo Japan
| | - M. Matsumoto
- Department of Biochemistry Showa University School of Medicine Tokyo Japan
| | - N. Murai
- Department of Physiology Showa University School of Medicine Tokyo Japan
| | - T. Nakamachi
- Laboratory of Regulatory Biology Graduate School of Science and Engineering University of Toyama Toyama Japan
| | - J. Hannibal
- Department of Clinical Biochemistry Faculty of Health and Medical Science Bispebjerg Hospital University of Copenhagen Copenhagen Denmark
| | - J. Fahrenkrug
- Department of Clinical Biochemistry Faculty of Health and Medical Science Bispebjerg Hospital University of Copenhagen Copenhagen Denmark
| | - H. Hashimoto
- Laboratory of Molecular Neuropharmacology Graduate School of Pharmaceutical Sciences Osaka University Osaka Japan
- iPS Cell‐based Research Project on Brain Neuropharmacology and Toxicology Graduate School of Pharmaceutical Sciences Osaka University Osaka Japan
- Molecular Research Centre for Children's Mental Development United Graduate School of Child Development Osaka University Kanazawa University Hamamatsu University School of Medicine Chiba University and University of Fukui Osaka Japan
| | - H. Watanabe
- Department of Dermatology Showa University School of Medicine Tokyo Japan
| | - H. Sueki
- Department of Dermatology Showa University School of Medicine Tokyo Japan
| | - K. Honda
- Department of Anatomy Showa University School of Medicine Tokyo Japan
| | - A. Miyazaki
- Department of Biochemistry Showa University School of Medicine Tokyo Japan
| | - S. Shioda
- Department of Neuropeptide Drug Discovery Hoshi University School of Pharmacy and Pharmaceutical Sciences Ebara 2‐4‐41 Shinagawa‐ku, Tokyo 142‐8501 Japan
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111
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Budamakuntla L, Loganathan E, George A, Revanth BN, Sankeerth V, Sarvjnamurthy SA. Comparative Study of Efficacy and Safety of Botulinum Toxin a Injections and Subcutaneous Curettage in the Treatment of Axillary Hyperhidrosis. J Cutan Aesthet Surg 2017; 10:33-39. [PMID: 28529419 PMCID: PMC5418980 DOI: 10.4103/jcas.jcas_104_16] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Primary focal axillary hyperhidrosis is a chronic distressing disorder affecting both the sexes. When the condition is refractory to conservative management, we should go for more promising therapies like intradermal botulinum toxin A (BtxA) injections in the axilla, and surgical therapies like subcutaneous curettage of sweat glands. AIMS AND OBJECTIVES The aim of this study is to compare the efficacy, safety and duration of action of intradermal BtxA injections in one axilla and subcutaneous curettage of sweat glands in the other axilla of the same patient with axillary hyperhidrosis. MATERIALS AND METHODS Twenty patients (40 axillae) received intradermal BtxA injections on the right side (20 axillae) and underwent tumescent subcutaneous curettage of sweat glands on the left side (20 axillae). Sweat production rate was measured using gravimetry analyses at baseline and at 3 months after the procedure. Subjective analyses were done using hyperhidrosis disease severity scale (HDSS) score at baseline, at 3rd and 6th month after the procedure. RESULTS At 3 months post-treatment, the resting sweat rate in the toxin group improved by 80.32% versus 79.79% in the subcutaneous curettage method (P = 0.21). Exercise-induced sweat rate in the toxin group improved by 88.76% versus 88.8% in the subcutaneous curettage group (P = 0.9). There was a significant difference in the HDSS score after treatment with both the modalities. There were no adverse events with BtxA treatment compared to very minor adverse events with the surgical method. CONCLUSION Both intradermal BtxA injections and tumescent subcutaneous curettage of sweat glands had a significant decrease in the sweat rates with no significant difference between the two modalities. Hence, in resource poor settings where affordability of BtxA injection is a constraint, subcutaneous curettage of sweat glands can be preferred which has been found equally effective with no or minimal adverse events.
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Affiliation(s)
- Leelavathy Budamakuntla
- Department of Dermatology, Bangalore Medical College and Research Institute, Bengaluru, Karnataka, India
| | - Eswari Loganathan
- Department of Dermatology, Bangalore Medical College and Research Institute, Bengaluru, Karnataka, India
| | - Anju George
- Department of Dermatology, Bangalore Medical College and Research Institute, Bengaluru, Karnataka, India
| | - B N Revanth
- Department of Dermatology, Bangalore Medical College and Research Institute, Bengaluru, Karnataka, India
| | - V Sankeerth
- Department of Dermatology, Bangalore Medical College and Research Institute, Bengaluru, Karnataka, India
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112
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Nasr MW, Jabbour SF, Haber RN, Kechichian EG, El Hachem L. Comparison of microwave ablation, botulinum toxin injection, and liposuction-curettage in the treatment of axillary hyperhidrosis: A systematic review. J COSMET LASER THER 2016; 19:36-42. [DOI: 10.1080/14764172.2016.1248438] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Marwan W. Nasr
- Department of Plastic and Reconstructive Surgery, Hotel Dieu de France University Hospital, Beirut, Lebanon
| | - Samer F. Jabbour
- Department of Plastic and Reconstructive Surgery, Hotel Dieu de France University Hospital, Beirut, Lebanon
| | - Roger N. Haber
- Department of Dermatology, Hotel Dieu de France University Hospital, Beirut, Lebanon
| | - Elio G. Kechichian
- Department of Dermatology, Hotel Dieu de France University Hospital, Beirut, Lebanon
| | - Lena El Hachem
- Department of Obstetrics and Gynecology, Lebanese American University Medical Center, Beirut, Lebanon
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113
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Bahar R, Zhou P, Liu Y, Huang Y, Phillips A, Lee TK, Su M, Yang S, Kalia S, Zhang X, Zhou Y. The prevalence of anxiety and depression in patients with or without hyperhidrosis (HH). J Am Acad Dermatol 2016; 75:1126-1133. [DOI: 10.1016/j.jaad.2016.07.001] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2016] [Revised: 06/28/2016] [Accepted: 07/05/2016] [Indexed: 11/26/2022]
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114
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Preliminary Experience With Transdermal Oxybutynin Patches for Hyperhidrosis. ACTAS DERMO-SIFILIOGRAFICAS 2016. [DOI: 10.1016/j.adengl.2016.09.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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115
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Bergón-Sendín M, Pulido-Pérez A, Sáez-Martín L, Suárez-Fernández R. Experiencia inicial con oxibutinina transdérmica en el tratamiento de la hiperhidrosis. ACTAS DERMO-SIFILIOGRAFICAS 2016; 107:845-850. [DOI: 10.1016/j.ad.2016.07.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2016] [Revised: 06/08/2016] [Accepted: 07/05/2016] [Indexed: 10/21/2022] Open
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116
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Al-Hashel J, Youssry D, Rashaed H, Shamov T, Rousseff R. Botulinum toxin A for palmar hyperhidrosis: assessment with sympathetic skin responses evoked by train of stimuli. ACTA ACUST UNITED AC 2016; 36:23-26. [DOI: 10.1111/aap.12050] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2016] [Revised: 10/23/2016] [Accepted: 10/26/2016] [Indexed: 11/30/2022]
Affiliation(s)
| | | | | | - T. Shamov
- Neurosurgery; Military Medical Academy; Sofia Bulgaria
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117
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Romero FR, Haddad GR, Miot HA, Cataneo DC. Palmar hyperhidrosis: clinical, pathophysiological, diagnostic and therapeutic aspects. An Bras Dermatol 2016; 91:716-725. [PMID: 28099590 PMCID: PMC5193180 DOI: 10.1590/abd1806-4841.20165358] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2015] [Accepted: 12/16/2015] [Indexed: 11/22/2022] Open
Abstract
Palmar hyperhidrosis affects up to 3% of the population and inflict significant impact on quality of life. It is characterized by chronic excessive sweating, not related to the necessity of heat loss. It evolves from a localized hyperactivity of the sympathetic autonomic system and can be triggered by stressful events. In this study, the authors discuss clinical findings, pathophysiological, diagnostic and therapeutic issues (clinical and surgical) related to palmar hyperhidrosis.
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Affiliation(s)
- Flávio Ramalho Romero
- Universidade Estadual Paulista "Júlio de
Mesquita Filho"BotucatuSPBrazilUniversidade Estadual Paulista "Júlio de
Mesquita Filho" (Unesp) – Botucatu (SP), BrazilUniversidade Estadual
Paulista
| | - Gabriela Roncada Haddad
- Universidade Estadual Paulista "Júlio de
Mesquita Filho"BotucatuSPBrazilUniversidade Estadual Paulista "Júlio de
Mesquita Filho" (Unesp) – Botucatu (SP), BrazilUniversidade Estadual
Paulista
| | - Hélio Amante Miot
- Universidade Estadual Paulista "Júlio de
Mesquita Filho"BotucatuSPBrazilUniversidade Estadual Paulista "Júlio de
Mesquita Filho" (Unesp) – Botucatu (SP), BrazilUniversidade Estadual
Paulista
| | - Daniele Cristina Cataneo
- Universidade Estadual Paulista "Júlio de
Mesquita Filho"BotucatuSPBrazilUniversidade Estadual Paulista "Júlio de
Mesquita Filho" (Unesp) – Botucatu (SP), BrazilUniversidade Estadual
Paulista
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118
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Grabell DA, Hebert AA. Current and Emerging Medical Therapies for Primary Hyperhidrosis. Dermatol Ther (Heidelb) 2016; 7:25-36. [PMID: 27787745 PMCID: PMC5336423 DOI: 10.1007/s13555-016-0148-z] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2016] [Indexed: 11/08/2022] Open
Abstract
Hyperhidrosis is defined as the production of sweat beyond what is physiologically necessary to maintain thermal homeostasis. This disease state may (and typically does) have a significant impact on the patient’s quality of life. Medications including antiperspirants, anticholinergics, and botulinum toxin have been shown to be effective in the management of hyperhidrosis. Several medical device technologies have also proven to be effective. This review article will explore the current and emerging pharmacological and medical device treatments for hyperhidrosis and provide a framework for treating patients who suffer with primary forms of hyperhidrosis.
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Affiliation(s)
- Daniel A Grabell
- Department of Dermatology, UTHealth McGovern Medical School, Houston, TX, USA
| | - Adelaide A Hebert
- Department of Dermatology, UTHealth McGovern Medical School, Houston, TX, USA. .,Department of Pediatrics, UTHealth McGovern Medical School, Houston, TX, USA.
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Abstract
Primary plantar hyperhidrosis is defined as excessive secretion of the sweat glands of the feet and may lead to significant limitations in private and professional lifestyle and reduction of health-related quality of life. Conservative therapy measures usually fail to provide sufficient relieve of symptoms and do not allow long-lasting elimination of hyperhidrosis. Endoscopic lumbar sympathectomy appears to be a safe and effective procedure for eliminating excessive sweating of the feet and improves quality of life of patients with severe plantar hyperhidrosis.
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Affiliation(s)
- Roman Rieger
- Department of Surgery, Salzkammergut-Klinikum Gmunden, Miller von Aichholzstrasse 49, Gmunden 4810, Austria.
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120
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Abstract
Plantar hyperhidrosis, excessive sweating on the soles of feet, can have a significant impact on patients' quality of life and emotional well-being. Hyperhidrosis is divided into primary and secondary categories, depending on the cause of the sweating, with plantar hyperhidrosis typically being primary and idiopathic. There is an overall increased risk of cutaneous infection in the presence of hyperhidrosis, including fungal, bacterial, and viral infections. This article discusses a range of treatment options including topical aluminum chloride, iontophoresis, injectable botulinum toxin A, glycopyrrolate, oxybutynin, laser, and endoscopic lumbar sympathectomy. Lifestyle changes regarding hygiene, shoe gear, insoles, and socks are also discussed.
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Affiliation(s)
- Tracey C Vlahovic
- Department of Podiatric Medicine, Temple University School of Podiatric Medicine, 148 North 8th Street, Philadelphia, PA 19107, USA.
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121
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Hamm H. [Severely impaired quality of life. "My sweating is intolerable."]. MMW Fortschr Med 2016; 158:46-50. [PMID: 27324004 DOI: 10.1007/s15006-016-8445-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Affiliation(s)
- Henning Hamm
- Klinik und Poliklinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Würzburg, Josef-Schneider-Str. 2, D-97080, Würzburg, Deutschland.
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Development of hybrid cotton/hydrogel yarns with improved absorption properties for biomedical applications. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2016; 63:563-9. [DOI: 10.1016/j.msec.2016.03.027] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/06/2015] [Revised: 02/19/2016] [Accepted: 03/10/2016] [Indexed: 11/18/2022]
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123
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Del Boz J, Millán-Cayetano JF, Blázquez-Sánchez N, de Troya M. Individualized Dosing of Oral Oxybutynin for the Treatment of Primary Focal Hyperhidrosis in Children and Teenagers. Pediatr Dermatol 2016; 33:327-31. [PMID: 27122197 DOI: 10.1111/pde.12857] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND/OBJECTIVES Oral anticholinergic drugs, such as oxybutynin, are often used in the treatment of hyperhidrosis, but few studies have focused on dosing strategies for children. The objective was to assess the effectiveness and safety of individualized dosing regimens of oral oxybutynin for treating primary focal hyperhidrosis (PFH) in children and teenagers. METHODS A prospective study was performed including patients who initiated treatment for hyperhidrosis between November 2011 and November 2014. Response to treatment and adverse effects were evaluated using the Hyperhidrosis Disease Severity Scale at baseline and at 3 and 12 months. RESULTS Of 16 patients included in the study, 15 (93.8%) had responded to treatment at the 3-month follow-up (62.5% with excellent response). At the 12-month follow-up, the 11 patients who continued the treatment were still responding (63.6% with excellent response). Adverse effects were reported for 68.8% of the patients at 3 months and 54.5% at 12 months, with a predominance of oropharyngeal xerosis. No serious adverse effects were observed. CONCLUSION Dose individualization of oral oxybutynin according to clinical response and tolerance observed in each patient is a useful management strategy in children and teenagers.
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Affiliation(s)
- Javier Del Boz
- Dermatology Department, Hospital Costa del Sol, Marbella, Spain
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124
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Liu Y, Bahar R, Kalia S, Huang RY, Phillips A, Su M, Yang S, Zhang X, Zhou P, Zhou Y. Hyperhidrosis Prevalence and Demographical Characteristics in Dermatology Outpatients in Shanghai and Vancouver. PLoS One 2016; 11:e0153719. [PMID: 27105064 PMCID: PMC4841532 DOI: 10.1371/journal.pone.0153719] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2016] [Accepted: 04/01/2016] [Indexed: 11/18/2022] Open
Abstract
Background There is a wide variation in the reported prevalence of primary hyperhidrosis in the literature. Further, it is unknown if primary hyperhidrosis is a lifelong condition, or if demographical factors influence hyperhidrosis prevalence. Objectives This study aims to examine the prevalence of hyperhidrosis in multiple ethnic groups from two ethnically diverse cities and to determine if the prevalence of primary hyperhidrosis changes according to age, gender, ethnicity, body mass index, and geographical locations. Methods In total, 1010 consecutive subjects attending dermatology outpatient clinics in Shanghai Skin Disease Hospital and 1018 subjects in Skin Care Center of Vancouver General Hospital were invited to fill out a questionnaire on their presenting concerns, demographical information, and sweating symptoms. The subjects were then classified to have primary hyperhidrosis using the criteria of International Hyperhidrosis Society, late-onset hyperhidrosis, or no-hyperhidrosis. The prevalence of primary HH and late-onset HH was calculated for the entire study population and in subgroups stratified according to age of examination, sex, ethnicity, presenting diagnosis, body mass index, and specific study cities. Multivariate logistic regression analyses were performed to assess the impact of these factors on HH prevalence. Results The prevalence of primary hyperhidrosis is very similar in Shanghai and in Vancouver, at 14.5% and 12.3% respectively. In addition, 4.0% of subjects in Shanghai and 4.4% subjects in Vancouver suffer from late-onset HH. Primary HH has highest prevalence in those younger than 30 years of age, decreasing dramatically in later years. Caucasian subjects are at least 2.5 times more likely to develop axillary hyperhidrosis compared to Chinese subjects. Obesity does not have much influence on primary HH presentation, although it does increase significantly the development of late-onset HH. Finally, there is no major difference of hyperhidrosis between Chinese subjects in Shanghai and Vancouver. Limitations The data were gathered according to patients’ self-reports only and the sample size was relatively small in some groups after stratification for gender, ethnicity and age. Conclusion Prevalence of primary HH and late-onset HH is similar in dermatology outpatients independent of geographical locations. However, certain specific HH subtypes can show great variations according to ethnicity, age, body mass index and sex.
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Affiliation(s)
- Yudan Liu
- Shanghai Skin Disease Hospital, Clinical School of Anhui Medical University, Shanghai, China
| | - Rayeheh Bahar
- Department of Dermatology and Skin Science, University of British Columbia, Vancouver, BC, Canada
- Molecular Medicine Lab and Chieng Genomics Center, Vancouver Coastal Health Research Institute, Vancouver, Canada
| | - Sunil Kalia
- Department of Dermatology and Skin Science, University of British Columbia, Vancouver, BC, Canada
| | - Rachel Yuanshen Huang
- Department of Dermatology and Skin Science, University of British Columbia, Vancouver, BC, Canada
- Molecular Medicine Lab and Chieng Genomics Center, Vancouver Coastal Health Research Institute, Vancouver, Canada
| | - Arlie Phillips
- Department of Dermatology and Skin Science, University of British Columbia, Vancouver, BC, Canada
| | - Mingwan Su
- Department of Dermatology and Skin Science, University of British Columbia, Vancouver, BC, Canada
- Molecular Medicine Lab and Chieng Genomics Center, Vancouver Coastal Health Research Institute, Vancouver, Canada
| | - Sen Yang
- Department of Dermatology, First Affiliated Hospital, Anhui Medical University, Hefei, Anhui, China
| | - Xuejun Zhang
- Department of Dermatology, First Affiliated Hospital, Anhui Medical University, Hefei, Anhui, China
| | - Pingyu Zhou
- Shanghai Skin Disease Hospital, Clinical School of Anhui Medical University, Shanghai, China
- Sexually Transmitted Disease Institute, Shanghai Skin Disease Hospital, Shanghai, China
- * E-mail: (PZ); (YZ)
| | - Youwen Zhou
- Department of Dermatology and Skin Science, University of British Columbia, Vancouver, BC, Canada
- Molecular Medicine Lab and Chieng Genomics Center, Vancouver Coastal Health Research Institute, Vancouver, Canada
- * E-mail: (PZ); (YZ)
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Abstract
AIM To critically appraise current literature regarding the management of plantar hyperhidrosis in the form of a structured review. METHOD A literature search was conducted using various databases and search criteria. DISCUSSION The literature reports the use of conservative, medical and surgical treatment modalities for the management of plantar hyperhidrosis. However, long-term follow-up data are rare and some treatment modalities currently available are not fully understood. CONCLUSION There is a considerable dearth in the literature on the management of plantar hyperhidrosis. Further study in larger populations with longer follow-up times is critical to access the long-term effects of treatment. Nonetheless, iontophoresis, botulinum toxin injection and lumbar sympathectomy are promising treatment modalities for this disorder.
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Affiliation(s)
- Sanjay Singh
- a Royal Lancaster Infirmary University Hospitals of Morecambe Bay , Lancaster , UK
| | - Simranjit Kaur
- a Royal Lancaster Infirmary University Hospitals of Morecambe Bay , Lancaster , UK
| | - Paul Wilson
- a Royal Lancaster Infirmary University Hospitals of Morecambe Bay , Lancaster , UK
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126
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Shayesteh A, Boman J, Janlert U, Brulin C, Nylander E. Primary hyperhidrosis: Implications on symptoms, daily life, health and alcohol consumption when treated with botulinum toxin. J Dermatol 2016; 43:928-33. [DOI: 10.1111/1346-8138.13291] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2015] [Accepted: 12/04/2015] [Indexed: 11/29/2022]
Affiliation(s)
- Alexander Shayesteh
- Department of Public Health and Clinical Medicine, Dermatology and Venereology; Umeå University; Umeå Sweden
| | - Jens Boman
- Department of Public Health and Clinical Medicine, Dermatology and Venereology; Umeå University; Umeå Sweden
| | - Urban Janlert
- Department of Public Health and Clinical Medicine, Epidemiology and Global Health; Umeå University; Umeå Sweden
| | | | - Elisabet Nylander
- Department of Public Health and Clinical Medicine, Dermatology and Venereology; Umeå University; Umeå Sweden
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127
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128
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Zhu LH, Chen W, Chen L, Yang S, Lu ZT. Transumbilical thoracic sympathectomy: a single-centre experience of 148 cases with up to 4 years of follow-up†. Eur J Cardiothorac Surg 2015; 49 Suppl 1:i79-83. [PMID: 26553662 DOI: 10.1093/ejcts/ezv391] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2015] [Accepted: 10/08/2015] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVES Thoracic sympathectomy is considered as the most effective method to treat palmar hyperhidrosis (PH). Here, we report our experience of transumbilical thoracic sympathectomy with an ultrathin flexible endoscope for PH in a series of 148 patients with up to 4 years of follow-up. METHODS A prospective database was used in this retrospective analysis of 148 patients (61 males, 87 females, with a mean age of 21.3 years) with PH who were operated on by the same surgeon in a single institution from April 2010 to March 2014. All procedures were performed under general anaesthesia involving intubation with a double-lumen endotracheal tube. Demographic, postoperative and long-term data of patients were recorded and statistical analyses were performed. All patients were followed up at least 6 months post procedure through clinic visits or telephone/e-mail interviews. RESULTS The procedure was performed successfully in 148 of the 150 patients. Two patients had to be converted to conventional thoracoscopic procedure because of severe pleural adhesions. The mean operating time was 43 min (ranging from 39 to 107 min) and the mean postoperative length of stay was 1 day (range 1-4 days). All patients were interviewed 6-48 months after surgery and no diaphragmatic hernia or syndrome was observed. The rate of resolution of PH and axillary hyperhidrosis was 98 and 74.6%, respectively. Compensatory sweating was reported in 22.3% of patients. Almost all of the patients were satisfied with the surgical results and the cosmetic outcome of the incision. CONCLUSIONS This preliminary human experience suggested that transumbilical thoracic sympathectomy was a safe and efficacious alternative to the conventional approach. This technique avoided the chronic pain and chest wall paraesthesia that are associated with the chest incision. In addition, this novel procedure afforded maximum cosmetic benefits.
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Affiliation(s)
- Li-Huan Zhu
- Department of Thoracic Surgery, Jinan Military General Hospital, Shandong, China
| | - Weisheng Chen
- Department of Cardiothoracic Surgery, Fuzhou General Hospital of Fujian Medical University, Fuzhou, China
| | - Long Chen
- Department of Cardiothoracic Surgery, Fuzhou General Hospital of Fujian Medical University, Fuzhou, China
| | - Shengsheng Yang
- Department of Cardiothoracic Surgery, Fuzhou General Hospital of Fujian Medical University, Fuzhou, China
| | - Zhao-Tong Lu
- Department of Thoracic Surgery, Jinan Military General Hospital, Shandong, China
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129
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Abstract
This article reviewed some of the more common diseases of the skin appendages that are encountered in medicine: hyperhidrosis, acne, AA, FPHL, AGA, and TE. The pathophysiology behind the conditions and their treatments were discussed so that the clinician can make logical therapeutic choices for their affected patients.
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Affiliation(s)
- Jay C Vary
- Division of Dermatology, Department of Medicine, University of Washington, Box 354697, 4225 Roosevelt Way Northeast, 4th Floor, Seattle, WA 98105-6920, USA.
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130
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Bahmer FA. Quantification of sweat secretion in focal axillary hyperhidrosis related to area and time: the hyperhidrosis area and secretion index. Int J Dermatol 2015; 54:1233-5. [DOI: 10.1111/ijd.12905] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2014] [Revised: 11/18/2014] [Accepted: 11/22/2014] [Indexed: 11/30/2022]
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131
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Schollhammer M, Brenaut E, Menard-Andivot N, Pillette-Delarue M, Zagnoli A, Chassain-Le Lay M, Sassolas B, Jouan N, Le Ru Y, Abasq-Thomas C, Greco M, Penven K, Roguedas-Contios AM, Dupré-Goetghebeur D, Gouedard C, Misery L, Le Gal G. Oxybutynin as a treatment for generalized hyperhidrosis: a randomized, placebo-controlled trial. Br J Dermatol 2015; 173:1163-8. [PMID: 26114588 DOI: 10.1111/bjd.13973] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/11/2015] [Indexed: 11/27/2022]
Abstract
BACKGROUND Hyperhidrosis is a disorder that can impair quality of life. Localized treatments may be cumbersome and ineffective, and no systemic treatments have proven to be significantly beneficial. OBJECTIVES To evaluate the effectiveness and tolerance of low-dose oxybutynin for hyperhidrosis. METHODS We conducted a prospective, randomized, placebo-controlled trial. From June 2013 to January 2014, 62 patients with localized or generalized hyperhidrosis were enrolled. Oxybutynin was started at a dose of 2·5 mg per day and increased gradually to 7·5 mg per day. The primary outcome was defined as improvement of at least one point on the Hyperhidrosis Disease Severity Scale (HDSS). Dermatology Life Quality Index (DLQI) and tolerance were also reported. RESULTS Most patients (83%) in our study had generalized hyperhidrosis. Oxybutynin was superior to placebo in improving the HDSS: 60% of patients treated with oxybutynin, compared with 27% of patients treated with placebo, improved at least one point on the HDSS (P = 0·009). The mean improvement in quality of life measured by DLQI was significantly better in the oxybutynin arm (6·9) than in the placebo arm (2·3). The most frequent side-effect was dry mouth, which was observed in 43% of the patients in the oxybutynin arm, compared with 11% in the placebo arm. CONCLUSIONS Treatment with low-dose oxybutynin is effective in reducing symptoms of hyperhidrosis in generalized or localized forms. Side-effects were frequent but minor and mainly involved dry mouth.
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Affiliation(s)
- M Schollhammer
- Dermatologist, Brest, France.,Department of Dermatology, University Hospital, Brest, France
| | - E Brenaut
- Department of Dermatology, University Hospital, Brest, France
| | | | - M Pillette-Delarue
- Dermatologist, Brest, France.,Department of Dermatology, University Hospital, Brest, France
| | | | | | - B Sassolas
- Department of Internal Medicine, University Hospital, Brest, France
| | - N Jouan
- Dermatologist, Brest, France.,Department of Dermatology, University Hospital, Brest, France
| | - Y Le Ru
- Dermatologist, Brest, France
| | - C Abasq-Thomas
- Department of Dermatology, University Hospital, Brest, France
| | - M Greco
- Dermatologist, Brest, France.,Department of Dermatology, University Hospital, Brest, France
| | | | | | | | | | - L Misery
- Department of Dermatology, University Hospital, Brest, France
| | - G Le Gal
- INSERM CIC 1412, Université de Brest, Brest, France
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132
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Glaser DA, Pariser DM, Hebert AA, Landells I, Somogyi C, Weng E, Brin MF, Beddingfield F. A Prospective, Nonrandomized, Open-Label Study of the Efficacy and Safety of OnabotulinumtoxinA in Adolescents with Primary Axillary Hyperhidrosis. Pediatr Dermatol 2015; 32:609-17. [PMID: 26059781 PMCID: PMC4744704 DOI: 10.1111/pde.12620] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To evaluate the efficacy and safety of onabotulinumtoxinA in adolescents with primary axillary hyperhidrosis. METHODS This 52-week, multicenter, nonrandomized, open-label study was conducted in 141 adolescents ages 12 to 17 years with severe primary axillary hyperhidrosis. Patients could receive up to six treatments with onabotulinumtoxinA (50 U per axilla), with re-treatment occurring no sooner than 8 weeks after the prior treatment cycle and no later than 44 weeks after the initial treatment cycle. The primary efficacy measure was treatment response, based on self-assessed hyperhidrosis severity following the first two treatments using the 4-point Hyperhidrosis Disease Severity Scale (HDSS). Other efficacy measures included spontaneous resting sweat production and health outcomes. RESULTS Fifty-six (38.9%) participants underwent one treatment, 59 (41.0%) underwent two, 20 (13.9%) underwent three, 6 (4.2%) underwent four, and 3 (2.1%) underwent five. OnabotulinumtoxinA significantly improved HDSS scores and decreased sweat production compared with treatment cycle baselines. Seventy-nine patients (54.9%) responded to treatment based on HDSS criteria. From 56.6% to 72.3% of patients experienced a two-grade or more improvement at 4 and 8 weeks after each of the first two treatments. The majority (79.4%-93.2%) had a 75% or greater reduction in sweat production at week 4 (treatments 1-3). The median duration of effect for responders ranged from 134 to 152 days. Using quality of life measures, health outcomes improved markedly. Eight patients (5.6%) had mild or moderate treatment-related adverse events. No unexpected safety signals were observed in this study. Neutralizing antibodies to onabotulinumtoxinA did not develop. CONCLUSION OnabotulinumtoxinA injections provided beneficial effects in adolescents with primary axillary hyperhidrosis.
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Affiliation(s)
- Dee Anna Glaser
- Department of Dermatology, Saint Louis University, St. Louis, Missouri
| | - David M Pariser
- Department of Dermatology, Eastern Virginia Medical School, Norfolk, Virginia.,Virginia Clinical Research, Inc., Norfolk, Virginia
| | - Adelaide A Hebert
- Department of Dermatology, University of Texas-Houston Medical School, Houston, Texas
| | - Ian Landells
- Memorial University of Newfoundland, St. John's, Newfoundland, Canada
| | | | | | - Mitchell F Brin
- Allergan, Inc., Irvine, California.,Department of Neurology, University of California at Irvine, Irvine, California
| | - Frederick Beddingfield
- Allergan, Inc., Irvine, California.,Division of Dermatology, Department of Medicine, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, California
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133
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Brehmer F, Lockmann A, Grönemeyer LL, Kretschmer L, Schön MP, Thoms KM. Wiederholte Injektionen von Botulinumtoxin Typ A steigern kontinuierlich die Wirkdauer bei primärer axillärer Hyperhidrose: Eine retrospektive Analyse von 101 Patienten. J Dtsch Dermatol Ges 2015. [DOI: 10.1111/ddg.50_12623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Franziska Brehmer
- Klinik für Dermatologie, Venerologie und Allergologie; Universitätsmedizin Göttingen; Göttingen Deutschland
| | - Anike Lockmann
- Klinik für Dermatologie, Venerologie und Allergologie; Universitätsmedizin Göttingen; Göttingen Deutschland
| | - Lisa-Lena Grönemeyer
- Klinik für Dermatologie, Venerologie und Allergologie; Universitätsmedizin Göttingen; Göttingen Deutschland
| | - Lutz Kretschmer
- Klinik für Dermatologie, Venerologie und Allergologie; Universitätsmedizin Göttingen; Göttingen Deutschland
| | - Michael P. Schön
- Klinik für Dermatologie, Venerologie und Allergologie; Universitätsmedizin Göttingen; Göttingen Deutschland
| | - Kai-Martin Thoms
- Klinik für Dermatologie, Venerologie und Allergologie; Universitätsmedizin Göttingen; Göttingen Deutschland
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134
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Swary JH, West DP, Kakar R, Ortiz S, Schaeffer MR, Veledar E, Alam M. Quantitative comparison of topical aluminum salt solution efficacy for management of sweating: a randomized, controlled trial. J Cosmet Dermatol 2015. [DOI: 10.1111/jocd.12168] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Jillian H Swary
- Department of Dermatology; Feinberg School of Medicine; Northwestern University; Chicago IL USA
| | - Dennis P West
- Department of Dermatology; Feinberg School of Medicine; Northwestern University; Chicago IL USA
| | - Rohit Kakar
- Department of Dermatology; University of Oklahoma; Norman OK USA
| | - Sara Ortiz
- Department of Dermatology; Feinberg School of Medicine; Northwestern University; Chicago IL USA
| | - Matthew R Schaeffer
- Department of Dermatology; Feinberg School of Medicine; Northwestern University; Chicago IL USA
| | - Emir Veledar
- Emory University School of Medicine; Atlanta GA USA
- Baptist Health South Florida; Miami FL USA
| | - Murad Alam
- Department of Dermatology; Feinberg School of Medicine; Northwestern University; Chicago IL USA
- Department of Otolaryngology-Head and Neck Surgery; Feinberg School of Medicine; Northwestern University; Chicago IL USA
- Department of Surgery; Feinberg School of Medicine; Northwestern University; Chicago IL USA
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135
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Brehmer F, Lockmann A, Grönemeyer LL, Kretschmer L, Schön MP, Thoms KM. Repetitive injections of botulinum toxin A continuously increase the duration of efficacy in primary axillary hyperhidrosis: a retrospective analysis in 101 patients. J Dtsch Dermatol Ges 2015; 13:799-805. [PMID: 26176740 DOI: 10.1111/ddg.12623] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND OBJECTIVES Botulinum toxin type A is an effective, well-tolerated, albeit temporary treatment for primary axillary hyperhidrosis. However, little is known about the influence of repetitive injections on the duration of efficacy. PATIENTS AND METHODS 139 patients with primary axillary hyperhidrosis were injected with 50 units of botulinum toxin per axilla. In 101 patients, who received at least three treatments, the duration of efficacy after the first, second, and last treatment was evaluated. RESULTS The median duration of efficacy was 4.0 months, 4.5 months, and 5.0 months after the first, second, and last injection, respectively. Overall, the duration of efficacy was significantly longer after the last injection compared to the duration of efficacy after the first injection (p = 0.0055, Wilcoxon matched-pairs signed-rank test). Likewise, the difference between the first and second injection (p = 0.0302) as well as the difference between the second and the last injection (p = 0.0381) were significant. In 25.7 % of patients, the duration of efficacy remained unchanged over the entire treatment period. CONCLUSIONS Repetitive botulinum toxin treatments led to a significantly increased duration of efficacy in axillary hyperhidrosis. While the average duration of efficacy continued to increase with each treatment, there were considerable interindividual differences.
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Affiliation(s)
- Franziska Brehmer
- Department of Dermatology, Venereology and Allergology, University Medical Center Göttingen, Göttingen, Germany
| | - Anike Lockmann
- Department of Dermatology, Venereology and Allergology, University Medical Center Göttingen, Göttingen, Germany
| | - Lisa-Lena Grönemeyer
- Department of Dermatology, Venereology and Allergology, University Medical Center Göttingen, Göttingen, Germany
| | - Lutz Kretschmer
- Department of Dermatology, Venereology and Allergology, University Medical Center Göttingen, Göttingen, Germany
| | - Michael P Schön
- Department of Dermatology, Venereology and Allergology, University Medical Center Göttingen, Göttingen, Germany
| | - Kai-Martin Thoms
- Department of Dermatology, Venereology and Allergology, University Medical Center Göttingen, Göttingen, Germany
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136
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Hyperhidrosis in children and review of its current evidence-based management. ANNALS OF PEDIATRIC SURGERY 2015. [DOI: 10.1097/01.xps.0000469364.71629.96] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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137
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Liu Y, Li H, Zheng X, Li X, Li J, Jiang G, Wang J. Sympathicotomy for palmar hyperhidrosis: the association between intraoperative palm temperature change and the curative effect. Ann Thorac Cardiovasc Surg 2015; 21:359-63. [PMID: 26041256 DOI: 10.5761/atcs.oa.14-00270] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
PURPOSE To investigate the association between intraoperative palm temperature change and the curative effect of sympathicotomy. METHODS 49 patients with palmar hyperhidrosis were treated with bilateral endoscopic sympathicotomy. Ipsilateral palm temperature was monitored before and at 3-5 min increments after the sympathetic trunk was transected. The maximum temperature elevation (Tmax) was calculated and used to evaluate the effect on postoperative cure rates. RESULTS Forty-nine patients underwent 98 sympathicotomies. There were 77 T4 sympathicotomies, 15 T4 + T5 sympathicotomies, and six T3 sympathicotomies due to pleural adhesions or neurovascular proximity. The Tmax was ≤1°C in 49 (50.0%), 1-1.5°C in 17 (17.3%), and >1.5°C in 32 (32.7%) palms. Ninety-two palms of 46 patients were followed with complete efficacy, and three patients were lost to follow up. Cure was achieved in 86 palms (93.4%). Of the 71 palms which underwent T4 sympathicotomy, cure was achieved in 67 palms (94.3%). In those palms which did not achieve cure, the Tmax was less than 1°C in each case, while in palms with a Tmax ≤1°C, 32 of 36 (88.9%) were cured. CONCLUSION There is an association between intraoperative palmar temperature change and curative effect. However, palmar temperature change cannot be used to predict cure or guide surgical approach.
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Affiliation(s)
- Yanguo Liu
- Department of Thoracic Surgery, Center of Thoracic Mini-invasive Surgery, Peking University People's Hospital, Beijing, 100044, China
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138
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Rezende RMD, Luz FB. Surgical treatment of axillary hyperhidrosis by suction-curettage of sweat glands. An Bras Dermatol 2015; 89:940-54. [PMID: 25387499 PMCID: PMC4230663 DOI: 10.1590/abd1806-4841.20142873] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2013] [Accepted: 09/05/2013] [Indexed: 11/22/2022] Open
Abstract
UNLABELLED Suction curettage is a dermatologic surgery technique for the treatment of axillary hyperhidrosis, which is becoming more popular. OBJECTIVE The purpose of this study is to describe the current technique of removal of axillary sweat glands, and evaluate its efficacy and safety. CONCLUSION Suction-curettage of sweat glands is a minimally invasive surgical technique that is easy to perform, safe, has high rates of success and relatively few side-effects. It is generally well tolerated by patients and requires shorter time away from daily activities, when compared with other surgical modalities.
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139
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Feldmeyer L, Bogdan I, Moser A, Specker R, Kamarashev J, French L, Läuchli S. Short- and long-term efficacy and mechanism of action of tumescent suction curettage for axillary hyperhidrosis. J Eur Acad Dermatol Venereol 2015; 29:1933-7. [DOI: 10.1111/jdv.13078] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2014] [Accepted: 01/27/2015] [Indexed: 11/26/2022]
Affiliation(s)
- L. Feldmeyer
- Department of Dermatology; University Hospital Zurich; Zurich Switzerland
| | - I. Bogdan
- Department of Dermatology; University Hospital Zurich; Zurich Switzerland
| | - A. Moser
- Department of Dermatology; University Hospital Zurich; Zurich Switzerland
| | - R. Specker
- Department of Dermatology; University Hospital Zurich; Zurich Switzerland
| | - J. Kamarashev
- Department of Dermatology; University Hospital Zurich; Zurich Switzerland
| | - L.E. French
- Department of Dermatology; University Hospital Zurich; Zurich Switzerland
| | - S. Läuchli
- Department of Dermatology; University Hospital Zurich; Zurich Switzerland
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140
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Kouris A, Armyra K, Stefanaki C, Christodoulou C, Karimali P, Kontochristopoulos G. Quality of life and social isolation in Greek adolescents with primary focal hyperhidrosis treated with botulinum toxin type A: a case series. Pediatr Dermatol 2015; 32:226-30. [PMID: 25557249 DOI: 10.1111/pde.12480] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Primary hyperhidrosis, although extensively documented in adults, typically has onset that dates back to early childhood. It is an unpleasant and socially disabling problem for the affected child, but little attention has been paid to the disease in adolescents. The objective of the current study was to evaluate the effectiveness of botulinum toxin type A (BTXA) in adolescents with primary palmar and axillary hyperhidrosis and to determine its effect on quality of life and social isolation. Thirty-five individuals (17 girls, 18 boys) with moderate to severe palmar and axillary hyperhidrosis were treated with BTXA (onabotulinum). Patients were examined at baseline and 6 months after treatment. The Hyperhidrosis Disease Severity Scale (HDSS) was used to evaluate disease severity and the Children's Dermatology Life Quality Index (CDLQI) was used to assess quality of life. The University of California at Los Angeles loneliness scale (UCLA version 3) was used to assess personal perception of loneliness and social isolation. The median age of the participants was 14 years, and 48.6% were female. Twenty-one had palmar hyperhidrosis, and 14 had axillary hyperhidrosis. Total CDLQI and social isolation scores decreased significantly after treatment with BTXA (both p < 0.001). There was a significant difference between pre- and post-treatment levels of severity of hyperhidrosis. No statistically significant difference was documented for CDLQI and UCLA scores between boys and girls. Treatment of hyperhidrosis with BTXA resulted in improvement in quality of life, social skills, and activities.
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Affiliation(s)
- Anargyros Kouris
- Department of Dermatology and Venereology, Andreas Sygros Hospital, Athens, Greece
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141
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Chen J, Lin M, Chen X, Cao Z, Tan Z, Xiong W, Tu Y, Yang J. A novel locus for primary focal hyperhidrosis mapped on chromosome 2q31.1. Br J Dermatol 2015; 172:1150-3. [PMID: 25195950 DOI: 10.1111/bjd.13383] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- J. Chen
- Department of Thoracic Surgery; The First Affiliated Hospital; Fujian Medical University; Fuzhou Fujian China
| | - M. Lin
- Department of Thoracic Surgery; The First Affiliated Hospital; Fujian Medical University; Fuzhou Fujian China
| | - X. Chen
- Biomedical Engineering Center; Fujian Medical University; Fuzhou Fujian China
| | - Z. Cao
- Department of Genetics; National Research Institute for Family Planning; Beijing China
| | - Z. Tan
- Biomedical Engineering Center; Fujian Medical University; Fuzhou Fujian China
| | - W. Xiong
- Hunan Cancer Hospital and the Affiliated Cancer Hospital of Xiangya School of Medicine; Central South University; Changsha Hunan China
| | - Y. Tu
- Department of Thoracic Surgery; The First Affiliated Hospital; Fujian Medical University; Fuzhou Fujian China
| | - J. Yang
- Biomedical Engineering Center; Fujian Medical University; Fuzhou Fujian China
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142
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Thorlacius L, Gyldenløve M, Zachariae C, Carlsen BC. Distinguishing hyperhidrosis and normal physiological sweat production: new data and review of hyperhidrosis data for 1980-2013. Int J Dermatol 2015; 54:e409-15. [PMID: 25599582 DOI: 10.1111/ijd.12822] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2014] [Revised: 06/25/2014] [Accepted: 07/22/2014] [Indexed: 11/30/2022]
Abstract
BACKGROUND Hyperhidrosis is a condition in which the production of sweat is abnormally increased. No objective criteria for the diagnosis of hyperhidrosis exist, mainly because reference intervals for normal physiological sweat production at rest are unknown. OBJECTIVE The main objective of this study was to establish reference intervals for normal physiological axillary and palmar sweat production. METHODS Gravimetric testing was performed in 75 healthy control subjects. Subsequently, these results were compared with findings in a cohort of patients with hyperhidrosis and with the results derived from a review of data on hyperhidrosis published between 1980 and 2013. RESULTS Approximately 90% of the controls had axillary and palmar sweat production rates of below 100 mg/5 min. In all except one of the axillary and palmar hyperhidrosis studies reviewed, average sweat production exceeded 100 mg/5 min. CONCLUSIONS A sweat production rate of 100 mg/5 min as measured by gravimetric testing may be a reasonable cut-off value for distinguishing axillary and palmar hyperhidrosis from normal physiological sweat production.
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Affiliation(s)
- Linnea Thorlacius
- Department of Dermato-Allergology, Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Mette Gyldenløve
- Department of Dermato-Allergology, Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Claus Zachariae
- Department of Dermato-Allergology, Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Berit C Carlsen
- Department of Dermato-Allergology, Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
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143
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Rieger R, Pedevilla S, Lausecker J. Quality of Life After Endoscopic Lumbar Sympathectomy for Primary Plantar Hyperhidrosis. World J Surg 2014; 39:905-11. [DOI: 10.1007/s00268-014-2885-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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144
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Lai FC, Tu YR, Li YP, Li X, Lin M, Chen JF, Lin JB. Nation wide epidemiological survey of primary palmar hyperhidrosis in the People’s Republic of China. Clin Auton Res 2014; 25:105-8. [DOI: 10.1007/s10286-014-0259-5] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2014] [Accepted: 10/21/2014] [Indexed: 10/24/2022]
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145
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Abstract
Primary hyperhidrosis (HH), a condition of sweating in excess of thermoregulatory requirements, affects nearly 3% of the US population and carries significant emotional and psychosocial implications. Unlike secondary HH, primary HH is not associated with an identifiable underlying pathology. Our limited understanding of the precise pathophysiologic mechanism for HH makes its treatment particularly frustrating. However, a wide array of interventions for the treatment of HH have been implemented throughout the world. Herein, we discuss the most extensively studied therapeutic options for primary HH, including systemic oxybutynin, botulinum toxin injections, skin excision, liposuction–curettage, and sympathotomy/sympathectomy. We conclude with a discussion of possible future therapies for HH, including the applications of laser, microwave, and ultrasound technologies.
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Affiliation(s)
- Anna-Bianca Stashak
- Internal Medicine Residency Program, Loma Linda University Medical Center, Loma Linda, CA, USA
| | - Jerry D Brewer
- Division of Dermatologic Surgery, Department of Dermatology, Mayo Clinic, Rochester, MN, USA
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146
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147
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148
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Weinberg T, Solish N, Murray C. Botulinum Neurotoxin Treatment of Palmar and Plantar Hyperhidrosis. Dermatol Clin 2014; 32:505-15. [DOI: 10.1016/j.det.2014.06.012] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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149
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Yaghobi Z, Goljarian S, Oskouei AE. Comparison of tap water and normal saline iontophoresis in idiopathic hyperhidrosis: a case report. J Phys Ther Sci 2014; 26:1313-5. [PMID: 25202204 PMCID: PMC4155243 DOI: 10.1589/jpts.26.1313] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2014] [Accepted: 02/22/2014] [Indexed: 11/24/2022] Open
Abstract
[Purpose] The purpose of this study was to evaluate the efficacy of tap water (drinking
water) and normal saline (sodium chloride solution 0.9%) iontophoresis treatment for a
patient with idiopathic hyperhidrosis [Subjects and Methods] In this study, tap water and
normal saline iontophoresis were used to treat a 21 year-old female who was suffering from
severe palmoplantar idiopathic hyperhidrosis. Post-iontophoresis sweat intensity of 8
treatment sessions were averaged and then normalized relative to the corresponding mean
value which was obtained before iontophoresis treatment. [Results] The subject showed
24.72% and 42.01% decreases in sweat intensity following tap water and normal saline
iontophoresis, respectively. [Conclusion] Tap water and normal saline iontophoresis are
effective in the treatment of idiopathic hyperhidrosis. However, normal saline
iontophoresis is 1.7 times more effective than tapwater iontophoresis at obstructing
secretion.
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Affiliation(s)
- Zahra Yaghobi
- Department of Physiotherapy, Faculty of Rehabilitation, Iran University of Medical Sciences, Iran
| | - Sakineh Goljarian
- Department of Physiotherapy, Faculty of Rehabilitation, Tabriz University of Medical Sciences, Iran
| | - Ali E Oskouei
- Physical Medicine and Rehabilitation Research Center, Department of Physiotherapy, Faculty of Rehabilitation, Tabriz University of Medical Sciences, Iran
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150
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Expanded level of sympathetic chain removal does not increase the incidence or severity of compensatory hyperhidrosis after endoscopic thoracic sympathectomy. J Thorac Cardiovasc Surg 2014; 148:2673-6. [PMID: 25131173 DOI: 10.1016/j.jtcvs.2014.06.080] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2013] [Revised: 03/03/2014] [Accepted: 06/12/2014] [Indexed: 11/20/2022]
Abstract
OBJECTIVE Compensatory hyperhidrosis is a common devastating adverse effect after endoscopic thoracic sympathectomy for patients undergoing surgical treatment of primary hyperhidrosis. We sought to determine whether a correlation existed in our patient population between the level and extent of sympathetic chain resection and the subsequent development of compensatory hyperhidrosis. METHODS All patients undergoing endoscopic thoracic sympathectomy in the T2-T3, T2-T4, T2-T5, or T2-T6 levels for palmar or axillary hyperhidrosis at the University of Iowa Hospital and Clinics (n = 97) from January 2004 to January 2013 were retrospectively reviewed. RESULTS Differences in the preoperative patient characteristics were not statistically significant among the patients receiving T2-T3, T2-T4, T2-T5, or T2-T6 level resections. Of the 97 included patients, 28 (29%) experienced transient compensatory hyperhidrosis and 4 (4%) complained of severe compensatory hyperhidrosis and required additional treatment. No operative mortalities occurred, and the morbidity was similar among the groups. CONCLUSIONS Most patients had successful outcomes after undergoing extensive resection without changes in the incidence of compensatory hyperhidrosis. Therefore, we recommend performing complete and adequate resection for relief of symptoms in patients with primary hyperhidrosis.
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