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Lima SO, Neto JM, Fontes LM, Galrão de Almeida Figueiredo MB, Santos JM, Santana VR. Evaluation of quality of life (QOL) of young patients with primary hyperhidrosis (PH) before and after endoscopic thoracic sympathectomy (ETS). J Am Acad Dermatol 2023; 88:e197-e201. [PMID: 37069802 DOI: 10.1016/j.jaad.2015.10.048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2015] [Revised: 10/23/2015] [Accepted: 10/30/2015] [Indexed: 04/19/2023]
Abstract
BACKGROUND Primary hyperhidrosis (PH) affects young patients and may cause emotional distress and a negative quality of life (QOL). OBJECTIVE We sought to evaluate the QOL of children and adolescents with PH treated by endoscopic thoracic sympathectomy. METHODS A study of 220 patients was performed, based on submitted QOL questionnaires from their first consultation. Patients were evaluated within 1 week and 24 months after surgery. RESULTS Before endoscopic thoracic sympathectomy, the QOL in relation to PH was declared very poor by 141 patients, and poor by the remaining 79 (P = .552). Postoperative cure was reported in 100% of palmar and axillary PH cases, and in 91.7% of facial PH. After 24 months, the QOL was described as much better by 212 patients, a little better by 6 patients, and 2 patients reported no change. LIMITATIONS Convenience sampling was used and patients were taken from private practice only, raising the possibility of bias in gathering the data. CONCLUSION Onset of PH symptoms was mainly before the age of 10 years and substantially affected daily activities. Endoscopic thoracic sympathectomy cured PH and promoted significant improvement in the QOL of these young patients.
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Carvalho C, Marinho AS, Barbosa-Sequeira J, Correia MR, Banquart-Leitão J, Carvalho F. Compensatory sweating after thoracoscopic sympathectomy for primary focal hyperhidrosis in children: Are there patient-related risk factors? J Pediatr Surg 2022; 57:203-206. [PMID: 34815104 DOI: 10.1016/j.jpedsurg.2021.10.036] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2021] [Accepted: 10/23/2021] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Compensatory sweating (CS) is a common complication after thoracoscopic sympathectomy (TS) and is mainly associated with surgical technique. Our aim was to identify potential risk-factors for CS following TS for primary focal hyperhidrosis in children. METHODS A retrospective, single-center review of all bilateral TS was performed between 2017 and 2019. Hyperhidrosis disease severity scale was used for pre-operative severity assessment. Post-operative evaluations were performed after three and six months. RESULTS More than the 36-month period, 41 patients were submitted to T2-T4 TS, and 25 were females (60.9%). Median age at surgery was 15.5 years. CS was identified at the 3rd month in 17 (41%) children with most in the dorsolumbar region (56%). By the 6th month, there was a significant reduction in CS (41 to 32%, p = 0.02). The probability of resolution of CS by 6 months is about 50% in both the dorsolumbar and abdominal regions. Neither age, gender, body mass index, family history, or concomitant illnesses seemed to influence CS (p > 0.05). Axillary hyperhidrosis appears to be associated with the development of dorsolumbar CS (p = 0.037). CONCLUSION Thoracoscopic sympathectomy for PFH is a safe and effective procedure, but compensatory sweating can be a common and debilitating side effect. Age, gender, and body mass index do not appear to influence CS. Axillary hyperhidrosis may be related to the development of dorsolumbar CS. LEVEL OF EVIDENCE III.
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Affiliation(s)
- Catarina Carvalho
- Department of Pediatric Surgery, Centro Hospitalar Universitário do Porto, Rua da Maternidade, Porto 4050-371, Portugal.
| | - Ana Sofia Marinho
- Department of Pediatric Surgery, Centro Hospitalar Universitário do Porto, Rua da Maternidade, Porto 4050-371, Portugal
| | - Joana Barbosa-Sequeira
- Department of Pediatric Surgery, Centro Hospitalar Universitário do Porto, Rua da Maternidade, Porto 4050-371, Portugal
| | - Mário Rui Correia
- Department of Pediatric Surgery, Centro Hospitalar Universitário do Porto, Rua da Maternidade, Porto 4050-371, Portugal
| | - José Banquart-Leitão
- Department of Pediatric Surgery, Centro Hospitalar Universitário do Porto, Rua da Maternidade, Porto 4050-371, Portugal
| | - Fátima Carvalho
- Department of Pediatric Surgery, Centro Hospitalar Universitário do Porto, Rua da Maternidade, Porto 4050-371, Portugal
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Vasconcelos-Castro S, Borges-Dias M, Soares-Oliveira M. Thoracoscopic sympathicotomy in children for the treatment of palmar and axillary primary focal hyperhidrosis: Caution advocated. J Pediatr Surg 2020; 55:2849. [PMID: 32981661 DOI: 10.1016/j.jpedsurg.2020.08.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Accepted: 08/27/2020] [Indexed: 10/23/2022]
Affiliation(s)
| | - Mariana Borges-Dias
- Department of Pediatric Surgery, Centro Hospitalar Universitário São João, Porto, Portugal
| | - Miguel Soares-Oliveira
- Department of Pediatric Surgery, Centro Hospitalar Universitário São João, Porto, Portugal
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Vasconcelos-Castro S, Soares-Oliveira M, Tuna T, Borges-Dias M. Thoracoscopic sympathotomy for palmar hyperhidrosis: How young is too young? J Pediatr Surg 2020; 55:2362-2365. [PMID: 31870560 DOI: 10.1016/j.jpedsurg.2019.11.024] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Revised: 11/15/2019] [Accepted: 11/22/2019] [Indexed: 10/25/2022]
Abstract
BACKGROUND/PURPOSE Primary hyperhidrosis affects 1%-3% of the general population, with increased incidence in teenagers, having an important impact in the quality of life. This study evaluates the efficacy and patients' satisfaction after bilateral thoracoscopic sympathotomy. METHODS Retrospective analysis of pediatric patients with palmar primary hyperhidrosis that underwent bilateral thoracoscopic sympathotomy over the last eight years. The procedure was performed with 2 ports and simple transection of the sympathetic chain. Pre and postoperative sweating severity was evaluated by telephone interview, using the Hyperhidrosis Disease Severity Scale (HDSS). RESULTS 23 patients (19 girls; 15.5 [11-19] years-old) underwent bilateral thoracoscopic sympathotomy. All complained of palmar hyperhidrosis, which resolved in all cases. Compensatory sweating occurred in 47.8% of patients. 21 patients answered the telephone interview: all of them would recommend the surgery to others. Sweating severity improved in all patients, with a mean decrease of 1.95 values of the HDSS from preoperative to postoperative evaluation (p < 0.05). There was neither morbidity nor mortality. CONCLUSIONS Bilateral thoracoscopic sympathotomy is a safe and effective treatment for primary palmar hyperhidrosis. Being the first report on pediatric application of HDSS, we conclude that children are very satisfied with the final outcome. TYPE OF STUDY Treatment study. LEVEL OF EVIDENCE Level III.
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Affiliation(s)
| | - Miguel Soares-Oliveira
- Department of Pediatric Surgery, Centro Hospitalar Universitário São João, Porto, Portugal
| | - Tiago Tuna
- Department of Pediatric Surgery, Centro Hospitalar Universitário São João, Porto, Portugal
| | - Mariana Borges-Dias
- Department of Pediatric Surgery, Centro Hospitalar Universitário São João, Porto, Portugal
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Trettin B, Hansen J, Bygum A. The impact of adolescents' everyday life experiences on their primary hyperhidrosis treatment - a qualitative study. J DERMATOL TREAT 2020; 33:928-934. [PMID: 32628056 DOI: 10.1080/09546634.2020.1789541] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
INTRODUCTION Hyperhidrosis is a disease affecting around 5% of the western population. The qualitative field within hyperhidrosis among adolescents has been sparsely investigated. The aim of this study was to investigate the impact of adolescent hyperhidrosis patients' everyday life experiences on their hyperhidrosis treatment. METHODS Qualitative, semi-structured interviews were carried out. In total, 10 adolescents, aged 12-18 years, participated in the study. Data were analyzed using a set of inseparable activities as described by Van Manen. RESULTS Three main themes were identified to represent common shared experiences across participants. The first theme was related to the impact of hyperhidrosis on the physical and psychological dimensions of life as it negatively affected both physical abilities and one's self-concept. Having hyperhidrosis was experienced as living a life in secrecy, characterized by individual routines for concealment and isolation in order to protect social identity. CONCLUSION The large negative impact of hyperhidrosis on adolescents is a strong justification for treatment of the disease. The substantial emotional distress suggests that treatment may need to include psychological support.
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Affiliation(s)
- Bettina Trettin
- Department of Dermatology and Allergy Centre, Odense University Hospital, Odense, Denmark.,Department of Clinical Research, University of Southern, Odense, Denmark
| | - Julie Hansen
- Department of Dermatology and Allergy Centre, Odense University Hospital, Odense, Denmark
| | - Anette Bygum
- Department of Dermatology and Allergy Centre, Odense University Hospital, Odense, Denmark.,Department of Clinical Research, University of Southern, Odense, Denmark
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Over a decade of single-center experience with thoracoscopic sympathicolysis for primary palmar hyperhidrosis: a case series. Surg Endosc 2020; 35:3313-3319. [PMID: 32642844 PMCID: PMC8195767 DOI: 10.1007/s00464-020-07769-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 06/25/2020] [Indexed: 11/01/2022]
Abstract
BACKGROUND Primary palmar hyperhidrosis is a severely debilitating condition that can affect patients of any age. We report our experience with thoracoscopic sympathicolysis in a large cohort of children less than 14 years of age. METHODS All children who underwent thoracoscopic sympathicolysis from April 2005 through January 2017 were evaluated retrospectively. The procedure entailed bilateral bipolar fulguration of the second and third thoracic ganglia with transverse disruption of collateral nerve fibers along the third and fourth rib. Demographic information, as well as postoperative outcome, complications, and satisfaction were analyzed. RESULTS Over the 12 year study interval, a total of 102 children underwent thoracoscopic sympathicolysis for palmar hyperhidrosis. Complete follow-up was available for 98 patients (median age 12 [range 5-14] years; 38 boys [39%]). Median follow-up was 4 [range 2-12] years. Complete palmar dryness was achieved in 93 (95%) cases. One patient suffered postoperative unilateral ptosis, 6 reported gustatory sweating, and 65 experienced compensatory sweating. Average postoperative rating on a 1 (lowest) to 10 (highest) rating scale was 9, with 97 (99%) patients saying that they would undergo the procedure again. CONCLUSION Our technique of thoracoscopic sympathicolysis in children was associated with very high postoperative satisfaction, despite a high rate of compensatory sweating and occasional autonomic gustatory sweating. Other more severe complications in this age group were rare.
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7
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The etiology, diagnosis, and management of hyperhidrosis: A comprehensive review. J Am Acad Dermatol 2019; 81:657-666. [DOI: 10.1016/j.jaad.2018.12.071] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2018] [Revised: 12/16/2018] [Accepted: 12/17/2018] [Indexed: 12/18/2022]
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8
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Campos JJGD, Figueiredo MBGDA, Dias ES, Ferrari YAC, Leão SC, Andrade RLBD, Araujo NM, Almeida MTBD, Lima MMP, Lima SO. Impact of primary hyperhidrosis on the life of physical education academics of a university in the Brazilian Northeast. MOTRIZ: REVISTA DE EDUCACAO FISICA 2019. [DOI: 10.1590/s1980-6574201900020006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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9
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Bessis D, Morice-Picard F, Bourrat E, Abadie C, Aouinti S, Baumann C, Best M, Bursztejn AC, Capri Y, Chiaverini C, Coubes C, Giuliano F, Hadj-Rabia S, Jacquemont ML, Lacombe D, Lyonnet S, Mallet S, Mazereeuw-Hautier J, Miquel J, Molinari N, Parfait B, Pernet C, Philip N, Pinson L, Pouvreau N, Vial Y, Sarda P, Sigaudy S, Verloes A, Cavé H, Geneviève D. Dermatological manifestations in cardiofaciocutaneous syndrome: a prospective multicentric study of 45 mutation-positive patients. Br J Dermatol 2018; 180:172-180. [PMID: 30141192 DOI: 10.1111/bjd.17077] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/22/2018] [Indexed: 12/25/2022]
Abstract
BACKGROUND Data on dermatological manifestations of cardiofaciocutaneous syndrome (CFCS) remain heterogeneous and almost without expert dermatological classification. OBJECTIVES To describe the dermatological manifestations of CFCS; to compare them with the literature findings; to assess those discriminating CFCS from other RASopathies, including Noonan syndrome (NS) and Costello syndrome (CS); and to test for dermatological phenotype-genotype correlations. METHODS We performed a 4-year, large, prospective, multicentric, collaborative dermatological and genetic study. RESULTS Forty-five patients were enrolled. Hair abnormalities were ubiquitous, including scarcity or absence of eyebrows and wavy or curly hair in 73% and 69% of patients, respectively. Keratosis pilaris (KP), ulerythema ophryogenes (UO), palmoplantar hyperkeratosis (PPHK) and multiple melanocytic naevi (MMN; over 50 naevi) were noted in 82%, 44%, 27% and 29% of patients, respectively. Scarcity or absence of eyebrows, association of UO and PPHK, diffuse KP and MMN best differentiated CFCS from NS and CS. Oral acitretin may be highly beneficial for therapeutic management of PPHK, whereas treatment of UO by topical sirolimus 1% failed. No significant dermatological phenotype-genotype correlation was determined. CONCLUSIONS A thorough knowledge of CFCS skin manifestations would help in making a positive diagnosis and differentiating CFCS from CS and NS.
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Affiliation(s)
- D Bessis
- Department of Dermatology, Saint-Eloi Hospital, University of Montpellier, Montpellier, France.,INSERM U1058, Montpellier, France
| | - F Morice-Picard
- Department of Pediatric Dermatology, Pellegrin University Hospital of Bordeaux, Bordeaux, AP-HP, France
| | - E Bourrat
- Department of Pediatric Dermatology, Robert-Debré Hospital, AP-HP, Paris, France
| | - C Abadie
- Department of Clinical Genetics, Sud Hospital and University Hospital of Rennes, Rennes, France
| | - S Aouinti
- Department of Statistics, La Colombière Hospital and University of Montpellier, Montpellier, France
| | - C Baumann
- Department of Clinical Genetics, Robert-Debré Hospital, AP-HP and University of Paris-Diderot, Paris, France
| | - M Best
- Department of Dermatology, Saint-Eloi Hospital, University of Montpellier, Montpellier, France
| | - A-C Bursztejn
- Department of Dermatology, Brabois Hospital, University of Nancy, Nancy, France
| | - Y Capri
- Department of Clinical Genetics, Robert-Debré Hospital, AP-HP and University of Paris-Diderot, Paris, France
| | - C Chiaverini
- Department of Dermatology, L'Archet 2 Hospital and University of Nice, Nice, France
| | - C Coubes
- Department of Clinical Genetics, Arnaud de Villeneuve Hospital, University of Montpellier, Montpellier, France
| | - F Giuliano
- Department of Clinical Genetics, L'Archet 2 Hospital and University of Nice, Nice, France
| | - S Hadj-Rabia
- Department of Pediatric Dermatology, Necker-Enfants Malades Hospital, AP-HP, Paris, France
| | - M-L Jacquemont
- Department of Clinical Genetics, Femme-Mère-Enfant Hospital, University of South Reunion, Saint-Pierre, Réunion, France
| | - D Lacombe
- Department of Clinical Genetics, Pellegrin University Hospital of Bordeaux, Bordeaux, AP-HP, France
| | - S Lyonnet
- Department of Clinical Genetics, Necker-Enfants Malades Hospital, AP-HP, Paris, France
| | - S Mallet
- Department of Dermatology, La Timone Hospital, AP-HM and University of Marseille, Marseille, France
| | - J Mazereeuw-Hautier
- Department of Dermatology, Larrey Hospital, Reference Center for Rare Skin Diseases, University of Toulouse, Toulouse, France
| | - J Miquel
- Department of Pediatric Dermatology, Femme-Mère-Enfant Hospital, University of South Reunion, Saint-Pierre, Réunion, France.,Department of Dermatology, University of Rennes, Rennes, France
| | - N Molinari
- Department of Statistics, La Colombière Hospital and University of Montpellier, Montpellier, France
| | - B Parfait
- Department of Molecular Genetics and Biology, Cochin Hospital, AP-HP, University Paris V, Paris, France
| | - C Pernet
- Department of Dermatology, Saint-Eloi Hospital, University of Montpellier, Montpellier, France
| | - N Philip
- Department of Clinical Genetics, La Timone Hospital, AP-HM and University of Marseille, Marseille, France
| | - L Pinson
- Department of Clinical Genetics, Arnaud de Villeneuve Hospital, University of Montpellier, Montpellier, France
| | - N Pouvreau
- Department of Genetic Biochemistry, Robert-Debré Hospital, AP-HP and University of Paris-Diderot, Paris, France
| | - Y Vial
- Department of Genetic Biochemistry, Robert-Debré Hospital, AP-HP and University of Paris-Diderot, Paris, France
| | - P Sarda
- Department of Clinical Genetics, Arnaud de Villeneuve Hospital, University of Montpellier, Montpellier, France
| | - S Sigaudy
- Department of Clinical Genetics, La Timone Hospital, AP-HM and University of Marseille, Marseille, France
| | - A Verloes
- Department of Clinical Genetics, Robert-Debré Hospital, AP-HP and University of Paris-Diderot, Paris, France
| | - H Cavé
- Department of Genetic Biochemistry, Robert-Debré Hospital, AP-HP and University of Paris-Diderot, Paris, France
| | - D Geneviève
- Department of Clinical Genetics, Arnaud de Villeneuve Hospital, University of Montpellier, Montpellier, France.,INSERM U1183, Montpellier, France
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Muthusamy A, Gajendran R, Ponnan S, Thangavel D, Rangan V. A Study on the Impact of Hyperhidrosis on the Quality of Life among College Students. J Clin Diagn Res 2016; 10:CC08-10. [PMID: 27504282 DOI: 10.7860/jcdr/2016/19495.8061] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2016] [Accepted: 04/30/2016] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Hyperhidrosis (HH) is a condition characterized by excessive sweating or perspiration. General population, especially in developing countries like India are seldom aware of this condition and sparsely seek medical attention. The tropical climate and the environment also influence this condition to a greater extent. This can be a hindrance in their professional and social life. Though, it is a widely explored topic, studies on hyperhidrosis from India are rare. AIM The current study was aimed at estimating the prevalence of hyperhidrosis among college students subjectively and to assess the quality of life using Dermatology Life Quality Index (DLQI). MATERIALS AND METHODS Five hundred students with age ranging from 17 to 21 years of both genders were included in this study using convenient sampling method. After explaining the study and getting written consent, the students were requested to respond to two questionnaires, one for the subjective diagnosis of hyperhidrosis using a standardized questionnaire developed by North Jersey Thoracic Surgical Associates and the other to assess the quality of life using DLQI. Based on the subjective prevalence scores, the students were divided into 3 groups as "Not bothersome" group, "Somewhat bothersome group" and "Extremely bothersome" group. The DLQI scores of these three groups were compared by ANOVA using SPSS 21.0. RESULTS The study revealed that overall, 38% of the students were suffering from somewhat bothersome to extremely bothersome hyperhidrosis. Gender analysis showed that male students were affected more (58%), especially with palmar hyperhidrosis and were significantly requiring treatment when compared to female students. Analysis of DLQI scores using ANOVA revealed the fact that overall quality of life was significantly affected in almost 35% of students to the extent that they require appropriate treatment and care. CONCLUSION This study brings into light the higher prevalence of hyperhidrosis and also its impact on the quality of life among college students in this tropical region.
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Affiliation(s)
- Anbarasi Muthusamy
- Associate Professor, Department of Physiology, Dhanalakshmi Srinivasan Medical College and Hospital , Siruvachur, Perambalur, Tamil Nadu, India
| | - Rajkumar Gajendran
- Associate Professor, Department of Paediatrics, Dhanalakshmi Srinivasan Medical College and Hospital , Siruvachur, Perambalur, Tamil Nadu, India
| | - Sathasivam Ponnan
- Student, Chennai Medical College Hospital and Research Center , Trichy, India
| | - Dinesh Thangavel
- Assistant Professor, Department of Physiology, Dhanalakshmi Srinivasan Medical College and Hospital , Siruvachur, Perambalur, Tamil Nadu, India
| | - Venkatesan Rangan
- Assistant Professor, Department of Physiology, Dhanalakshmi Srinivasan Medical College and Hospital , Siruvachur, Perambalur, Tamil Nadu, India
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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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12
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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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13
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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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14
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15
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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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Abstract
Hyperhidrosis is a common and under-recognized disease in the pediatric population that has a significant impact on quality of life. Focal and generalized forms of hyperhidrosis exist, which can be idiopathic or secondary to underlying medical conditions or medications. Treatment is tailored to the specific patient needs, characteristics and goals. These include topical preparations, iontophoresis, botulinum toxin and anticholinergic medications.
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Affiliation(s)
- Jennifer R S Gordon
- Department of Dermatology, University of Texas Southwestern Austin, Austin, Texas
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Wolosker N, Schvartsman C, Krutman M, Campbell TPDA, Kauffman P, de Campos JRM, Puech-Leão P. Efficacy and quality of life outcomes of oxybutynin for treating palmar hyperhidrosis in children younger than 14 years old. Pediatr Dermatol 2014; 31:48-53. [PMID: 23627681 DOI: 10.1111/pde.12142] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The effects of oxybutynin for treating hyperhidrosis in children are still unknown. Therefore the aim of this study was to investigate the effects of oxybutynin on improving symptoms of hyperhidrosis and quality of life (QOL) in children with palmar hyperhidrosis (PH). Forty-five children ages 7-14 years with PH were evaluated 6 weeks after protocol treatment with oxybutynin. QOL was evaluated before and after treatment using a validated clinical questionnaire. More than 85% of the children with PH treated with oxybutynin experienced moderate or greater improvement in the level of sweating and 80% experienced improvement in QOL. Children who initially presented with very poor QOL were those who benefited most from oxybutynin therapy. Side effects occurred in 25 children (55.5%) and were mainly dry mouth. Only one patient had neurologic symptoms, which was reported as drowsiness. Oxybutynin is an effective treatment option for children with PH because it improves clinical symptoms and QOL. Further studies are required to determine the long-term outcomes of treatment with oxybutynin.
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Affiliation(s)
- Nelson Wolosker
- Division of Vascular Surgery, Hospital das Clínicas, University of São Paulo Medical School, São Paulo, Brazil; Department of Vascular Surgery, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil
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18
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Ibrahim O, Kakar R, Bolotin D, Nodzenski M, Disphanurat W, Pace N, Becker L, West DP, Poon E, Veledar E, Alam M. The comparative effectiveness of suction-curettage and onabotulinumtoxin-A injections for the treatment of primary focal axillary hyperhidrosis: A randomized control trial. J Am Acad Dermatol 2013; 69:88-95. [DOI: 10.1016/j.jaad.2013.02.013] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2012] [Revised: 02/11/2013] [Accepted: 02/21/2013] [Indexed: 11/16/2022]
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Ak M, Dincer D, Haciomeroglu B, Akarsu S, Cinar A, Lapsekili N. Temperament and character properties of primary focal hyperhidrosis patients. Health Qual Life Outcomes 2013; 11:5. [PMID: 23311945 PMCID: PMC3579690 DOI: 10.1186/1477-7525-11-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2012] [Accepted: 10/15/2012] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Primary focal hyperhidrosis is a health problem, which has negative effects on the patient's quality of life and significantly affects the patients' daily activities, social and business life. The aim of this study is to evaluate temperament and character properties of patients diagnosed with primary focal hyperhidrosis. METHODS Fifty-six primary focal hyperhidrosis (22.42 ± 7.80) and 49 control subjects (24.48 ± 5.17) participated in the study. Patients who met the diagnostic criteria for PFH were referred to psychiatry clinic where the subjects were evaluated through Structured Clinical Interview for DSM Disorders-I and Temperament and Character Inventory. RESULTS In order to examine the difference between the PFH and control group in terms of temperament and character properties, one-way Multivariate Analysis of Variance (MANOVA) was conducted. In terms of temperament properties, PFH group took significantly higher scores than control group in Fatigability and asthenia dimension. In terms of character properties, PFH group scored significantly lower than control group in Purposefulness, Resourcefulness, Self-Directedness and scored significantly higher than control group in Self-forgetfulness and Self-Transcendence. CONCLUSION Temperament and character features of PFH patients were different from healthy group and it was considered that these features were affected by many factors including genetic, biological, environmental, socio-cultural elements. During the follow-up of PFH cases, psychiatric evaluation is important and interventions, especially psychotherapeutic interventions can increase the chances of success of the dermatological treatments and can have a positive impact on the quality of life and social cohesion of chronic cases.
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Affiliation(s)
- Mehmet Ak
- Department of Psychiatry, Gulhane School of Medicine, Etlik, Ankara, 06018, Turkey.
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20
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Neves S, Uchoa PC, Wolosker N, Munia MA, Kauffman P, de Campos JRM, Puech-Leão P. Long-term comparison of video-assisted thoracic sympathectomy and clinical observation for the treatment of palmar hyperhidrosis in children younger than 14. Pediatr Dermatol 2012; 29:575-9. [PMID: 22486301 DOI: 10.1111/j.1525-1470.2012.01751.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
The results of video-assisted thoracic sympathectomy (VATS)in children are unknown. To investigate the improvement in quality of life (QOL) of a group of 45 children who did and did not undergo VATS for the treatment of palmar hyperhidrosis (PH) 4 years after the initial evaluation. Forty-five children with PH were initially evaluated. Children were divided into two groups: 30 in the VATS group and 15 in the control group. We studied the evolution of PH, negative effect of hyperhidrosis on the QOL before the treatment, and improvement in QOL after treatment. Twenty-five patients (83.4%) in the VATS group experienced great improvement in PH, and five (16.6%) experienced partial improvement; 12 (80.0%) children from the control group had some type of improvement, and three (20.0%) had partial improvement. Two (13.3%) children in the control group and 23 (76.7%) in the VATS group had great improvement in QOL. For children with PH and poor QOL, VATS is better than no treatment. It produces better results with regard to sweating and greater improvement in QOL.
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Affiliation(s)
- Samantha Neves
- Division of Vascular Surgery, Hospital das Clínicas, University of São Paulo Medical School, Sao Paulo, Brazil
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21
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The evaluation of primary idiopathic focal hyperhidrosis patients in terms of alexithymia. J Health Psychol 2012; 18:704-10. [DOI: 10.1177/1359105312454908] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
The aim of this study was to evaluate the primary focal hyperhidrosis patients in terms of alexithymia. Participants ( n = 50) diagnosed with primary focal hyperhidrosis by a dermatologist were referred to a psychiatrist and evaluated via Structured Clinical Interview for DSM-IV Axis I Disorders and Toronto Alexithymia Scale-20. The rate of alexithymia was 45.6 percent and 18.2 percent, respectively, for primary focal hyperhidrosis and control participants ( n = 44). Multivariate analysis of variance results showed that the primary focal hyperhidrosis group scored significantly higher than the control group in Difficulty Identifying Feelings and Difficulty Describing Feelings subscales, and total score. Psychotherapeutic interventions can increase the chances of dermatological treatment success and can have a positive impact on the quality of life in chronic cases.
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Paller AS, Shah PR, Silverio AM, Wagner A, Chamlin SL, Mancini AJ. Oral glycopyrrolate as second-line treatment for primary pediatric hyperhidrosis. J Am Acad Dermatol 2012; 67:918-23. [PMID: 22405644 DOI: 10.1016/j.jaad.2012.02.012] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2012] [Revised: 02/01/2012] [Accepted: 02/03/2012] [Indexed: 10/28/2022]
Abstract
BACKGROUND Primary focal hyperhidrosis not uncommonly begins during the first two decades of life, and can have a profound effect on quality of life. Few treatment options have been studied in children. OBJECTIVE We sought to evaluate the response to oral glycopyrrolate in pediatric patients. METHODS Records of pediatric patients with hyperhidrosis seen at a pediatric hospital in a 10-year period were reviewed retrospectively and, if possible, parents and patients were also interviewed. The efficacy and adverse effects of oral glycopyrrolate were assessed. RESULTS In all, 31 children took at least one dose of oral glycopyrrolate. All had daily hyperhidrosis that affected their quality of life and were resistant or intolerant of aluminum salts. The mean age of hyperhidrosis onset was 10.3 years, and mean age of initiation of glycopyrrolate was 14.8 years. At a mean dosage of 2 mg daily, 90% of patients experienced improvement, which was major in 71% of responders. Improvement occurred within hours of administration and disappeared within a day of discontinuation. Duration of treatment averaged 2.1 years (range to 10 years). Side effects were noted by 29% of children, most commonly dry mouth (26%) and eyes (10%), and were dose-related. One patient developed blurred vision, which resolved with dosing below 5 mg/d; one patient experienced palpitations and discontinued the medication. LIMITATIONS This was a retrospective analysis of a limited number of pediatric patients. CONCLUSION Oral glycopyrrolate is a cost-effective, painless second-line therapy for children and adolescents with primary focal hyperhidrosis that impacts their quality of life.
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Affiliation(s)
- Amy S Paller
- Departments of Dermatology and Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, Illinois 60611-2941, USA.
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Thoracoscopic excision of the sympathetic chain: an easy and effective treatment for hyperhidrosis in children. Pediatr Surg Int 2012; 28:245-8. [PMID: 21960313 DOI: 10.1007/s00383-011-2984-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/06/2011] [Indexed: 10/17/2022]
Abstract
BACKGROUND Thoracoscopic sympathectomy (TS) is an effective treatment for hyperhidrosis. Various surgical approaches are described in the literature. We describe the technique of thoracoscopic excision of the sympathetic chain done exclusively in children younger than 13 years. METHODS All patients younger than 13 years who underwent TS from 2006 at a single institution were prospectively identified and fully evaluated with emphasis on demographic data, age, surgical management, complications and follow-up. All patients were contacted again at the end of 2009 to complete a follow-up questionnaire. RESULTS Twelve patients underwent TS between 2006 and 2009. Age ranged from 6 to 13 years. This involved T2-T3 excision for nine patients with isolated palmar hyperhidrosis, and T2-T3-T4 excision for three with additional axillary hyperhidrosis. Six underwent bilateral TS at the same session and six underwent unilateral TS for the dominant side. Four of them had their contralateral operation performed 2-3 months later. Dry limbs were immediately achieved in all patients. Compensatory sweating (CS) was noted in eight patients. Complications included transient ptosis in two and mild recurrence in one. CONCLUSIONS Thoracoscopic excision of the sympathetic chain is a simple and safe procedure that relieves hyperhidrosis in all cases and significantly improves the quality of life.
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María Luisa PCS. Dermatosis del adolescente. REVISTA MÉDICA CLÍNICA LAS CONDES 2011. [DOI: 10.1016/s0716-8640(11)70491-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Abstract
Hyperhidrosis is characterized by localized or general excessive sweating which is severe enough to be perceived as pathological. Since excessive sweating often starts in childhood and adolescence, usually in children between 6 and 16 years of age, hyperhidrosis is an important disorder for children and juveniles. This condition causes considerable disruption of both social life and educational career, leading to severe deterioration in the patient's quality of life. In addition, therapy is often challenging since many treatment modalities are not approved for children. Nonetheless, there are still effective therapeutic options for children with hyperhidrosis.
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