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Majid Hosseini S, Ghandali E, Reza Moghimi H, Khademi-Kalantari K, Talebian Moghaddam S, Akbarzadeh Baghban A, Maryam Mortazavi S. A comparative evaluation of aluminum chloride hexahydrate gel iontophoresis versus tap water iontophoresis in people with primary palmar hyperhidrosis: A randomised clinical trial. Indian J Dermatol Venereol Leprol 2024; 90:52-58. [PMID: 37436009 DOI: 10.25259/ijdvl_975_2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Accepted: 04/25/2023] [Indexed: 07/13/2023]
Abstract
Background Primary palmar hyperhidrosis causes a lot of problems for patients and negatively affects their quality of life. Currently, iontophoresis with tap water and aluminum chloride hexahydrate is used for primary palmar hyperhidrosis. Yet, little evidence exists about iontophoresis with aluminum chloride hexahydrate in the form of gel. This study investigated the effect of aluminum chloride hexahydrate gel iontophoresis compared to tap water iontophoresis on primary palmar hyperhidrosis. Methods In this randomised controlled trial study, 32 patients with primary palmar hyperhidrosis were divided randomly into two groups (n = 16). Participants received 7 sessions of iontophoresis with aluminum chloride hexahydrate gel or tap water every other day on the dominant hand. The sweating rate was measured by gravimetry and iodine-starch tests before and after the last treatment session. Results Following the iontophoresis, the rate of sweating in both hands in the two groups was significantly reduced (P < 0.001). However, the sweating rate in the treated hand and the non-treated hand showed no significant difference. There was no significant difference observed in sweating rate reduction between both groups over time, but the larger effect size values observed in the aluminum chloride hexahydrate gel iontophoresis group may suggest the superiority of this gel over tap water in reducing the rate of sweating. Limitations Further investigations with longer follow-up are needed to confirm the hypothesis regarding the effectiveness of aluminum chloride hexahydrate gel iontophoresis over other types of iontophoresis. In addition, contraindications of iontophoresis such as pregnancy, pacemakers, and epilepsy should be considered. Conclusion The present study provides preliminary evidence suggesting that aluminum chloride hexahydrate gel iontophoresis is an effective alternative treatment to decrease sweating rate in extended areas with fewer side effects in patients with primary palmar hyperhidrosis.
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Affiliation(s)
- Seyed Majid Hosseini
- Physiotherapy Research Center, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Elham Ghandali
- Physiotherapy Research Center, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hamid Reza Moghimi
- Department of Pharmaceutics and Pharmaceutical Nanotechnology, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Khosro Khademi-Kalantari
- Physiotherapy Research Center, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Saeed Talebian Moghaddam
- Department of Physiotherapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran
| | - Alireza Akbarzadeh Baghban
- Department of Biostatistics, Proteomics Research Center, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Seyedeh Maryam Mortazavi
- Department of Pharmaceutics and Pharmaceutical Nanotechnology, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Malek-Khatabi A, Rad-Malekshahi M, Shafiei M, Sharifi F, Motasadizadeh H, Ebrahiminejad V, Rad-Malekshahi M, Akbarijavar H, Faraji Rad Z. Botulinum toxin A dissolving microneedles for hyperhidrosis treatment: design, formulation and in vivo evaluation. Biomater Sci 2023; 11:7784-7804. [PMID: 37905676 DOI: 10.1039/d3bm01301d] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2023]
Abstract
Multiple periodic injections of botulinum toxin A (BTX-A) are the standard treatment of hyperhidrosis which causes excessive sweating. However, BTX-A injections can create problems, including incorrect and painful injections, the risk of drug entry into the bloodstream, the need for medical expertise, and waste disposal problems. New drug delivery systems can substantially reduce these problems. Transdermal delivery is an effective alternative to conventional BTX-A injections. However, BTX-A's large molecular size and susceptibility to degradation complicate transdermal delivery. Dissolving microneedle patches (DMNPs) encapsulated with BTX-A (BTX-A/DMNPs) are a promising solution that can penetrate the dermis painlessly and provide localized translocation of BTX-A. In this study, using high-precision 3D laser lithography and subsequent molding, DMNPs were prepared based on a combination of biocompatible polyvinylpyrrolidone and hyaluronic acid polymers to deliver BTX-A with ultra-sharp needle tips of 1.5 ± 0.5 µm. Mechanical, morphological and histological assessments of the prepared DMNPs were performed to optimize their physicochemical properties. Furthermore, the BTX-A release and diffusion kinetics across the skin layers were investigated. A COMSOL simulation was conducted to study the diffusion process. The primary stability analysis reported significant stability for three months. Finally, the functionality of the BTX-A/DMNPs for the suppression of sweat glands was confirmed on the hyperhidrosis mouse footpad, which drastically reduced sweat gland activity. The results demonstrate that these engineered DMNPs can be an effective, painless, inexpensive alternative to hypodermic injections when treating hyperhidrosis.
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Affiliation(s)
- Atefeh Malek-Khatabi
- Department of Pharmaceutical Biomaterials and Medical Biomaterials Research Center, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran
| | - Mazda Rad-Malekshahi
- Department of Pharmaceutical Biomaterials and Medical Biomaterials Research Center, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran
| | - Morvarid Shafiei
- Department of Bacteriology, Pasteur Institute of Iran, Tehran, Iran
| | - Fatemeh Sharifi
- Department of Mechanical Engineering, Sharif University of Technology, Tehran, Iran
| | - Hamidreza Motasadizadeh
- Department of Pharmaceutical Nanotechnology, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran
| | - Vahid Ebrahiminejad
- School of Engineering, University of Southern Queensland, Springfield, Queensland, 4300, Australia.
| | | | - Hamid Akbarijavar
- Department of Pharmaceutical Biomaterials and Medical Biomaterials Research Center, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran
- Department of Pharmaceutics, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran
| | - Zahra Faraji Rad
- School of Engineering, University of Southern Queensland, Springfield, Queensland, 4300, Australia.
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3
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Sanajou S, Şahin G, Baydar T. Aluminium in cosmetics and personal care products. J Appl Toxicol 2021; 41:1704-1718. [PMID: 34396567 DOI: 10.1002/jat.4228] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 07/27/2021] [Accepted: 07/29/2021] [Indexed: 11/08/2022]
Abstract
Usage of inorganic ingredients like aluminium salts in cosmetics and personal care products has been a concern for producers and consumers. Although aluminium is used to treat hyperhidrosis, some worries have been raised about aluminium's role in breast cancer, breast cyst and Alzheimer's disease. The human population is exposed to aluminium from vaccines, diet, and drinking water, but the frequent use of aluminium-based cosmetics might add additional local exposure. This paper reviews literature to determine if aluminium-based products may pose potential harm to the body. The dermal absorption of aluminium is not widely understood. It is not yet known whether aluminium can travel from the skin to brain to cause Alzheimer's disease. Aluminium may cause gene instability, alter gene expression or enhance oxidative stress, but the carcinogenicity of aluminium has not been proved yet. Until now, epidemiological researches were based on oral information, which lacks consistency, and the results are conflicting. Future studies should target real-life-based long-time exposure to antiperspirants and other aluminium-containing cosmetics and personal care products.
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Affiliation(s)
- Sonia Sanajou
- Faculty of Pharmacy, Eastern Mediterranean University, Famagusta, Turkey.,Department of Toxicology, Faculty of Pharmacy, Hacettepe University, Ankara, Turkey
| | - Gönül Şahin
- Faculty of Pharmacy, Eastern Mediterranean University, Famagusta, Turkey
| | - Terken Baydar
- Department of Toxicology, Faculty of Pharmacy, Hacettepe University, Ankara, Turkey
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4
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Intra tester reliability of sympathetic skin responses in subjects with primary palmar hyperhidrosis. J Bodyw Mov Ther 2020; 24:57-62. [DOI: 10.1016/j.jbmt.2020.02.024] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Revised: 02/12/2020] [Accepted: 02/24/2020] [Indexed: 11/19/2022]
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Cohen SR, Goodacre AK, Leong TS, Southwell L, Nomachi T. Short-Term Clinical Outcomes and Safety Associated With Percutaneous Radiofrequency Treatment for Excessive Sweating. Aesthet Surg J 2019; 39:1390-1399. [PMID: 30535166 DOI: 10.1093/asj/sjy277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Primary excessive sweating of the axilla affects approximately 3.12% of the US population and has a negative impact on individuals' lives. OBJECTIVES We report the safety and effectiveness up to 90 days after treating excessive sweating with percutaneous radiofrequency when using a standardized protocol. METHODS Twenty adult subjects (13 females, 7 males) aged 18-49 years with excessive sweating were enrolled in a single-center, single-treatment unblinded prospective study conducted at the FACES+ Aesthetic Facility. Forty axilla were treated using the ThermiGen ThermiRF device. The Dermatology Quality of Life Index (DLQI), the Hyperhidrosis Disease Severity Scale (HDSS), and the Odor Scale (OS) were used for qualitative assessment. RESULTS Primary and secondary exploratory evaluations were favorable at 90 days, indicating a significant improvement in quality of life and a significant reduction in both sweating and odor. The DLQI demonstrated an average improvement of 10.8 points at day 30, 10.7 at day 60, and 11.1 at day 90 (P = 0.0001). At day 90, 100% of individuals had ≥50% improvement in their excessive sweating based on the HDSS. At the conclusion of the study, 15 subjects had a ≥1-point drop in their OS, whereas 5 subjects had no change (P = 0.0002). There were no serious adverse events reported during this study. All adverse events were classified as mild and moderate and resolved within 2 months. CONCLUSIONS The addition of the ThermiRF temperature-controlled radiofrequency device to the algorithm of hyperhidrosis treatments reduces sweating and odor with minimal downtime. LEVEL OF EVIDENCE: 4
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Affiliation(s)
- Steven R Cohen
- Clinical Professor, Division of Plastic Surgery, University of California, San Diego, CA
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6
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Guida S, Farnetani F, Nisticò S, Giorgio Mariarosaria C, Babino G, Pellacani G, Fulgione E. New trends in botulinum toxin use in dermatology. Dermatol Pract Concept 2019. [DOI: 10.5826/10.5826/dpc.0804a05] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
Background: Recent studies have highlighted new botulinum neurotoxin (BoNT) applications in the field of dermatology. Objective: To review current knowledge of BoNT use in dermatology. Methods: The literature of the last 5 years has been reviewed. Results: We describe interesting protocols of BoNT treatment for hyperhidrosis (HH), hypertrophic scars and keloids, Raynaud phenomenon, facial flushing, oily skin, psoriasis, Hailey-Hailey disease, and cutaneous lesions like painful lesions and periorbital syringomas. Conclusions: Several skin conditions eligible for BoNT treatment have been described. After the wide application for HH treatment, scars as well as vascular and inflammatory skin disorders, oily skin and cutaneous lesions represent fields of application of BoNT.
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Affiliation(s)
- Stefania Guida
- Dermatology Unit, Department of Surgical, Medical, Dental and Morphological Sciences related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, Italy
| | - Francesca Farnetani
- Dermatology Unit, Department of Surgical, Medical, Dental and Morphological Sciences related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, Italy
| | - Steven Nisticò
- Department of Health Sciences, University Magna Graecia, Catanzaro, Italy
| | | | - Graziella Babino
- Department of Dermatology, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Giovanni Pellacani
- Dermatology Unit, Department of Surgical, Medical, Dental and Morphological Sciences related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, Italy
| | - Elisabetta Fulgione
- Department of Dermatology, University of Campania Luigi Vanvitelli, Naples, Italy
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Shim DH, Nguyen TT, Park PG, Kim MJ, Park BW, Jeong HR, Kim DS, Joo HW, Choi SO, Park JH, Lee JM. Development of Botulinum Toxin A-Coated Microneedles for Treating Palmar Hyperhidrosis. Mol Pharm 2019; 16:4913-4919. [DOI: 10.1021/acs.molpharmaceut.9b00794] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Affiliation(s)
| | - Thuy Trang Nguyen
- Department of BioNano Technology and Gachon BioNano Research Institute, Gachon University, Gyeonggi-do 13120, Republic of Korea
| | | | | | | | - Hye-Rin Jeong
- Department of BioNano Technology and Gachon BioNano Research Institute, Gachon University, Gyeonggi-do 13120, Republic of Korea
| | - Dae-Sung Kim
- Department of BioNano Technology and Gachon BioNano Research Institute, Gachon University, Gyeonggi-do 13120, Republic of Korea
| | - Hyun Woo Joo
- Department of BioNano Technology and Gachon BioNano Research Institute, Gachon University, Gyeonggi-do 13120, Republic of Korea
| | - Seong-O Choi
- Department of Anatomy and Physiology, Kansas State University, Manhattan, Kansas 66506, United States
| | - Jung-Hwan Park
- Department of BioNano Technology and Gachon BioNano Research Institute, Gachon University, Gyeonggi-do 13120, Republic of Korea
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8
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Guida S, Farnetani F, Nisticò SP, Mariarosaria CG, Babino G, Pellacani G, Fulgione E. New trends in botulinum toxin use in dermatology. Dermatol Pract Concept 2018; 8:277-282. [PMID: 30479855 PMCID: PMC6246063 DOI: 10.5826/dpc.0804a05] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2018] [Accepted: 05/28/2018] [Indexed: 12/17/2022] Open
Abstract
Background Recent studies have highlighted new botulinum neurotoxin (BoNT) applications in the field of dermatology. Objective To review current knowledge of BoNT use in dermatology. Methods The literature of the last 5 five years has been reviewed. Results We describe interesting protocols of BoNT treatment for hyperhidrosis (HH), hypertrophic scars and keloids, Raynaud phenomenon, facial flushing, oily skin, psoriasis, Hailey-Hailey disease, and cutaneous lesions like painful lesions and periorbital syringomas. Conclusions Several skin conditions eligible for BoNT treatment have been described. After the wide application for HH treatment, scars as well as vascular and inflammatory skin disorders, oily skin and cutaneous lesions represent fields of application of BoNT.
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Affiliation(s)
- Stefania Guida
- Dermatology Unit, Department of Surgical, Medical, Dental and Morphological Sciences related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, Italy
| | - Francesca Farnetani
- Dermatology Unit, Department of Surgical, Medical, Dental and Morphological Sciences related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, Italy
| | - Steven P Nisticò
- Department of Health Sciences, University Magna Graecia, Catanzaro, Italy
| | | | - Graziella Babino
- Department of Dermatology, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Giovanni Pellacani
- Dermatology Unit, Department of Surgical, Medical, Dental and Morphological Sciences related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, Italy
| | - Elisabetta Fulgione
- Department of Dermatology, University of Campania Luigi Vanvitelli, Naples, Italy
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9
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Estevan FA, Wolosker MB, Wolosker N, Puech-Leão P. Epidemiologic analysis of prevalence of the hyperhidrosis. An Bras Dermatol 2018; 92:630-634. [PMID: 29166497 PMCID: PMC5674693 DOI: 10.1590/abd1806-4841.20175551] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2016] [Accepted: 07/10/2016] [Indexed: 11/21/2022] Open
Abstract
Background The present paper aims to study the prevalence of the various manifestations
of hyperhidrosis in patients who sought treatment in a specialized
ambulatory in the state of São Paulo. Objectives Opposite to previous studies, this paper studies the different combinations
of sweating sites, not being restricted to the main complaint site of the
patients, but taking into consideration secondary complaints patients may
present. Methods This was a retrospective approach of a database containing more than 1200
patients in which were mapped: combination of sweating sites, age of onset,
age spectrum, mean age, body mass index and gender of patients. Patients
were categorized into four groups based on their main sweating site -
palmar, plantar, axillary and facial. Results We concluded that hyperhidrosis appears frequently in more than one site,
being the main complaint that affects the most patients palmar
hyperhidrosis, which appears early in the patients during adolescence. When
there are two sites of sweating, the most frequent combination is palmar +
plantar, and when there are three sites of sweating the most frequent
combinations are palmar + plantar + axillary and axillary + palmar +
plantar. Study limitations This research has casuistics limited to a single care service for patients
with hyperhidrosis. Conclusion It is necessary to keep in mind that the disease manifests itself mainly in
more than one location, with different intensities in each of the patients,
generating a significant impairment of their quality of life.
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Affiliation(s)
| | - Marina Borri Wolosker
- School of Medicine of the Universidade de São Paulo (FMUSP) - São Paulo (SP), Brazil
| | - Nelson Wolosker
- Department of Surgery - Division of Vascular and Endovascular Surgery of the Clinics Hospital of the School of Medicine of the Universidade de São Paulo (HCFMUSP) - São Paulo (SP), Brazil.,Department of Vascular and Endovascular Surgery of the Hospital Israelita Albert Einstein - São Paulo (SP), Brazil
| | - Pedro Puech-Leão
- Department of Surgery - Division of Vascular and Endovascular Surgery of the Clinics Hospital of the School of Medicine of the Universidade de São Paulo (HCFMUSP) - São Paulo (SP), Brazil
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Elalfy K, Emile S, Elfeki H, Elmetwally A, Farag M, Gado W. Sequential Extended Thoracoscopic Sympathicotomy for Palmo-Axillo-Plantar Hyperhidrosis. Ann Thorac Surg 2017; 104:1200-1207. [DOI: 10.1016/j.athoracsur.2017.04.035] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2017] [Revised: 03/21/2017] [Accepted: 04/14/2017] [Indexed: 11/15/2022]
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11
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Hsu TH, Chen YT, Tu YK, Li CN. A systematic review of microwave-based therapy for axillary hyperhidrosis. J COSMET LASER THER 2017; 19:275-282. [DOI: 10.1080/14764172.2017.1303168] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Tzu-Herng Hsu
- School of Medicine, College of Medicine, Medical University, Taipei, Taiwan
| | - Yu-Tsung Chen
- Department of Dermatology, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan
- School of Public Health, College of Public Health and Nutrition, Taipei Medical University, Taipei, Taiwan
| | - Yu-Kang Tu
- Department of Public Health, Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Chien-Nien Li
- Department of Dermatology, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan
- Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
- Kuanshi clinic
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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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13
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Joo S, Lee GD, Haam S, Lee S. Comparisons of the clinical outcomes of thoracoscopic sympathetic surgery for palmar hyperhidrosis: R4 sympathicotomy versus R4 sympathetic clipping versus R3 sympathetic clipping. J Thorac Dis 2016; 8:934-41. [PMID: 27162669 DOI: 10.21037/jtd.2016.03.57] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Thoracoscopic sympathetic surgery is regarded as a definitive treatment for palmar hyperhidrosis. However, the optimal surgical strategy remains unclear. The aim of this study was to compare outcomes based on the level and type of sympathetic disconnection in patients with palmar hyperhidrosis. METHODS From January 2009 to December 2014, 101 patients with palmar hyperhidrosis underwent thoracoscopic sympathetic surgery at Gangnam Severance Hospital. Complete follow-up information was obtained from 59 patients. We retrospectively analyzed the results of operation, degree of palmar sweating (%), grade of compensatory sweating (none, mild, moderate, severe, very severe), grade of satisfaction (very satisfied, satisfied, moderate, dissatisfied, very dissatisfied), and recurrence/failure. RESULTS R4 sympathicotomy, R4 sympathetic clipping, and R3 sympathetic clipping were performed in 16, 20, and 23 patients, respectively. The mean degree of palmar sweating after sympathetic surgery was not significantly different between these three groups (17.50% vs. 27.00% vs. 29.78%; P=0.38). The rate of life-bothering compensatory sweating was lower in the R4 sympathicotomy group compared with those of other two groups (0% vs. 25%, 47.8%; P=0.09). The rate of very satisfied to moderate grades of satisfaction were lower in the R3 sympathetic clipping group compared with those of other two groups (93.8%, 100% vs. 73.9%; P=0.07). The rate of recurrence/failure rates were lower in the R4 sympathicotomy group compared with those of other two groups (12.50% vs. 35.00%, 34.8%; P=0.25). Sympathetic surgery at the R3 level was the only significant risk factor for patient dissatisfaction (odd ratio =12.353, 95% confidence interval =1.376-110.914; P=0.025). CONCLUSIONS Our data support that R4 sympathicotomy had lower grades of compensatory sweating, higher grades of satisfaction, and lower rates of recurrence/failure. We therefore consider R4 sympathicotomy as an optimal surgical treatment for palmar hyperhidrosis.
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Affiliation(s)
- Seok Joo
- 1 Department of Trauma Surgery, Regional Trauma Center, Gachon University Gil Hospital, Incheon, Republic of Korea ; 2 Department of Thoracic Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Geun Dong Lee
- 1 Department of Trauma Surgery, Regional Trauma Center, Gachon University Gil Hospital, Incheon, Republic of Korea ; 2 Department of Thoracic Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Seokjin Haam
- 1 Department of Trauma Surgery, Regional Trauma Center, Gachon University Gil Hospital, Incheon, Republic of Korea ; 2 Department of Thoracic Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Sungsoo Lee
- 1 Department of Trauma Surgery, Regional Trauma Center, Gachon University Gil Hospital, Incheon, Republic of Korea ; 2 Department of Thoracic Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
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