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Ogawa S, Tayama J, Murota H, Kobayashi M, Kinoshita H, Nakamichi S. The reliability and validity of a developed anxiety scale specific to primary focal hyperhidrosis symptoms. Biopsychosoc Med 2024; 18:14. [PMID: 38835082 DOI: 10.1186/s13030-024-00310-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2024] [Accepted: 05/24/2024] [Indexed: 06/06/2024] Open
Abstract
BACKGROUND Patients with primary focal hyperhidrosis (hyperhidrosis) are known to have higher levels of anxiety induced by sweating than those who do not. However, in hyperhidrosis, no scale has been developed to measure anxiety specific to hyperhidrosis symptoms. Therefore, this study aimed to develop an anxiety scale specific to hyperhidrosis symptoms (ASSHS) and to verify its reliability and validity. METHODS Based on previous studies on hyperhidrosis and a preliminary survey conducted with 26 university students who met the diagnostic criteria for hyperhidrosis, 40 items that adequately reflected anxiety specific to hyperhidrosis symptoms were obtained. A survey was done to examine the internal consistency and validity of the our developed ASSHS. In total, 1,207 participants (680 male and 527 female; mean age ± standard deviation 18.7 ± 0.9 years) were included. A second survey (re-survey) was conducted three weeks later to verify the reliability. It included 201 participants (85 male and 116 female; mean age ± standard deviation 18.6 ± 0.7 years). The survey items included (1) the diagnostic criteria for hyperhidrosis, (2) our anxiety scale developed for primary focal hyperhidrosis symptoms (ASSHS), (3) Hyperhidrosis Disease Severity Scale (HDSS), (4) State-Trait Anxiety Inventory (STAI), (5) Hospital Anxiety and Depression Scale (HADS), (6) Dermatology Life Quality Index (DLQI), and (7) presence of anxiety induced by sweating. RESULTS The results of the factor analysis revealed 10 items with one factor, "anxiety specific to hyperhidrosis symptoms." The alpha coefficient of the ASSHS was α = 0.94. The correlation coefficient between the scores at re-test was r = 0.75. A moderate positive correlation was found between the ASSHS, HDSS (r = 0.53), and anxiety induced by sweating (r = 0.47) (all p < 0.001). Additionally, participants with hyperhidrosis symptoms had significantly higher ASSHS scores than did those without hyperhidrosis symptoms (p < 0.001). Those with mild/moderate hyperhidrosis and those with severe hyperhidrosis had significantly higher the ASSHS scores than did those without hyperhidrosis (p < 0.001). CONCLUSIONS This scale has sufficient reliability and validity as an instrument to measure anxiety specific to hyperhidrosis symptoms.
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Affiliation(s)
- Sayaka Ogawa
- Faculty of Humanities, Nagasaki Junshin Catholic University, 235 Mitsuyama-Mach, Nagasaki, 852-8558, Japan.
| | - Jun Tayama
- Faculty of Human Sciences, Waseda University, 2-579-15 Mikajima, Tokorozawa, 359-1192, Japan
| | - Hiroyuki Murota
- Department of Dermatology, Nagasaki University, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan
| | - Masakazu Kobayashi
- Health Center, Nagasaki University, 1-14 Bunkyo-Machi, Nagasaki, 852-8521, Japan
| | - Hirohisa Kinoshita
- Health Center, Nagasaki University, 1-14 Bunkyo-Machi, Nagasaki, 852-8521, Japan
| | - Seiko Nakamichi
- Health Center, Nagasaki University, 1-14 Bunkyo-Machi, Nagasaki, 852-8521, Japan
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Kobayashi M, Kumaya Y, Hirayama Y, Oda H, Cho H, Huang CL. Single-center experience of thoracoscopic sympathectomy for palmar hyperhidrosis with long-term postoperative questionnaire survey. Gen Thorac Cardiovasc Surg 2024:10.1007/s11748-024-02034-w. [PMID: 38676901 DOI: 10.1007/s11748-024-02034-w] [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: 01/24/2024] [Accepted: 04/09/2024] [Indexed: 04/29/2024]
Abstract
OBJECTIVES Thoracoscopic sympathectomy is an effective treatment for palmar hyperhidrosis. However, compensatory hyperhidrosis occurs frequently as a postoperative complication of the procedure. The goal of this study was to elucidate the clinical significance of thoracoscopic sympathectomy using our surgical procedure. METHODS Consecutive 151 patients who underwent thoracoscopic sympathectomy for palmar hyperhidrosis were studied. In addition, to investigate patients' satisfaction and long-term quality of life, 111 patients were asked to complete a mailing questionnaire survey, and 84 responded (response rate of 75.7%). RESULTS All of the 151 patients reported a reduction in palmar sweating during the immediate postoperative period. None of the patients had pneumothorax, hemothorax, Horner's syndrome, or worsening of bradycardia. Based on the questionnaire, the surgical success rate was 98.8%. None of the patients had a recurrence of palmar hyperhidrosis during the long-term postoperative period. However, compensatory hyperhidrosis was reported in 82 patients (97.6%). In total, 94.0% of patients had high levels of postoperative satisfaction. CONCLUSIONS Thoracoscopic sympathectomy is an effective surgical treatment for palmar hyperhidrosis. By contrast, the careful preoperative explanation of compensatory hyperhidrosis is considered to be very important.
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Affiliation(s)
- Megumi Kobayashi
- Department of Thoracic Surgery, Tazuke Kofukai Medical Research Institute, Kitano Hospital, 2-4-20 Ohgimachi, Kita-Ku, Osaka, 530-8480, Japan.
| | - Yosuke Kumaya
- Department of Thoracic Surgery, Tazuke Kofukai Medical Research Institute, Kitano Hospital, 2-4-20 Ohgimachi, Kita-Ku, Osaka, 530-8480, Japan
| | - Yasumiko Hirayama
- Department of Thoracic Surgery, Tazuke Kofukai Medical Research Institute, Kitano Hospital, 2-4-20 Ohgimachi, Kita-Ku, Osaka, 530-8480, Japan
| | - Hiromi Oda
- Department of Thoracic Surgery, Tazuke Kofukai Medical Research Institute, Kitano Hospital, 2-4-20 Ohgimachi, Kita-Ku, Osaka, 530-8480, Japan
| | - Hiroyuki Cho
- Department of Thoracic Surgery, Tazuke Kofukai Medical Research Institute, Kitano Hospital, 2-4-20 Ohgimachi, Kita-Ku, Osaka, 530-8480, Japan
| | - Cheng-Long Huang
- Department of Thoracic Surgery, Tazuke Kofukai Medical Research Institute, Kitano Hospital, 2-4-20 Ohgimachi, Kita-Ku, Osaka, 530-8480, Japan
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Fujimoto T, Terahara T, Okawa K, Inakura H, Hirayama Y, Yokozeki H. Long-term evaluation of the safety and efficacy of a novel 20% oxybutynin hydrochloride lotion for primary palmar hyperhidrosis: An open-label extension study. J Dermatol 2023; 50:1459-1472. [PMID: 37605375 DOI: 10.1111/1346-8138.16922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 07/19/2023] [Accepted: 07/28/2023] [Indexed: 08/23/2023]
Abstract
The long-term safety and efficacy of 52-week application of oxybutynin hydrochloride 20% lotion (20% OL) for the treatment of primary palmar hyperhidrosis (PPHH) in Japanese patients aged ≥12 years were evaluated in an open-label extension (OLE) of a 4-week, randomized, double-blind (DB) study. The OLE included 114 patients who completed the DB study and wished to continue treatment and 12 new patients. In the safety analysis population (125 patients), the incidence of adverse events (AEs) and adverse drug reactions (ADRs) was 79.2% and 36.0%, respectively. Serious AEs were observed in two patients but were considered unrelated to the investigational drug. The incidence of AEs that led to study discontinuation was 1.6%. The incidence of application site AEs and ADRs was 35.2% and 26.4%, respectively. The severity of most events was mild. The incidence of anticholinergic AEs related to dry mouth was 3.2% for thirst and 0.8% for dry throat. The long-term efficacy of 20% OL was confirmed by a long-lasting reduction in sweat volume and improvement in the Hyperhidrosis Disease Severity Scale and Dermatology Life Quality Index. This study has several limitations: First the results may include some bias because most of the participants were from the prior DB study; second, the results may not be generalizable because only a few participants were in the age group most susceptible to PPHH (i.e., < 15 years old); and third, the study did not obtain safety information from treatment for more than 52 weeks, so this information must be collected in clinical practice in the future. No reduced therapeutic effect was observed in patients with PPHH in this study after 52-week application of 20% OL. Also, few patients experienced serious AEs or AEs that led to study treatment discontinuation.
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Affiliation(s)
- Tomoko Fujimoto
- Ikebukuro Nishiguchi Fukurou Dermatology Clinic, Tokyo, Japan
| | | | - Koji Okawa
- Hisamitsu Pharmaceutical Co., Inc, Tokyo, Japan
| | | | | | - Hiroo Yokozeki
- Department of Dermatology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
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Oshima Y, Fujimoto T, Nomoto M, Fukui J, Ikoma A. Hyperhidrosis: A targeted literature review of the disease burden. J Dermatol 2023; 50:1227-1236. [PMID: 37519134 DOI: 10.1111/1346-8138.16908] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 06/23/2023] [Accepted: 07/12/2023] [Indexed: 08/01/2023]
Abstract
Hyperhidrosis is a chronic skin condition characterized by excessive sweating. It poses a burden on affected people, reducing their quality of life and productivity. We undertook a targeted literature review (TLR) to gather current evidence on the epidemiology as well as the human and economic burden posed on patients with hyperhidrosis. Searches were performed in Medline database (access via OVID interface) and ICHUSHI database. Articles published between January 2000 and September 2020 that analyzed at least 50 patients were included. Sixty-four publications were identified and 38 publications covering a unique domain were selected to inform this TLR. The incidence of hyperhidrosis ranged from 0.13% in the UK to 0.28% in the USA, with a higher rate in females. The prevalence of hyperhidrosis varied from 2.8%-4.8% in the US general population to 18.40% in Chinese inpatients, while the prevalence of axillary hyperhidrosis varied from 1.4% in the US general population to 5.75% in Japanese employees/students. Due to excessive sweating, hyperhidrosis was reported to be a moderate-to-extreme limitation at work for the US patients, with 33.5% feeling unhappy. Patients' satisfaction was high post-treatment. Considerable costs were related to the treatment with botulinum toxin and surgery. Hospital stays for surgery lasted from 10 h to 3 days. The percentage of patients who sought a medical consultation varied from 6.3% for Japanese patients with primary focal hyperhidrosis to 51% for the US general population with any type of hyperhidrosis. There is limited evidence of the hyperhidrosis burden, particularly among Japanese patients; however, the burden was high and limited patients' daily functioning. Future actions should include implementation of educational programs to raise awareness of the condition, conduct of larger studies, and generation of more evidence. Understanding the nature of hyperhidrosis and the burden it poses is of utmost importance.
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Affiliation(s)
- Yuichiro Oshima
- Department of Dermatology, Aichi Medical University School of Medicine, Aichi, Japan
| | - Tomoko Fujimoto
- Ikebukuro Nishiguchi Fukurou Dermatology Clinic, Tokyo, Japan
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Watanabe H, Ohshima Y, Watanabe D. Therapeutic Effectiveness of Needle Injection Versus Needle-Free Jet Injector System for Botulinum Toxin Type A in Palmar Hyperhidrosis. J Cutan Med Surg 2023; 27:481-486. [PMID: 37537972 DOI: 10.1177/12034754231191062] [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] [Indexed: 08/05/2023]
Abstract
BACKGROUND The most important problem with local injections of botulinum toxin type A (BTX-A) in palmar hyperhidrosis is pain during the injections. OBJECTIVES We evaluated therapeutic effectiveness and pain of local injections of BTX-A using needle-free direct administration system. METHODS We performed BTX-A local injection therapy using a conventional injection needle in the left hand and a needle-free direct administration system in the right hand. RESULTS A reduction in the quantity of perspiration was observed 4 weeks after administration of both Needle and Needle-free BTX-A, and reduction was maintained throughout 28 weeks observation period. Both hyperhidrosis Disease Severity Scale scores and Dermatology Life Quality Index for hands treated with Needle BTX-A and hands treated with Needle-free BTX-A had decreased significantly by 4 weeks after treatment. Pain visual analog scale scores and the degree of pain were significantly lower in hands treated with Needle-free BTX-A than in hands treated with Needle BTX-A. CONCLUSIONS When the trigger of the pressurized needle-free injector device is activated, the gas powered driving pressure propels BTX-A through an orifice (0.13 mm) about four times narrower than a 30 G needle at very high speed. As most pain occurs during the needle prick itself, the advantage of a small orifice coupled with high-speed penetration of BTX-A through the pressurized device results in reduced pain during administration. The needle-free direct administration system administers the injectate under the skin without a visible needle.
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Affiliation(s)
- Hitomi Watanabe
- Department of Dermatology, Aichi Medical University, Nagakute, Aichi, Japan
| | - Yuichiro Ohshima
- Department of Dermatology, Aichi Medical University, Nagakute, Aichi, Japan
| | - Daisuke Watanabe
- Department of Dermatology, Aichi Medical University, Nagakute, Aichi, Japan
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Fujimoto T, Terahara T, Okawa K, Inakura H, Hirayama Y, Yokozeki H. A novel lotion formulation of 20% oxybutynin hydrochloride for the treatment of primary palmar hyperhidrosis: A randomized, placebo-controlled, double-blind, phase III study. J Am Acad Dermatol 2023; 89:62-69. [PMID: 36990320 DOI: 10.1016/j.jaad.2023.03.025] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 03/09/2023] [Accepted: 03/15/2023] [Indexed: 03/30/2023]
Abstract
BACKGROUND No previous controlled studies have been specifically designed or adequately powered to show the efficacy of topical oxybutynin for palmar hyperhidrosis by using quantitative measures. OBJECTIVE To evaluate efficacy of 20% oxybutynin hydrochloride lotion (20% OL) in reducing palmar sweat volume in patients with primary palmar hyperhidrosis (PPHH). METHODS In a randomized controlled trial, Japanese patients with PPHH aged 12 years and older received either 20% OL (n = 144) or placebo (n = 140) on both palms once daily for 4 weeks. Palmar sweat volume was measured by the ventilated capsule method. For the primary outcome, response was defined as a reduction of sweat volume of at least 50% from baseline. RESULTS At week 4, the responder rate for sweat volume was significantly higher in the 20% OL arm than in the placebo arm (52.8% vs 24.3%, respectively; treatment difference, 28.5% [95% CI, 17.7% to 39.3%]; P < .001). No serious adverse events occurred, and no adverse events led to treatment discontinuation. LIMITATIONS The treatment period was only 4 weeks. CONCLUSIONS In patients with PPHH, 20% OL is superior to placebo in reducing palmar sweat volume.
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Affiliation(s)
- Tomoko Fujimoto
- Ikebukuro Nishiguchi Fukurou Dermatology Clinic, Tokyo, Japan
| | | | - Koji Okawa
- R&D Division, Hisamitsu Pharmaceutical Co, Inc, Tokyo, Japan
| | - Hiroshi Inakura
- R&D Division, Hisamitsu Pharmaceutical Co, Inc, Tokyo, Japan
| | - Yuta Hirayama
- R&D Division, Hisamitsu Pharmaceutical Co, Inc, Tokyo, Japan.
| | - Hiroo Yokozeki
- Department of Dermatology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
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Fujimoto T, Inose Y, Nakamura H, Kikukawa Y. Questionnaire-based epidemiological survey of primary focal hyperhidrosis and survey on current medical management of primary axillary hyperhidrosis in Japan. Arch Dermatol Res 2023; 315:409-417. [PMID: 35768620 PMCID: PMC10020310 DOI: 10.1007/s00403-022-02365-9] [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: 01/17/2022] [Revised: 05/15/2022] [Accepted: 06/10/2022] [Indexed: 11/02/2022]
Abstract
To obtain current epidemiological information on primary focal hyperhidrosis in Japan, a large epidemiological survey was conducted using a web-based questionnaire. The prevalence of primary focal hyperhidrosis was 10.0% and the site-specific prevalence was highest for primary axillary hyperhidrosis (5.9%). The proportion of respondents with primary focal hyperhidrosis who had consulted a physician was 4.6%, which was similar to the low prevalence reported previously in 2013 in Japan. A questionnaire survey for physicians and individuals with primary axillary hyperhidrosis on the current medical management of primary axillary hyperhidrosis showed that physicians recognized the existence of patients who were very worried about hyperhidrosis, but failed to provide active treatment. Regarding the information provided by patients to physicians at presentation, it was found that patients failed to provide sufficient information to the physicians about their worries in daily life. Among individuals who had sought medical care with primary axillary hyperhidrosis, 62.3% reported that they were not currently receiving treatment, highlighting a challenge to be addressed regarding continued treatment. Frequently chosen options leading to willingness to receive treatment were less expensive treatment and highly effective treatment as well as feeling free to consult a physician, suggesting a desire for an improved medical environment.
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Affiliation(s)
- Tomoko Fujimoto
- Ikebukuro Nishiguchi Fukurou Dermatology Clinic, 1-39-4 Nishi-Ikebukuro, Toshima-ku, Tokyo, Japan.
| | - Yuri Inose
- Maruho Co., Ltd., 1-5-22 Nakatsu, Kita-ku, Osaka, Japan
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Ogawa S, Tayama J, Murota H, Kobayashi M, Kinoshita H, Nishino T. Association of primary focal hyperhidrosis with anxiety induced by sweating: A cross-sectional study of Japanese university students focusing on the severity of hyperhidrosis and site of sweating. J Dermatol 2023; 50:364-374. [PMID: 36282908 DOI: 10.1111/1346-8138.16617] [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: 06/17/2022] [Revised: 10/04/2022] [Accepted: 10/09/2022] [Indexed: 12/01/2022]
Abstract
Hyperhidrosis significantly reduces patients' quality of life, with many reporting feeling highly anxious. However, the relationship between hyperhidrosis and anxiety induced by sweating has not been examined in detail. The current study examined the relationship between: (1) the presence of hyperhidrosis symptoms, (2) hyperhidrosis severity, and (3) the sites of the most sweating and anxiety induced by sweating. A cross-sectional web-based survey was conducted among university students, and 1080 consenting participants (600 males and 480 females; mean age, 18.8 years) were included in the analysis. The survey items were: (1) diagnostic criteria for hyperhidrosis, (2) Hyperhidrosis Disease Severity Scale, (3) presence of anxiety induced by sweating, and (4) site of the most sweating. The results of multiple logistic regression analysis adjusted for sex and age showed that the odds ratio (OR) for anxiety induced by sweating was significantly higher in participants who screened positive for hyperhidrosis than in those who screened negative (OR, 9.72 [95% CI, 5.80-16.27]). The OR of anxiety induced by sweating was 7.11 (95% CI, 3.99-12.65) for mild/moderate hyperhidrosis and 23.46 (95% CI, 7.15-76.93) for severe hyperhidrosis, compared with those who screened negative for hyperhidrosis. Compared with those who screened negative for hyperhidrosis, the OR for anxiety induced by sweating in those with the palmar, plantar, axillary, and head/face as the site of the most sweating was 7.74 (95% CI, 3.91-15.33), 14.86 (95% CI, 1.83-120.58), 16.92 (95% CI, 5.95-48.14), and 5.38 (95% CI, 1.39-20.74), respectively. Our findings suggest that participants who screened positive for hyperhidrosis, mild/moderate or severe, are at a higher risk of anxiety induced by sweating than participants who screened negative for hyperhidrosis.
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Affiliation(s)
- Sayaka Ogawa
- Health Center, Nagasaki University, Nagasaki, Japan
| | - Jun Tayama
- Faculty of Human Sciences, Waseda University, Tokorozawa, Japan
| | - Hiroyuki Murota
- Department of Dermatology, Nagasaki University, Nagasaki, Japan
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Nationwide Cross-sectional Analysis of Endoscopic Thoracic Sympathectomy to Treat Hyperhidrosis Over 12 years in Brazil: Epidemiology, Costs, and Mortality. Ann Surg 2023; 277:e483-e487. [PMID: 34417365 DOI: 10.1097/sla.0000000000005178] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To analyze the number of endoscopic thoracic sympathectomies performed to treat hyperhidrosis in the Universal Public Health System of Brazil, the government reimbursements, and the in-hospital mortality rates. BACKGROUND Even though endoscopic thoracic sympathectomy has been widely performed for the definitive treatment of hyperhidrosis, no series reported mortality and there are no population-based studies evaluating its costs or its mortality rate. METHODS Data referring to endoscopic thoracic sympathectomy to treat hyperhidrosis between 2008 and 2019 were extracted from the database of the Brazilian Public Health System, which insures more than 160 million inhabitants. RESULTS Thirteen thousand two hundred one endoscopic thoracic sympathectomies to treat hyperhidrosis were performed from 2008 to 2019, with a rate of 68.44 procedures per 10 million inhabitants per year. There were 6 in-hospital deaths during the whole period, representing a mortality rate of 0.045%. The total expended throughout the years was U$ 6,767,825.14, with an average of U$ 512.68 per patient. CONCLUSIONS We observed a rate of 68.44 thoracoscopic sympathectomies for hyperhidrosis' treatment per 10 million inhabitants per year. The inhospital mortality rate was very low, 0.045%, though not nil. To our knowledge, no published series is larger than ours and we are the first authors to formally report deaths after endoscopic thoracic sympathectomies to treat hyperhidrosis. Moreover, there is no other population-based study addressing costs and mortality rates of every endoscopic thoracic sympathectomy for the treatment of any site of hyperhidrosis in a given period.
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Carvalho F, Magalhaes C, Fernandez-Llimos F, Mendes J, Gonçalves J. Skin temperature response to thermal stimulus in patients with hyperhidrosis: A comparative study. J Therm Biol 2022; 109:103322. [DOI: 10.1016/j.jtherbio.2022.103322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 06/07/2022] [Accepted: 08/30/2022] [Indexed: 11/28/2022]
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Chinese expert consensus on the surgical treatment of primary palmar hyperhidrosis (2021 version). Chin Med J (Engl) 2022; 135:1264-1271. [PMID: 35830261 PMCID: PMC9433061 DOI: 10.1097/cm9.0000000000002198] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Primary palmar hyperhidrosis (PPH) is a pathologic condition of excessive sweating on hands that has adverse impacts on patients’ social activity, professional life, and psychological state. Endoscopic thoracic sympathicotomy (ETS) is by far the treatment choice for PPH with the most stable and durable curative effects, but special attention should be given to the side effects of the surgery, especially compensatory hyperhidrosis (CH). This consensus is the second version of the Chinese Expert Consensus on the Surgical Treatment of PPH by the China Expert Committee on Palmar Hyperhidrosis (CECPH), which was published 10 years ago. This consensus emphasizes the need for special attention and careful assessment of the patients’ feelings, as well as their emotional and mental state, and emphasizes that distress due to palmar sweating and the desire for treatment are prerequisites for diagnosis. It also provides a more nuanced delineation of CH and reviews all new attempts to prevent and treat this side effect. New evidence of the epidemiology, pathogenesis of PPH, and indications for surgery were also assessed or recommended.
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Off-Label Use of Botulinum Toxin in Dermatology—Current State of the Art. Molecules 2022; 27:molecules27103143. [PMID: 35630620 PMCID: PMC9147387 DOI: 10.3390/molecules27103143] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 05/10/2022] [Accepted: 05/11/2022] [Indexed: 01/01/2023] Open
Abstract
Botulinum toxin (BoNT) is a neurotoxin produced by the Clostridium botulinum bacteria. Among seven different isoforms, only BoNT-A and BoNT-B are commercially used. Currently, botulinum toxin has been indicated by the U.S. Food and Drug Administration in several disorders, among others: chronic migraine, hyperhidrosis, urinary incontinence from detrusor overactivity, or cosmetics. However, there are numerous promising reports based on off-label BTX usage, indicating its potential effectiveness in other diseases, which remains unknown to many. Among them, dermatological conditions, such as rosacea, annal fissure, Raynaud phenomenon, hypertrophic scars and keloids, and also hidradenitis suppurativa, are currently being investigated. This article aims to provide a comprehensive update on the off-label use of botulinum toxin in dermatology, based on an analysis and summary of the published literature.
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Fujimoto T, Okatsu H, Miyama H. Two-week prospective observational study of 5% sofpironium bromide gel in Japanese patients with primary axillary hyperhidrosis. J Dermatol 2022; 49:594-599. [PMID: 35394087 PMCID: PMC9321746 DOI: 10.1111/1346-8138.16384] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 03/08/2022] [Accepted: 03/21/2022] [Indexed: 11/29/2022]
Abstract
In 2020, 5% sofpironium bromide (ECCLOCK®) gel (hereinafter referred to as sofpironium) was approved in Japan for the topical treatment of primary axillary hyperhidrosis. A phase III study of sofpironium demonstrated the efficacy and safety of sofpironium; however, no study has assessed its early efficacy at <6 weeks after starting treatment. Therefore, to assess the earlier effectiveness of sofpironium, we conducted a 2‐week, single‐center, exploratory, prospective, observational study in Japanese patients with primary axillary hyperhidrosis. Patients aged ≥20 years and satisfying with a Hyperhidrosis Disease Severity Scale (HDSS) score of 3 or 4 at baseline were eligible for the study. The primary endpoint for the effectiveness was change in the proportion of patients with a HDSS score of 1, 2, 3, or 4 during the 2‐week study period. In 80 patients included in the full analysis set (FAS), there were more women than men (93.8% vs. 6.3%), and the mean age (±standard deviation [SD]) was 33.3 ± 9.4 years. In the FAS, the proportion of patients with a HDSS score of 1 or 2 was 55.0% on day 7, and statistically significant changes were observed after day 3 compared to baseline (p < 0.05). Mean HDSS scores (±SD) were significantly decreased from baseline value of 3.5 ± 0.5 to 2.4 ± 0.9 on day 7 (p < 0.001). The median period for sofpironium treatment to achieve a HDSS score of 1 or 2 for a continuous 2 days was 6 days (95% confidence interval, 4–8). Safety was evaluated in 92 patients in the safety analysis set, and no adverse events were reported during the study period of 2 weeks. These results suggest that after 1‐week treatment with sofpironium for patients with a HDSS score of 3 or 4, approximately 50% of the patients can achieve a HDSS score of 1 or 2, which is a clinically significant improvement for the patients.
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Affiliation(s)
- Tomoko Fujimoto
- Ikebukuro Nishiguchi Fukurou Dermatology Clinic, Tokyo, Japan
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Ando Y, Ohshima Y, Yanagishita T, Watanabe H, Tamada Y, Akiyama M, Watanabe D. Clinical utility of botulinum toxin type A local injection therapy for head and forehead hyperhidrosis. J Dermatol 2022; 49:719-723. [PMID: 35393718 DOI: 10.1111/1346-8138.16368] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 02/15/2022] [Accepted: 03/06/2022] [Indexed: 12/01/2022]
Abstract
Head and forehead hyperhidrosis (HFH) is a disease that causes a large amount of sweating from the head region, and it significantly reduces patients' quality of life. Only a few reports have shown the effectiveness of botulinum toxin type A (BTX-A) local injection therapy (BTX-A therapy) for HFH. To clarify the benefits of BTX-A for HFH, BTX-A therapy was performed in 15 patients, and its efficacy was evaluated. The amount of sweating was measured by the ventilation capsule method and Minor's iodine-starch test. Evaluation was also performed using the Hyperhidrosis Disease Severity Scale (HDSS) and the Dermatology Life Quality Index (DLQI). In most cases, a remarkable antiperspirant effect was observed from 2 weeks after the injection, and the effect lasted for approximately 30 weeks. HDSS and DLQI improved along with the decrease in sweating. Two patients (13.3%) complained of transient mild ptosis. There were no serious side-effects. This study showed that BTX-A therapy is a safe and effective treatment for HFH.
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Affiliation(s)
- Yoriko Ando
- Department of Dermatology, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Yuichiro Ohshima
- Department of Dermatology, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Takeshi Yanagishita
- Department of Dermatology, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Hitomi Watanabe
- Department of Dermatology, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Yasuhiko Tamada
- Department of Dermatology, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Masashi Akiyama
- Department of Dermatology, Nagoya University School of Medicine, Nagoya, Japan
| | - Daisuke Watanabe
- Department of Dermatology, Aichi Medical University School of Medicine, Nagakute, Japan
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15
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Dunford L, Clifton AV, Stephenson J, Radley K, McDonald L, Fretwell L, Cheung ST, Hague L, Boyle RJ. Interventions for hyperhidrosis. Hippokratia 2022. [DOI: 10.1002/14651858.cd015135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Louise Dunford
- Institute of Allied Health Sciences; De Montfort University; Leicester UK
| | - Andrew V Clifton
- School of Health and Sports Science; University of Suffolk; Ipswich UK
| | - John Stephenson
- School of Human and Health Sciences; University of Huddersfield; Huddersfield UK
| | - Kathy Radley
- Postgraduate Medicine; University of Hertfordshire; Hatfield UK
| | | | | | | | - Lynne Hague
- c/o Cochrane Skin Group; University of Nottingham; Nottingham UK
| | - Robert J Boyle
- National Heart and Lung Institute; Imperial College London; London UK
- Centre of Evidence Based Dermatology; University of Nottingham; Nottingham UK
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16
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Shoe Allergens: A Retrospective Analysis of Cross-sectional Data From the North American Contact Dermatitis Group, 2005-2018. Dermatitis 2022; 33:62-69. [PMID: 35029350 DOI: 10.1097/der.0000000000000750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Shoe contact allergy can be difficult to diagnose and manage. OBJECTIVE The aim of the study was to characterize demographics, clinical characteristics, patch test results, and occupational data for the North American Contact Dermatitis Group patients with shoe contact allergy. METHODS This is a retrospective study of 33,661 patients, patch tested from 2005 to 2018, with a shoe source, foot as 1 of 3 sites of dermatitis, and final primary diagnosis of allergic contact dermatitis. RESULTS Three hundred fifty-two patients met the inclusion criteria. They were more likely to be male (odds ratio = 3.36, confidence interval = 2.71-4.17) and less likely to be older than 40 years (odds ratio = 0.49, confidence interval = 0.40-0.61) compared with others with positive patch test reactions. The most common relevant North American Contact Dermatitis Group screening allergens were potassium dichromate (29.8%), p-tert-butylphenol formaldehyde resin (20.1%), thiuram mix (13.3%), mixed dialkyl thioureas (12.6%), and carba mix (12%). A total of 29.8% (105/352) had positive patch test reactions to supplemental allergens, and 12.2% (43/352) only had reactions to supplemental allergens. CONCLUSIONS Shoe contact allergy was more common in younger and male patients. Potassium dichromate and p-tert-butylphenol formaldehyde resin were the top shoe allergens. Testing supplemental allergens, personal care products, and shoe components should be part of a comprehensive evaluation of suspected shoe contact allergy.
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17
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Gregoriou S, Tsiogka A, Kontochristopoulos G, Offidani A, Campanati A. Sofpironium bromide: an investigational agent for the treatment of axillary hyperhidrosis. Expert Opin Investig Drugs 2021; 31:15-21. [PMID: 34890517 DOI: 10.1080/13543784.2022.2017880] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
INTRODUCTION In recent years, increased knowledge about pathophysiology of primary hyperhidrosis has led to novel therapeutic advances. Topical and systemic anticholinergic agents have been proven beneficial in reducing sweat production in primary axillary hyperhidrosis (PAH), although their use is limited by the increased likelihood of systemic anticholinergic drug reactions, particularly regarding systemic agents. AREAS COVERED This paper provides an overview of pharmaceutical characteristics, efficacy and safety data from phase II and III clinical trials on sofpironium bromide (SB), a topical anticholinergic agent that has been employed for the treatment of PAH and has already received its first approval in Japan for the treatment of PAH in the form of 5% gel formulation. EXPERT OPINION The retrometabolic drug design of topical SB presents distinct advantages, by limiting systemic absorption and therefore development of anticholinergic adverse events. This along with the popularity of the non-greasy gel formulation is expected to increase compliance. However, this therapy still offers a temporary control of PAH, compared to sympathectomy or device-based treatments, such as microwave thermolysis. Hence, physicians should balance the effectiveness against adverse events of each therapeutic modality and use a personalized approach based on patient's needs.
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Affiliation(s)
- Stamatios Gregoriou
- Faculty of Medicine, 1st Department of Dermatology-Venereology, Andreas Sygros Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Aikaterini Tsiogka
- Faculty of Medicine, 1st Department of Dermatology-Venereology, Andreas Sygros Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - George Kontochristopoulos
- Faculty of Medicine, 1st Department of Dermatology-Venereology, Andreas Sygros Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Annamaria Offidani
- Dermatology Clinic, Department of Clinical and Molecular Sciences, Polytechnic Marche University, Ancona, Italy
| | - Anna Campanati
- Dermatology Clinic, Department of Clinical and Molecular Sciences, Polytechnic Marche University, Ancona, Italy
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18
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Gan J, Liu S, Wang XD, Hu W, Lv Y, Niu J, Meng X, Chen Y, Shi Z, Ji Y. The Association Between Hyperhidrosis and Dementia: A Community-Based Research. J Alzheimers Dis 2021; 84:1657-1667. [PMID: 34744079 DOI: 10.3233/jad-210611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Dementia and hyperhidrosis (HH) are common in the elderly while there is little research to investigate the association between them. OBJECTIVE To clarify a possible association between HH and dementia in population of adults ≥65 years old in China. METHODS A cross-sectional survey for elderly adults ≥65 years old was conducted from April to December 2019. A total of 5,958 participants were analyzed after two phases investigation. Goodness-of-fit tests (Pearson and deviance) were used to estimate the dispersion parameter and examine the adequacy of the models. Logistic and linear regression analyses were used to evaluate the association between HH and dementia. RESULTS The overall prevalence of all-cause dementia was 10.17%, that of dementia with Lewy bodies (DLB) was 1.41%, and HH was 14.97%. Prevalence rates of HH were higher in participants with dementia and DLB. There was a significant positive relationship between HH duration and MMSE score (r = 0.207, p < 0.001, Durbin-Watson test = 1.806). Participants with HH were 1.275 (95% CI: 1.015-1.601, p = 0.037) times to have dementia, and 3.616 (95% CI: 2.267-5.767, p < 0.001) times to suffer from DLB than those without HH. Pearson and deviance chi square tests did not indicate overdispersion (p > 0.05 in the logistic regression models). CONCLUSION HH was common in the Chinese population ≥65 years old. It can increase the risk of dementia, particularly in DLB, in the elderly. It is important to improve the awareness of HH among dermatologists and neurologists.
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Affiliation(s)
- Jinghuan Gan
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, China National Clinical Research Center for Neurological Diseases, Beijing, China
| | - Shuai Liu
- Tianjin Key Laboratory of Cerebrovascular and of neurodegenerative diseases, Tianjin Dementia Institute, Department of Neurology, Tianjin Huanhu Hospital, Tianjin, China
| | - Xiao-Dan Wang
- Tianjin Key Laboratory of Cerebrovascular and of neurodegenerative diseases, Tianjin Dementia Institute, Department of Neurology, Tianjin Huanhu Hospital, Tianjin, China
| | - Wenzheng Hu
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, China National Clinical Research Center for Neurological Diseases, Beijing, China
| | - Yang Lv
- Department of Neurology, the First Affiliated Hospital, Chongqing University of Medical Science, Chongqing, China
| | - Jianping Niu
- Department of Neurology, the Second Hospital of Xiamen, Xiamen, China
| | - Xinling Meng
- Department of Neurology, Affiliated Traditional Chinese Medicine Hospital, Xinjiang Medical University, Urumqi, China
| | - Yongjie Chen
- Department of Epidemiology and Statistics, School of Public Health, Tianjin Medical University, Tianjin, China; Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China
| | - Zhihong Shi
- Tianjin Key Laboratory of Cerebrovascular and of neurodegenerative diseases, Tianjin Dementia Institute, Department of Neurology, Tianjin Huanhu Hospital, Tianjin, China
| | - Yong Ji
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, China National Clinical Research Center for Neurological Diseases, Beijing, China.,Tianjin Key Laboratory of Cerebrovascular and of neurodegenerative diseases, Tianjin Dementia Institute, Department of Neurology, Tianjin Huanhu Hospital, Tianjin, China
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19
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Yokozeki H, Fujimoto T, Wanatabe S, Ogawa S, Fujii C. Topical glycopyrronium tosylate in Japanese patients with primary axillary hyperhidrosis: A randomized, double-blind, vehicle-controlled study. J Dermatol 2021; 49:86-94. [PMID: 34636057 PMCID: PMC9293301 DOI: 10.1111/1346-8138.16188] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 08/19/2021] [Accepted: 09/25/2021] [Indexed: 11/24/2022]
Abstract
Glycopyrronium tosylate cloth, an anticholinergic drug, has been approved for the topical treatment of primary axillary hyperhidrosis in the USA, but its effects in Japanese patients have not been previously investigated. This 4-week, randomized, double-blind, vehicle-controlled, multicenter study was conducted to evaluate the efficacy and safety of glycopyrronium tosylate cloth for primary axillary hyperhidrosis patients in Japan. Eligible patients, who were ≥9 years of age and had primary axillary hyperhidrosis ≥6 months, with gravimetrically-measured sweat production ≥50 mg/5 min, and Hyperhidrosis Disease Severity Scale ≥3 (moderate) were randomized 1:1:1 to once daily topical glycopyrronium tosylate 3.75%, 2.5%, or vehicle. Overall, 497 patients (163 in the glycopyrronium tosylate 3.75% group, 168 in the glycopyrronium tosylate 2.5% group, and 166 in the vehicle group, hereinafter in this order) were randomized. Statistically higher proportions of patients in the glycopyrronium tosylate groups achieved ≥2-point improvement in Hyperhidrosis Disease Severity Scale and ≥50% reduction in sweat production from baseline versus vehicle at week 4 (51.6%, 41.1%, and 16.4%, respectively; p < 0.001 in both cases). Higher responder rates in the glycopyrronium tosylate groups compared with the vehicle group occurred as early as week 1. The most common treatment-emergent adverse events in patients treated with glycopyrronium tosylate were photophobia, mydriasis, thirst, and dysuria. Most treatment-emergent adverse events were mild as determined by the investigators. The incidence of treatment-emergent adverse events leading to treatment modification was low in the three groups. The 4-week use of topical glycopyrronium tosylate improved the patient-reported outcome measure Hyperhidrosis Disease Severity Scale and objectively-evaluated sweat production with a favorable benefit/risk profile.
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Affiliation(s)
- Hiroo Yokozeki
- Department of Dermatology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Tomoko Fujimoto
- Ikebukuro Nishiguchi Fukurou Dermatology Clinic, Tokyo, Japan
| | | | - Shuhei Ogawa
- Clinical Development Department, Maruho Co., Ltd., Kyoto, Japan
| | - Chie Fujii
- Clinical Development Department, Maruho Co., Ltd., Kyoto, Japan
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20
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Abels C, Soeberdt M, Kilic A, Reich H, Knie U, Jourdan C, Schramm K, Heimstaedt‐Muskett S, Masur C, Szeimies R. A glycopyrronium bromide 1% cream for topical treatment of primary axillary hyperhidrosis: efficacy and safety results from a phase IIIa randomized controlled trial. Br J Dermatol 2021; 185:315-322. [PMID: 33445205 PMCID: PMC8451866 DOI: 10.1111/bjd.19810] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/09/2021] [Indexed: 12/30/2022]
Abstract
BACKGROUND Effective topical treatment options for patients with primary axillary hyperhidrosis (PAHH) are limited. A phase I trial showed promising results regarding the efficacy and safety of a topical cream containing glycopyrronium bromide (GPB). OBJECTIVES To assess the efficacy, safety and tolerability of a 4-week topical treatment of GPB 1% cream in patients with PAHH vs. placebo. METHODS In total, 171 patients (84 receiving placebo; 87 receiving GPB 1%) with PAHH were included in the 4-week, multicentre, randomized, double-blind, placebo-controlled phase IIIa part of the pivotal study. Sweat production was measured by gravimetry. Patients rated the impact of disease with the Hyperhidrosis Disease Severity Scale (HDSS) and Hyperhidrosis Quality of Life Index (HidroQoL© ). RESULTS Absolute change in sweat production from baseline to day 29 in logarithmic values was significantly larger in the GPB 1% group compared with the placebo group (P = 0·004). The improvement in HidroQoL exceeded the minimal clinically important difference of 4. The proportion of responders was twofold higher for sweat reduction (-197·08 mg GPB 1% vs. -83·49 mg placebo), HDSS (23% GPB 1% vs. 12% placebo) and HidroQoL (60% GPB 1% vs. 26% placebo). Treatment was safe: most treatment-emergent adverse effects were mild or moderate, and transient. Local tolerability was very good, with 9% of patients having only mild or moderate application-site reactions. The most reported adverse drug reaction was dry mouth (16%), an expected anticholinergic effect of the treatment. CONCLUSIONS GPB 1% cream may provide an effective new treatment option exhibiting a good safety profile for patients with PAHH. The long-term open-label part (phase IIIb) is ongoing.
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Affiliation(s)
- C. Abels
- Dr. August Wolff GmbH & Co. KG Arzneimittel33611BielefeldGermany
| | - M. Soeberdt
- Dr. August Wolff GmbH & Co. KG Arzneimittel33611BielefeldGermany
| | - A. Kilic
- Dr. August Wolff GmbH & Co. KG Arzneimittel33611BielefeldGermany
| | - H. Reich
- Dr. August Wolff GmbH & Co. KG Arzneimittel33611BielefeldGermany
| | - U. Knie
- Dr. August Wolff GmbH & Co. KG Arzneimittel33611BielefeldGermany
| | | | | | | | - C. Masur
- Dr. August Wolff GmbH & Co. KG Arzneimittel33611BielefeldGermany
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21
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Murota H, Fujimoto T, Oshima Y, Tamada Y, Yanagishita T, Murayama N, Inoue S, Okatsu H, Miyama H, Yokozeki H. Cost-of-illness study for axillary hyperhidrosis in Japan. J Dermatol 2021; 48:1482-1490. [PMID: 34245048 PMCID: PMC8518070 DOI: 10.1111/1346-8138.16050] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 05/17/2021] [Accepted: 06/12/2021] [Indexed: 12/01/2022]
Abstract
The prevalence of primary axillary hyperhidrosis in Japan is 5.75% (males, 6.60%; females, 4.72%) in the population aged 5–64 years. No study on comprehensively evaluated direct medical costs, hygiene product costs, and productivity loss in axillary hyperhidrosis patients has been published in Japan. The aim of this study was to estimate the cost of illness for axillary hyperhidrosis in Japan by conducting a nationwide insurance claims database analysis and a cross‐sectional Web‐based survey. Among patients diagnosed with primary axillary hyperhidrosis at least once between November 2012 and October 2019, health insurance receipt data of 1447 patients were analyzed. A cross‐sectional Web‐based survey was conducted on 321 patients aged 16–59 years with axillary hyperhidrosis to calculate hygiene product costs and productivity loss using a Work Productivity and Activity Impairment questionnaire. Furthermore, nationwide estimation was performed for the hygiene product costs and productivity loss based on the number of patients estimated from the prevalence. The annual direct medical costs per axillary hyperhidrosis patient were ¥91 491 in 2016, ¥93 155 in 2017, and ¥75 036 in 2018. In all of these years, botulinum toxin type A injection accounted for approximately 90% of the total costs. The annual total cost of hygiene products per axillary hyperhidrosis patient was ¥9325. The overall work impairment (%) of working patients with axillary hyperhidrosis was 30.52%, and its monthly productivity loss was ¥120 593/patient. The activity impairment (%) of full‐time housewives with axillary hyperhidrosis was 49.05% and its monthly productivity loss was ¥176 368/patient. The annual hygiene product cost based on the nationwide estimation was ¥24.5 billion and the monthly productivity loss was ¥312 billion. The significant cost associated with axillary hyperhidrosis was clarified. If out‐of‐pocket expenses for treatments not covered by health insurance are included in the estimation, the cost will further increase.
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Affiliation(s)
- Hiroyuki Murota
- Department of Dermatology, Nagasaki University, Nagasaki, Japan
| | - Tomoko Fujimoto
- Ikebukuro Nishiguchi Fukurou Dermatology Clinic, Tokyo, Japan
| | - Yuichiro Oshima
- Department of Dermatology, Aichi Medical University School of Medicine, Aichi, Japan
| | - Yasuhiko Tamada
- Department of Dermatology, Aichi Medical University School of Medicine, Aichi, Japan
| | - Takeshi Yanagishita
- Department of Dermatology, Aichi Medical University School of Medicine, Aichi, Japan
| | - Naoya Murayama
- Department of Dermatology, Nagasaki University, Nagasaki, Japan
| | | | - Hiromichi Okatsu
- Medical Affairs Department, Kaken Pharmaceutical Co., Ltd., Tokyo, Japan
| | - Hiroshi Miyama
- Medical Affairs Department, Kaken Pharmaceutical Co., Ltd., Tokyo, Japan
| | - Hiroo Yokozeki
- Department of Dermatology, Tokyo Medical and Dental University, Tokyo, Japan
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22
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Fujimoto T, Abe Y, Igarashi M, Ishikoh A, Omi T, Kanda H, Kitahara H, Kinoshita M, Nakasu I, Hattori N, Horiuchi Y, Maruyama R, Mizutani H, Murakami Y, Watanabe C, Kume A, Hanafusa T, Hamaguchi M, Yoshioka A, Egami Y, Matsuo K, Matsuda T, Akamatsu M, Yorozuya T, Takayama S, Yokozeki H. A phase III, 52-week, open-label study to evaluate the safety and efficacy of 5% sofpironium bromide (BBI-4000) gel in Japanese patients with primary axillary hyperhidrosis. J Dermatol 2021; 48:1149-1161. [PMID: 34041788 PMCID: PMC8453842 DOI: 10.1111/1346-8138.15927] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 03/18/2021] [Accepted: 04/06/2021] [Indexed: 11/27/2022]
Abstract
A long‐term study was conducted in Japanese patients with primary axillary hyperhidrosis who completed the preceding 6‐week phase III, confirmatory study of 5% sofpironium bromide gel (hereinafter referred to as sofpironium) to evaluate the safety and efficacy of 52‐week treatment with sofpironium. In the long‐term study, 185 patients who completed the confirmatory study (94 and 91 patients in the vehicle and sofpironium groups, respectively) started to receive sofpironium (switching and extension groups, respectively), and all these patients were included in both the full analysis set (FAS) and the safety analysis set (SAF). In the FAS, there were more females than males (73.0% vs. 27.0%), and median age was 38.0 years. A total of 161 patients (86 and 75 patients in the switching and extension groups, respectively) completed the study at week 52. The proportions of patients with hyperhidrosis disease severity score of 1 or 2 and a 50% or more reduction in total gravimetric weight of sweat were 57.4% in the switching group and 58.2% in the extension group at week 52. The proportions of patients who achieved this efficacy end‐point in the long‐term study were similar to that (53.9%) in the sofpironium group in the confirmatory study. In the SAF, the incidences of adverse events (AEs) were 80.9% in the switching group and 83.5% in the extension group, and the incidences of adverse drug reactions were 39.4% and 45.1%, respectively. AEs that occurred in at least 20% of patients in both treatment groups were application site dermatitis (25.5% and 33.0%, respectively) and nasopharyngitis (31.9% and 23.1%, respectively). Reported AEs were generally mild, and there were no deaths. Serious AEs occurred in three patients, but none were considered related to the study drug. In this study, the efficacy of sofpironium was maintained during 52‐week treatment, and no new safety risk was observed.
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Affiliation(s)
- Tomoko Fujimoto
- Ikebukuro Nishiguchi Fukurou Dermatology Clinic, Tokyo, Japan
| | - Yoichiro Abe
- Department of Pain Clinic, NTT Medical Center Tokyo, Tokyo, Japan
| | | | | | - Tokuya Omi
- Department of Dermatology, Queen's Square Medical Center, Kanagawa, Japan
| | | | | | | | | | | | | | | | | | | | | | - Akihiro Kume
- Dermatology and Ophthalmology Kume Clinic, Osaka, Japan
| | | | | | | | - Yuriko Egami
- Ekihigashi Dermatology and Allergology Clinic, Fukuoka, Japan
| | | | | | | | | | | | - Hiroo Yokozeki
- Department of Dermatology, Tokyo Medical and Dental University, Tokyo, Japan
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23
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How to diagnose and measure primary hyperhidrosis: a systematic review of the literature. Clin Auton Res 2021; 31:511-528. [PMID: 33772671 DOI: 10.1007/s10286-021-00794-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 03/02/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE Hyperhidrosis (i.e. excessive sweating) is diagnosed from patient medical history and physical examination. In addition, focal sweat measurements can substantiate the hyperhidrosis diagnosis. Likewise, the impact of living with hyperhidrosis can be assessed with patient-reported outcome measures. However, no consensus exists on how to diagnose hyperhidrosis, how to quantify the disease, or how to measure the impact hyperhidrosis has on patients. Therefore, the objective of this review was to summarize the literature on diagnostic criteria, focal sweat measurement methods, and patient-reported outcome measures of hyperhidrosis. METHODS A literature search of Cochrane Library, Embase, and PubMed was conducted. Studies that included and aimed at developing or validating hyperhidrosis diagnostic criteria, focal sweat measurement methods, or patient-reported outcome measures for individuals with hyperhidrosis were eligible for inclusion. The methodological quality of diagnostic accuracy studies about focal sweat measurement methods was determined using the Quality Assessment of Diagnostic Accuracy Studies-2. RESULTS Overall, 33 studies were included. We identified two sets of hyperhidrosis diagnostic criteria, one scale for assessment of severity of hyperhidrosis sweating, four focal sweat measurement methods, and 15 patient-reported outcome measures. CONCLUSION The algorithm for diagnosing hyperhidrosis and focal sweat measurement methods needs validation in large cohorts. Most patient-reported outcome measures for hyperhidrosis are not adequately validated. A potential solution is to develop a core outcome set that can standardize outcomes reported in clinical trials.
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24
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Yokozeki H, Fujimoto T, Abe Y, Igarashi M, Ishikoh A, Omi T, Kanda H, Kitahara H, Kinoshita M, Nakasu I, Hattori N, Horiuchi Y, Maruyama R, Mizutani H, Murakami Y, Watanabe C, Kume A, Hanafusa T, Hamaguchi M, Yoshioka A, Egami Y, Matsuo K, Matsuda T, Akamatsu M, Yorozuya T, Takayama S. A phase 3, multicenter, randomized, double-blind, vehicle-controlled, parallel-group study of 5% sofpironium bromide (BBI-4000) gel in Japanese patients with primary axillary hyperhidrosis. J Dermatol 2021; 48:279-288. [PMID: 33410265 PMCID: PMC7986147 DOI: 10.1111/1346-8138.15668] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Accepted: 09/30/2020] [Indexed: 01/06/2023]
Abstract
A phase 3 study was conducted to verify the efficacy and safety of 5% sofpironium bromide (BBI‐4000) gel (hereinafter referred to as sofpironium) administrated for 6 weeks in Japanese patients with primary axillary hyperhidrosis. The primary efficacy end‐point was the proportion of patients who satisfied both criteria of a Hyperhidrosis Disease Severity Score (HDSS) of 1 or 2 at the end of 6‐week treatment and a 50% or more reduction in total gravimetric weight of sweat at the end of treatment relative to baseline. A total of 281 patients were randomized to receive 5% sofpironium (141 patients) or vehicle (140 patients), and all patients were included in the full analysis set (FAS). In the FAS, 70.1% of patients were female, and the median age was 35.0 years. The proportion of patients who achieved the primary efficacy end‐point was 53.9% in the sofpironium group and 36.4% in the vehicle group, with a statistically significant difference of 17.5% (95% confidence interval, 6.02–28.93) between these two groups (P = 0.003). The incidence of adverse events was 44.0% in the sofpironium group and 30.7% in the vehicle group, and the incidence of adverse drug reactions was 16.3% in the sofpironium group and 5.0% in the vehicle group. Reported adverse events were generally mild or moderate in severity. In the sofpironium group, common events (incidence, ≥5%) were nasopharyngitis (14.2%) and dermatitis/erythema at the application site (8.5%/5.7%), with no serious adverse events reported. This study demonstrated the efficacy and safety of 5% sofpironium.
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Affiliation(s)
- Hiroo Yokozeki
- Department of Dermatology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Tomoko Fujimoto
- Ikebukuro Nishiguchi Fukurou Dermatology Clinic, Tokyo, Japan
| | - Yoichiro Abe
- Department of Pain Clinic, NTT Medical Center Tokyo, Tokyo, Japan
| | | | | | - Tokuya Omi
- Department of Dermatology, Queen's Square Medical Center, Kanagawa, Japan
| | | | | | | | | | | | | | | | | | | | | | - Akihiro Kume
- Dermatology and Ophthalmology Kume Clinic, Osaka, Japan
| | | | | | | | - Yuriko Egami
- Ekihigashi Dermatology and Allergology Clinic, Fukuoka, Japan
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Garcia-Souto F, Del Boz J, Colmenero-Sendra M, Polo-Padillo J. Craniofacial hyperhidrosis: Clinical characteristics and response to treatment in a cohort of 97 patients treated with oral oxybutynin. Dermatol Ther 2020; 34:e14658. [PMID: 33301207 DOI: 10.1111/dth.14658] [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] [Received: 10/06/2020] [Revised: 11/18/2020] [Accepted: 12/04/2020] [Indexed: 11/28/2022]
Abstract
The term craniofacial hyperhidrosis (HH) refers to HH that affects the face and/or scalp. Few studies have focused on this specific location, and even fewer distinguish between the two areas. Our study aims are to describe the clinical characteristics of patients with craniofacial HH, specifying whether the condition affects the scalp, face or both, and to compare these cases with those recorded at other locations. As secondary objectives, we determine the effectiveness and adverse effects of oral oxybutynin (OOx), and assess patients' adherence to treatment. This prospective observational study was carried out with respect to the period 2007-2019. All patients diagnosed with HH of the scalp and/or face and who were treated with OOx at our HH unit were included in the study group. Of 292 patients treated with OOx, 97 (33.2%) had craniofacial HH. Of these, 4 (4.1%) presented HH exclusively on the scalp, 56 (57.7%) exclusively on the face and 37 (38.1%) in both locations. The patients in the latter category (compared with those with exclusively facial HH) were significantly older than the others, had a later onset of HH, a greater frequency of secondary HH, less simultaneous involvement of the classical areas of primary focal HH (the palms, soles, and armpits) and greater generalized HH and of the trunk. No significant differences were observed between the three locations (face, scalp, or both) regarding the efficacy and side effects of OOx. The patients with exclusively facial HH presented greater adherence to treatment.
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Affiliation(s)
- Fernando Garcia-Souto
- Department of Dermatology, Hospital Universitario de Valme, Seville, Spain.,Faculty of Medicine, University of Seville, Seville, Spain
| | - Javier Del Boz
- Department of Dermatology, Hospital Costa del Sol, Málaga, Spain
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Differences in subjective and objective evaluation of hyperhidrosis. Study among medical students. Postepy Dermatol Alergol 2020; 37:700-704. [PMID: 33240009 PMCID: PMC7675081 DOI: 10.5114/ada.2019.84227] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Accepted: 03/01/2019] [Indexed: 11/21/2022] Open
Abstract
Introduction Hyperhidrosis is a condition that significantly impairs patients’ quality of life. Qualification for treatment in most cases is based only on subjective evaluation of symptoms without objective confirmation. Aim To evaluate the differences between subjective and objective evaluation of sweating among medical students. Material and methods There were 179 participants involved in the study. Subjective evaluation of sweating was conducted using the Hyperhidrosis Disease Severity Scale and Numeric Rating Scale in 4 body areas: the face, palms, armpits and abdomino-lumbar area. Objective evaluation of sweating was performed using gravimetry. Results The prevalence of hyperhidrosis in gravimetric measures was 1.12%. In subjective evaluation hyperhidrosis (HDSS 3 or 4) was present in 11.17% of cases. There was no significant difference in subjective evaluation of hyperhidrosis between men and women (15% vs. 9.24%; p = 0.32). In gravimetry men showed a higher perspiration rate on the face (5.85 vs. 3.38; p < 0.05) and in the armpits (17.27 vs. 9.12; p < 0.05). Individuals with body mass index ≥ 25 kg/m2 reported hyperhidrosis more often (28% vs. 8.44%; p < 0.05); however, in gravimetric evaluation, beside the facial area, no significant differences in above-mentioned groups were observed. Conclusions There is a discrepancy between subjective and objective methods of evaluating sweating.
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Kato K, Al-Sobaihi S, Al-Busani H, Nishizawa A, Ohmi M, Yokozeki H, Namiki T. Analysis of sweating by optical coherence tomography in patients with palmoplantar hyperhidrosis. J Dermatol 2020; 48:334-343. [PMID: 33230876 DOI: 10.1111/1346-8138.15694] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Accepted: 10/19/2020] [Indexed: 12/13/2022]
Abstract
Optical coherence tomography (OCT) is a high-resolution tomographic imaging technique that uses optical interference. OCT has enabled the non-invasive three-dimensional analysis of individual acrosyringia in the stratum corneum in human skin. However, no report on the measurement of sweating by OCT using clinical data from humans has been published to date. Twenty patients with hyperhidrosis and twenty healthy subjects were included in this study. Imaging of acrosyringia in the stratum corneum using OCT and measurement of the sweat rate using the ventilated capsule method were performed simultaneously. The hand grip exercise of the right hand was used as a load to induce sweating, and the left fingertip was measured before and after the exercise load. Five acrosyringia were extracted from each OCT image, and their volumes were calculated. The mean volume of each acrosyringium was divided by the thickness of the stratum corneum to calculate the mean cross-sectional area of the acrosyringium. Furthermore, the number of sweat droplets on the skin surface was measured. The mean cross-sectional area of acrosyringia after the load increased both in patients with hyperhidrosis and in healthy subjects (P < 0.001). The mean cross-sectional area of acrosyringia of patients with hyperhidrosis was larger than that of healthy subjects (P < 0.001). The mean cross-sectional area of acrosyringia and the sweat rate showed a positive correlation before and after the load (r = 0.88 to 0.91). The number of droplets also increased after the load (P < 0.001), and the number of droplets in patients with hyperhidrosis was higher than in healthy subjects (P < 0.001). Our study has shown that acrosyringia in the stratum corneum increase in proportion to the sweat rate. OCT is a rigorous and valuable method that can measure and quantify sweating in the body without being an invasive procedure.
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Affiliation(s)
- Kohei Kato
- Department of Dermatology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Bunkyo-ku, Japan
| | - Saber Al-Sobaihi
- Department of Global Health Entrepreneurship, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Hind Al-Busani
- Department of Dermatology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Bunkyo-ku, Japan
| | - Aya Nishizawa
- Department of Dermatology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Bunkyo-ku, Japan
| | - Masato Ohmi
- Division of Health Sciences, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Hiroo Yokozeki
- Department of Dermatology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Bunkyo-ku, Japan
| | - Takeshi Namiki
- Department of Dermatology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Bunkyo-ku, Japan
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Shayesteh A, Brulin C, Nylander E. The Meaning of Living for Men Suffering From Primary Hyperhidrosis. Am J Mens Health 2020; 13:1557988319892725. [PMID: 31849276 PMCID: PMC6920586 DOI: 10.1177/1557988319892725] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Primary hyperhidrosis means excessive focal sweating and it has a negative effect on the mental health of those affected. Although there is no gender difference regarding the prevalence of the disease, men are less likely to seek help for this condition. The aim of this study was to explore the meaning of living with primary hyperhidrosis in men. Interviews with 15 men, selected by purposive sampling, were performed at Umeå University Hospital in Sweden between June 2016 and October 2017, and analyzed using qualitative content analysis technique according to Graneheim and Lundman (2004). This study found one theme, namely, to be captured in a filthy body, based on the categories: surrender to the condition reluctantly; prepare for a sweat attack; withdraw from close contacts; and worry about others' perceptions. The theme describes men living with hyperhidrosis feeling filthy while they struggle to control or hide the excessive sweating. Insufficient understanding from others and being reminded from the sweating is stressful and results in a sense of captivity. Interpreting the result, we conclude that the disease could stigmatize the individual, which has a negative effect on mental health and the will to seek help. Meanwhile, providing information about the disease early, as in schools, could increase the willingness of men to seek medical help. The results of this study also reinforce quantitative studies reporting the negative effects of primary hyperhidrosis on mental health.
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Affiliation(s)
- Alexander Shayesteh
- Department of Public Health and Clinical Medicine, Dermatology and Venereology, Umeå University, Sweden
| | | | - Elisabet Nylander
- Department of Public Health and Clinical Medicine, Dermatology and Venereology, Umeå University, Sweden
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Thianboonsong T, Kanokrungsee S, Paichitrojjana A, Udompataikul M, Kamanamool N, Rojhirunsakool S. Efficacy and tolerability of 20% aluminum sesquichlorohydrate vs 20% aluminum chloride for the treatment of axillary hyperhidrosis: A randomized controlled trial. Dermatol Ther 2020; 33:e14354. [PMID: 32990370 DOI: 10.1111/dth.14354] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 09/07/2020] [Accepted: 09/23/2020] [Indexed: 11/29/2022]
Abstract
This study evaluated the efficacy and tolerability of topical aluminum sesquichlorohydrate (AS) when compared to aluminum chloride (AC) as a treatment for primary axillary hyperhidrosis (PAH). Twenty subjects were included in this randomized, controlled, split-side 8-week study. All participants applied 20% AS and 20% AC lotions in their axillae (one treatment per axilla) every night for 2 weeks; next, the application was reduced to three times a week for 4 weeks. The assessment was performed using the sweating intensity visual scale (SIVS), hyperhidrosis disease severity score (HDSS), patient satisfaction score, and the appearance of adverse effects on weeks 0, 1, 2, 4, 6, and 8. Both AS as well as AC application showed positive results, significantly differing from the baseline, as assessed using SIVS, HDSS, and patient satisfaction score at every follow-up visit; however, no significant difference was observed between the AS and AC groups at any follow-up visit. The mean time of response was 1.14 weeks for both treatments. A side effect was observed in one subject (5%), who reported itching on the AC axilla. The therapeutic effects persisted even after reducing the frequency of application and lasted for at least 2 weeks after cessation of use. In conclusion, topical 20% AS demonstrated similar efficacy to topical 20% AC in the treatment of PAH, with a high safety profile.
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Affiliation(s)
| | | | | | | | - Nanticha Kamanamool
- Department of Preventive and Social Medicine, Srinakharinwirot University, Bangkok, Thailand
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Wei Y, Xu ZQD, Li H. Quality of life after thoracic sympathectomy for palmar hyperhidrosis: a meta-analysis. Gen Thorac Cardiovasc Surg 2020; 68:746-753. [PMID: 32390086 DOI: 10.1007/s11748-020-01376-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Accepted: 04/26/2020] [Indexed: 10/24/2022]
Abstract
OBJECTIVE Palmar hyperhidrosis affects 0.6-10% of the general population, having an important impact in patients' quality of life. The definitive treatment for palmar hyperhidrosis is thoracic sympathectomy. The purpose of this study is to evaluate the quality of life after thoracic sympathectomy for palmar hyperhidrosis. METHODS The interest studies were searched in six comprehensive databases. The quality of the studies was assessed using the risk of bias tool recommended by the Cochrane system evaluation manual. Meta-analysis was performed with RevMan version 5.3. The outcome of interest was quality of life. The subgroup analysis and sensitive analysis were performed. RESULTS Nine trials, including 895 patients, with accessible data comparing preoperative quality of life score with postoperative quality-of-life score were used for data analysis. Compared with preoperative quality-of-life score, application of thoracic sympathectomy improved the postoperative quality of life of palmar hyperhidrosis patients (MD = 57.81, 95% CI 53.33-62.30). Subgroup analysis of the different thoracic sympathectomy segment showed that there was no significant difference in the results obtained when operated with single segment or multiple segments (single segment: MD = 61.16, 95% CI [56.10, 66.22], multiple segments: MD = 52.14, 95% CI [48.39, 55.88]). CONCLUSION The meta-analysis provided evidence of the improved quality of life after thoracic sympathectomy for palmar hyperhidrosis.
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Affiliation(s)
- Yunwei Wei
- Capital Medical University, Beijing, China.,Department of Thoracic Surgery, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Zhi-Qing David Xu
- Department of Neurobiology, School of Basic Medical Science, Capital Medical University, Beijing, China
| | - Hui Li
- Department of Thoracic Surgery, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China.
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Nawrocki S, Cha J. Botulinum toxin: Pharmacology and injectable administration for the treatment of primary hyperhidrosis. J Am Acad Dermatol 2019; 82:969-979. [PMID: 31811879 DOI: 10.1016/j.jaad.2019.11.042] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Revised: 11/15/2019] [Accepted: 11/22/2019] [Indexed: 01/17/2023]
Abstract
Hyperhidrosis is a dermatological condition defined by excessive sweating beyond thermoregulatory needs with significant effects on patients' quality of life. Hyperhidrosis is categorized as primary or secondary: primary hyperhidrosis is mostly focal and idiopathic, whereas secondary hyperhidrosis is commonly generalized and caused by an underlying medical condition or use of medications. Various surgical and nonsurgical therapies exist for primary hyperhidrosis. Although botulinum toxin is one of the deadliest toxins known, when used in small doses, it is one of the most effective therapies for primary hyperhidrosis. Botulinum toxin injections are widely used as a second-line primary hyperhidrosis treatment option once topical treatment strategies have failed. This article provides an overview of the commercially available botulinum toxin formulations and their applications in the treatment of primary hyperhidrosis.
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Affiliation(s)
- Shiri Nawrocki
- Rutgers-Robert Wood Johnson Medical School, Department of Dermatology, Piscataway, New Jersey.
| | - Jisun Cha
- Thomas Jefferson University, Department of Dermatology, Philadelphia, Pennsylvania
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Wadhawa S, Agrawal S, Chaudhary M, Sharma S. Hyperhidrosis Prevalence: A Disease Underreported by Patients and Underdiagnosed by Physicians. Indian Dermatol Online J 2019; 10:676-681. [PMID: 31807447 PMCID: PMC6859754 DOI: 10.4103/idoj.idoj_55_19] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Hyperhidrosis (HH) is a disorder characterized by excessive sweating beyond required for normal thermoregulation, as a result of the excessive functioning of the sudomotor sweat control system. HH is broadly classified into 2 categories: primary HH and secondary. Our aim was to study the prevalence of HH in patients attending dermatological outpatients. METHODS Randomly selected 832 attendees of dermatology outpatient department were requested to fill out a questionnaire for their presenting concerns to attend, the demography information (age, gender, and occupation), and presence of excessive visible sweating symptoms after the informed, written, and understood consent. This questionnaire was then evaluated by the researchers. And those who had a history of excessive sweating were evaluated in detail about HH by another questionnaire. RESULTS The overall prevalence of HH was 17.9% (149/832), whereas only self-reported prevalence was 10.2% (85/832) in the dermatology outpatients. Of 149 patients, 110 (73.8%) were of primary HH followed by 39 (26.2%) of secondary HH. CONCLUSION This study showed a higher prevalence of HH in the attendees of dermatology outpatients of a tertiary care center but estimates that this disease affects a much larger proportion of individuals in the Nepalese population.
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Affiliation(s)
- Surajsingh Wadhawa
- Department of Dermatology, B.P. Koirala Institute of Health Sciences, Ghopa, Dharan, Nepal
| | - Sudha Agrawal
- Department of Dermatology, B.P. Koirala Institute of Health Sciences, Ghopa, Dharan, Nepal
| | - Manoj Chaudhary
- Department of Dermatology, B.P. Koirala Institute of Health Sciences, Ghopa, Dharan, Nepal
| | - Sanjib Sharma
- Department of Internal Medicine, B.P. Koirala Institute of Health Sciences Ghopa, Dharan, Nepal
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Ribeiro Santos Morard M, Betanho Martins R, Lopes Ribeiro AC, Guimarães Rocha Lima P, dos Santos Carvalho B, Junior JCBS. Primary hyperhidrosis prevalence and characteristics among medical students in Rio de Janeiro. PLoS One 2019; 14:e0220664. [PMID: 31518360 PMCID: PMC6744157 DOI: 10.1371/journal.pone.0220664] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Accepted: 07/19/2019] [Indexed: 11/24/2022] Open
Abstract
Background Hyperhidrosis is a pathological condition defined by excessive sweating beyond thermoregulatory physiological needs, which can cause substantial psychological impact and impairment of daily activities. Studies regarding its prevalence, however, are scarce and vary widely in their findings. The population of medical students is a particularly interesting subset for its recurring demand of physical contact during patient examination or procedures, and the potential for professional adversity. We aimed at furthering the comprehension of this disease prevalence and characteristics among medical students. Methods Questionnaires inquiring about the presence and characteristics of Primary Hyperhidrosis (PH) were applied through either written or digital means to all eligible medical students enrolled in three Medical Schools in the State of Rio de Janeiro who agreed to take part in the study. Demographic data regarding gender, ethnicity, current age, weight and height was collected in addition to clinical data (sweat site, age of onset, familial history, severity and previous treatments). Severity was evaluated through the Hyperhidrosis Disease Severity Scale (HDSS) and a symptoms survey. Findings Our response rate was roughly 1/3 of all eligible students (900/2700). PH prevalence was 20.56% (185/900). It was similar between men and women (23.08% and 19.41%, respectively) and strongly associated with family history of the disease (Prevalence Ratio of 4.27). Regarding ethnicity, of the total sample 73.78% (664/900) self-declared white, among which 19.28% (128/664) had PH. Mixed-race and other ethnicities encompassed 26.22% (236/900) of the sample, among which 24.15% (57/236) had PH. Most positive subjects (64.32%) presented associated forms of PH. Overall involvement of each site (both associated and isolated) was: 63.78% axillary, 50.81% palmar, 43.24% plantar, 20.54% craniofacial, 18.38% facial flushing and 2.16% gustatory sweating. Mean current age was 23.11(±4.04) years for PH patients, and age of onset was ≤18 years in 93.94% of cases. Regarding body mass index (BMI), 71.09% of PH patients had BMI<25kg/m2 and only 4.69% presented BMI≥30kg/m2, none ≥35kg/m2. Some degree of life quality impairment was reported by 89.20% of PH patients, and 23.89% had HDSS 3 or 4 (moderate to severe). Conclusions PH prevalence among Rio de Janeiro medical students was 20.56%, similar between men and women, predominating associated presentations, axillary, palmar and plantar sites, strong familial history, age of onset before 18 years, and some degree of life impairment.
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Affiliation(s)
- Maria Ribeiro Santos Morard
- UNIRIO—Universidade Federal do Estado do Rio De Janeiro, Rio de Janeiro, RJ, Brazil
- UNESA—Universidade Estácio de Sá, Rio de Janeiro, RJ, Brazil
- * E-mail: (MRSM); (RBM)
| | - Ricardo Betanho Martins
- UNIRIO—Universidade Federal do Estado do Rio De Janeiro, Rio de Janeiro, RJ, Brazil
- * E-mail: (MRSM); (RBM)
| | | | - Pedro Guimarães Rocha Lima
- UNIRIO—Universidade Federal do Estado do Rio De Janeiro, Rio de Janeiro, RJ, Brazil
- FMP–Faculdade de Medicina de Petrópolis, Petrópolis, RJ, Brazil
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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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Yamamoto H, Okada M. The management of compensatory sweating after thoracic sympathectomy. J Thorac Cardiovasc Surg 2019; 158:1481-1488. [PMID: 31358338 DOI: 10.1016/j.jtcvs.2019.05.062] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Revised: 05/14/2019] [Accepted: 05/16/2019] [Indexed: 11/25/2022]
Abstract
OBJECTIVE The main therapeutic method of treatment for local hyperhidrosis is endoscopic thoracic sympathectomy. Generally, resections of the sympathetic trunk or ganglia are performed between the second rib and sixth rib. However, this procedure can result in compensatory sweating, in which excess sweating occurs on the back, chest, and abdomen. Compensatory sweating has been regarded as a thermoregulatory response and thought to be untreatable. This study suggests that compensatory sweating is not a physiologic reaction and is indeed treatable. METHODS Eight patients with severe compensatory sweating were treated by observing blood perfusion of the skin with laser speckle flowgraphy, which determines the sympathetic nerves related to the area of skin with compensatory sweating. When intraoperative monitoring with laser speckle flowgraphy indicated the position of compensatory sweating by electrical stimulation of the sympathetic ganglion, ganglionectomy was performed. RESULTS The skin domain that each sympathetic nerve controls was able to be detected by laser speckle flowgraphy. In all patients, compensatory sweating was resolved after interruption of the ganglia or sympathetic nerves related to compensatory sweating. CONCLUSIONS Our results demonstrate that compensatory sweating is caused by denatured sympathetic nerves influenced by endoscopic thoracic sympathectomy and is not the result of a physiological response. With laser speckle flowgraphy, the sympathetic nerve related to the sweating of various parts of the body could be identified. The treatment of compensatory sweating on the back, chest, and stomach was previously considered to be difficult; however, compensatory sweating is demonstrated to be treatable with this technique.
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Affiliation(s)
| | - Masayoshi Okada
- Department of Surgery, Yamamoto-Hidehiro Clinic, Tokyo, Japan
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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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Madke B, Pradhan S, Sirka C. Review of oral anticholinergics in the treatment of palmoplantar hyperhidrosis. INDIAN JOURNAL OF DRUGS IN DERMATOLOGY 2019. [DOI: 10.4103/ijdd.ijdd_40_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Minimally invasive dorsal sympathicotomies for the treatment of hyperhidrosis: palmar microcirculatory assessment as an intraoperative-aid. EUROPEAN JOURNAL OF PLASTIC SURGERY 2018. [DOI: 10.1007/s00238-017-1384-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Hasimoto EN, Cataneo DC, Reis TAD, Cataneo AJM. Hyperhidrosis: prevalence and impact on quality of life. ACTA ACUST UNITED AC 2018; 44:292-298. [PMID: 30066741 PMCID: PMC6326708 DOI: 10.1590/s1806-37562017000000379] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2017] [Accepted: 12/15/2017] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To determine the prevalence of primary hyperhidrosis in the city of Botucatu, Brazil, and to evaluate how this disorder affects the quality of life in those suffering from it. METHODS A population survey was conducted in order to identify cases of hyperhidrosis among residents in the urban area of the city, selected by systematic cluster sampling. In accordance with the census maps of the city, the sample size should be at least 4,033 participants. Ten interviewers applied a questionnaire that evaluated the presence of excessive sweating and invited the subjects who reported hyperhidrosis to be evaluated by a physician in order to confirm the diagnosis. RESULTS A total of 4,133 residents, in 1,351 households, were surveyed. Excessive sweating was reported by 85 residents (prevalence = 2.07%), of whom 51 (60%) were female. Of those 85 respondents, 51 (60%) agreed to undergo medical evaluation to confirm the diagnosis and only 23 (45%) were diagnosed with primary hyperhidrosis (prevalence = 0.93%). Of the 23 subjects diagnosed with primary hyperhidrosis, 11 (48%) reported poor or very poor quality of life. CONCLUSIONS Although the prevalence of self-reported excessive sweating was greater than 2%, the actual prevalence of primary hyperhidrosis in our sample was 0.93% and nearly 50% of the respondents with primary hyperhidrosis reported impaired quality of life.
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Affiliation(s)
- Erica Nishida Hasimoto
- . Programa de Pós-Graduação em Bases Gerais da Cirurgia, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista - UNESP - Botucatu (SP) Brasil
| | - Daniele Cristina Cataneo
- . Serviço de Cirurgia Torácica, Departamento de Cirurgia e Ortopedia, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista - UNESP - Botucatu (SP) Brasil
| | - Tarcísio Albertin Dos Reis
- . Programa de Pós-Graduação em Medicina, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista - UNESP - Botucatu (SP) Brasil
| | - Antonio José Maria Cataneo
- . Serviço de Cirurgia Torácica, Departamento de Cirurgia e Ortopedia, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista - UNESP - Botucatu (SP) Brasil
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Musa AF, Gandhi VP, Dillon J, Nordin RB. A retrospective review on minimally invasive technique via endoscopic thoracic sympathectomy (ETS) in the treatment of severe primary hyperhidrosis: Experiences from the National Heart Institute, Malaysia. F1000Res 2018; 7:670. [PMID: 32724556 PMCID: PMC7338916 DOI: 10.12688/f1000research.14777.1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/14/2018] [Indexed: 12/03/2022] Open
Abstract
Background: Hyperhidrosis is due to the hyperactive autonomic stimulation of the sweat glands in response to stress. Primary hyperhidrosis is a common yet psychologically disabling condition. This study will describe our experience in managing hyperhidrosis via endoscopic thoracic sympathectomy (ETS). Methods: The information was obtained from the patient records from 1
st January 2011 until 31
st December 2016. Pertinent information was extracted and keyed into a study proforma. Results: 150 patients were operated on but only 118 patients were included in this study. The mean age was 22.9±7.3 years. The majority (54.2%) had palmar-plantar hyperhidrosis and 39.8% had associated axillary hyperhidrosis. Excision of the sympathetic nerve chain and ganglia were the main surgical technique with the majority (55.9%) at T2-T3 level. Mean ETS procedure time was 46.6±14.29 minutes with no conversion. Surgical complications were minimal and no Horner’s Syndrome reported. Mean hospital stay was 3.5±1.05 days. The majority of patients (67.8%) had only one follow-up and only half of the study sample (58.5%) complained mild to moderate degree of compensatory sweating, even though the long-term resolution is yet to be determined by another study. Following ETS, 98.3% of patients had instant relief and resolved their palmar hyperhidrosis. Predictors of CS were sympathectomy level and follow-up. The odds of reporting CS was 2.87 times in patients undergoing ETS at the T2-T3 level compared to those undergoing ETS at the T2-T4 level. The odds of reporting CS was 13.56 times in patients having more than one follow-up compared to those having only one follow-up. Conclusion: We conclude that ETS is a safe, effective and aesthetically remarkable procedure for the treatment of primary hyperhidrosis with only half of the patients developing mild to moderate degree of CS. Significant predictors of CS were sympathectomy level during ETS and frequency of follow-up after ETS.
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Affiliation(s)
- Ahmad Farouk Musa
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway, Malaysia
| | - Vignaa Prashanth Gandhi
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway, Malaysia
| | - Jeswant Dillon
- Department of Cardiothoracic Surgery, National Heart Institute, Kuala Lumpur, Malaysia
| | - Rusli Bin Nordin
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway, Malaysia
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42
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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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43
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Chang CK, Chen CY, Hsu KF, Chiu HT, Chu TS, Liu HH, Goh MX, Chen SG. Brachial plexus injury after microwave-based treatment for axillary hyperhidrosis and osmidrosis. J COSMET LASER THER 2017; 19:439-441. [PMID: 28657370 DOI: 10.1080/14764172.2017.1342039] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Axillary hyperhidrosis combined with osmidrosis is a common problem, especially in Asian communities, that patients find annoying. Even though several surgical techniques have been reported to treat hyperhidrosis/osmidrosis permanently, patients would prefer a non-surgical approach. A microwave-based device was invented during this decade, and it has proven to be a safe and efficient way to treat axillary hyperhidrosis/osmidrosis without major complications. Mild complications reported are vacuum-associated marks, oedema, tenderness and temporary altered skin sensation. We herein report a rare case of brachial plexus injury with sensory and motor dysfunction that occurred after microwave-based treatment. The patient did not fully recover after 6 months of rehabilitation. Our case suggests that a lower initial energy level should be used for thin patients with less fat tissue on the underarm areas, regardless of the patient's sex.
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Affiliation(s)
- Chun-Kai Chang
- a Department of Plastic Surgery , Tri-Service General Hospital , Taipei , Taiwan.,b Department of Surgery , Kaohsiung Armed Forces General Hospital Zuoying Branch , Kaohsiung , Taiwan.,c National Defense Medical Center , Taipei , Taiwan
| | - Chun-Yu Chen
- a Department of Plastic Surgery , Tri-Service General Hospital , Taipei , Taiwan.,c National Defense Medical Center , Taipei , Taiwan
| | - Kuo-Feng Hsu
- a Department of Plastic Surgery , Tri-Service General Hospital , Taipei , Taiwan.,c National Defense Medical Center , Taipei , Taiwan
| | - Han-Ting Chiu
- a Department of Plastic Surgery , Tri-Service General Hospital , Taipei , Taiwan.,c National Defense Medical Center , Taipei , Taiwan
| | - Tzi-Shiang Chu
- a Department of Plastic Surgery , Tri-Service General Hospital , Taipei , Taiwan.,c National Defense Medical Center , Taipei , Taiwan
| | - Hung-Hui Liu
- a Department of Plastic Surgery , Tri-Service General Hospital , Taipei , Taiwan.,c National Defense Medical Center , Taipei , Taiwan
| | - Meng-Xun Goh
- c National Defense Medical Center , Taipei , Taiwan
| | - Shyi-Gen Chen
- a Department of Plastic Surgery , Tri-Service General Hospital , Taipei , Taiwan.,c National Defense Medical Center , Taipei , Taiwan
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44
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Kamudoni P, Mueller B, Halford J, Schouveller A, Stacey B, Salek MS. The impact of hyperhidrosis on patients' daily life and quality of life: a qualitative investigation. Health Qual Life Outcomes 2017; 15:121. [PMID: 28595584 PMCID: PMC5465471 DOI: 10.1186/s12955-017-0693-x] [Citation(s) in RCA: 57] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2016] [Accepted: 05/24/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND An understanding of the daily life impacts of hyperhidrosis and how patients deal with them, based on qualitative research, is lacking. This study investigated the impact of hyperhidrosis on the daily life of patients using a mix of qualitative research methods. METHODS Participants were recruited through hyperhidrosis patient support groups such as the Hyperhidrosis Support Group UK. Data were collected using focus groups, interviews and online surveys. A grounded theory approach was used in the analysis of data transcripts. Data were collected from 71 participants, out of an initial 100 individuals recruited. RESULTS Seventeen major themes capturing the impacts of hyperhidrosis were identified; these covered all areas of life including daily life, psychological well-being, social life, professional /school life, dealing with hyperhidrosis, unmet health care needs and physical impact. CONCLUSIONS Psychosocial impacts are central to the overall impacts of hyperhidrosis, cutting across and underlying the limitations experienced in other areas of life.
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Affiliation(s)
- P Kamudoni
- Institute of Medicines Development, Duffryn House, Cardiff, CF, 23 6NP, UK.
| | - B Mueller
- Medical Science and Operations Department, Riemser Pharma GmbH, Greifswald, Germany
| | | | | | | | - M S Salek
- Institute of Medicines Development, Duffryn House, Cardiff, CF, 23 6NP, UK.,Department of pharmacy, School of Life and Medical Sciences, University of Hertfordshire, College Lane, Hatfield, Herts, UK
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45
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Yamamoto H, Okada M. A New Device of Needlescopic Thoracic Sympathectomy Through a Skin Incision. Ann Thorac Surg 2017; 103:e465-e467. [PMID: 28431730 DOI: 10.1016/j.athoracsur.2016.11.068] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2016] [Revised: 11/15/2016] [Accepted: 11/20/2016] [Indexed: 10/19/2022]
Abstract
We describe a new technique of performing sympathectomy with a new device. A single skin incision 3 mm long was made in the armpit. The device enables complete resection of the sympathetic segment through a single skin incision, whereas sympathectomy is limited by the use of the conventional needle technique. Even if sympathetic nerves and blood vessels were overlapping, separation of the two organs was performed safely. This device increases the possibility of planning surgical procedures for patients with difficult anatomies.
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46
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Munetsugu T, Fujimoto T, Satoh T, Nakazato Y, Ohshima Y, Asahina M, Yokozeki H. Evaluation of the correlation between severity of acquired idiopathic generalized anhidrosis and quality of life scores. J Dermatol 2017; 44:747-752. [PMID: 28328088 DOI: 10.1111/1346-8138.13785] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2016] [Accepted: 01/04/2017] [Indexed: 11/29/2022]
Abstract
Symptoms of acquired idiopathic generalized anhidrosis (AIGA) include heat retention and/or heat stroke due to the effects of the disorder on the perspiration ability of the whole body under thermal environmental changes or exercise. Additionally, cholinergic urticaria can also occur in these patients. AIGA has a major impact on everyday life. However, the effects of AIGA severity on the quality of life (QOL) of the patients have not been sufficiently defined. The objective of this study was to evaluate the correlation between AIGA severity and QOL. Study subjects comprised 44 patients diagnosed with AIGA at three registered institutions. AIGA severity assessment was conducted and the Dermatology Life Quality Index (DLQI) questionnaire was administered. Correlations between AIGA severity and DLQI, as well as severity by DLQI subscale, were assessed. We found a positive correlation between total score of AIGA severity criteria and DLQI total scores (R = 0.720, P = 0.001). The impairment increased with the increase in AIGA severity (P < 0.01). In relation to the DLQI subscales, leisure (social and sporting activities) impairment was significantly higher for patients with severe AIGA than those with mild AIGA (P < 0.01). Comparing QOL for AIGA patients with that of patients with other dermatological disorders, it is possible that QOL impairment for AIGA patients is as severe as that for patients with atopic dermatitis. AIGA severity and DLQI are correlated and AIGA patients experience disruption of everyday life more broadly than conventionally perceived.
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Affiliation(s)
- Takichi Munetsugu
- Department of Dermatology, Tokyo Medical and Dental University, Tokyo, Japan.,Department of Dermatology, National Defense Medical College, Saitama, Japan
| | - Tomoko Fujimoto
- Department of Dermatology, Tokyo Metropolitan Ohtsuka Hospital, Tokyo, Japan
| | - Takahiro Satoh
- Department of Dermatology, National Defense Medical College, Saitama, Japan
| | | | - Yuichiro Ohshima
- Department of Dermatology, Aichi Medical University, Aichi, Japan
| | - Masato Asahina
- Department of Neurology, Chiba University, Chiba, Japan.,Neurology Clinic Tsudanuma, Chiba, Japan
| | - Hiroo Yokozeki
- Department of Dermatology, Tokyo Medical and Dental University, Tokyo, Japan
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47
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Doolittle J, Walker P, Mills T, Thurston J. Hyperhidrosis: an update on prevalence and severity in the United States. Arch Dermatol Res 2016; 308:743-749. [PMID: 27744497 PMCID: PMC5099353 DOI: 10.1007/s00403-016-1697-9] [Citation(s) in RCA: 115] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2016] [Revised: 10/04/2016] [Accepted: 10/12/2016] [Indexed: 11/30/2022]
Abstract
Current published estimates of the prevalence of hyperhidrosis in the United States are outdated and underestimate the true prevalence of the condition. The objectives of this study are to provide an updated estimate of the prevalence of hyperhidrosis in the US population and to further assess the severity and impact of sweating on those affected by the condition. For the purposes of obtaining prevalence, a nationally representative sample of 8160 individuals were selected using an online panel, and information as to whether or not they experience hyperhidrosis was obtained. The 393 individuals (210 female, 244 non-Hispanic white, 27 black, mean age 40.3, SE 0.64) who indicated that they have hyperhidrosis were asked further questions, including body areas impacted, severity of symptoms, age of onset, and socioemotional impact of the condition. Current results estimate the prevalence of hyperhidrosis at 4.8 %, which represents approximately 15.3 million people in the United States. Of these, 70 % report severe excessive sweating in at least one body area. In spite of this, only 51 % have discussed their excessive sweating with a healthcare professional. The main reasons are a belief that hyperhidrosis is not a medical condition and that no treatment options exist. The current study’s findings with regard to age of onset and prevalence by body area generally align with the previous research. However, current findings suggest that the severity and prevalence are both higher than previously thought, indicating a need for greater awareness of the condition and its associated treatment options among medical professionals.
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Affiliation(s)
- James Doolittle
- Burke Inc., 500 West 7th Street, Cincinnati, OH, 45203, USA.
| | - Patricia Walker
- Brickell Biotech, 2600 SW 3rd Avenue #300, Miami, FL, 33129, USA
| | - Thomas Mills
- Burke Inc., 500 West 7th Street, Cincinnati, OH, 45203, USA
| | - Jane Thurston
- Burke Inc., 500 West 7th Street, Cincinnati, OH, 45203, USA
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48
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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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49
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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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50
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Chen J, Lin J, Tu Y, Lin M, Li X, Lai F. Nonintubated Transareolar Endoscopic Thoracic Sympathectomy with a Flexible Endoscope: Experience of 58 Cases. Ann Thorac Cardiovasc Surg 2015; 22:12-9. [PMID: 26424150 DOI: 10.5761/atcs.oa.15-00241] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVE Natural orifice transluminal endoscopic surgery (NOTES) has recently become a hot spot in the field of minimally invasive surgery. But, most of the procedures are still in the early stages of development and limited to animal experiments. Transareolar endoscopic surgery could work as a viable intermediate step before thoracic NOTES. Under intravenous anesthesia without endotracheal intubation, transareolar endoscopic thoracic sympathectomy (ETS) with a flexible endoscope has rarely been attempted. The objective of this study is to evaluate the feasibility and safety of this novel minimally invasive technique in managing primary palmar hyperhidrosis (PPH). METHODS From June 2012 to July 2014, a total of 58 male patients with severe PPH underwent transareolar ETS by use of a flexible endoscope. Under intravenous anesthesia without endotracheal intubation, a flexible endoscope was introduced through the incision on the edge of the areola into the thoracic cavity. The thoracic sympathetic chain was ablated at the level of the fourth rib. RESULTS All procedures were successfully performed with a mean operating time of 33.6 ± 8.3 min. All patients regained consciousness rapidly and none of them complained about sore throat after surgery. There were no operative mortality and conversion to open procedure. The symptoms of all patients disappeared as soon as the sympathetic chain was cut off. Fifty six patients (96.6%) were discharged from the hospital on the first postoperative day. The postoperative complications were minor, and no patients developed Horner's syndrome. At 3 months postoperatively, there was no obvious surgical scar on the chest wall, and none of the patients complained about postoperative pain. Compensatory hyperhidrosis (CH) appeared in 19 patients. No recurrent symptoms were observed in our study. One year follow-up revealed an excellent cosmetic result and degree of satisfaction. CONCLUSION Nonintubated transareolar ETS with a flexible endoscope is a safe, effective and minimally invasive therapeutic procedure, which has the possible advantages of thoracic NOTES and can be performed in routine clinical practice for male PPH patients.
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Affiliation(s)
- Jianfeng Chen
- Department of Thoracic Surgery, First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China
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