1
|
Parveen A, Abbas S, Mehmood N, Patafi MAM, Wajid U, Luqman M, Arshad S. Primary hyperhidrosis: From a genetics point of view. J Family Med Prim Care 2023; 12:3028-3032. [PMID: 38361865 PMCID: PMC10866286 DOI: 10.4103/jfmpc.jfmpc_1568_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 03/27/2023] [Accepted: 03/30/2023] [Indexed: 02/17/2024] Open
Abstract
Primary hyperhidrosis is a disorder of profuse sweating which negatively influences a patient's quality of life and is caused because of over-activation of the sympathetic nervous system. It was believed that hyperhidrosis is a condition limited to only anxious individuals; however, this hypothesis is discredited now. It has been found that people with a positive family history of primary hyperhidrosis are likely to suffer from this condition, suggesting a strong genetic basis. Genetic analysis has revealed a dominant autosomal pattern of inheritance with a variable degree of penetrance and is a sex-independent trait. It is a heterogeneous condition both genetically and clinically as different studies revealed variable genetics and clinical factors. There are no proper criteria for diagnosis as it is not treated as disease by most affected persons. Various studies revealed opposing results in localizing disease gene loci, so further genetic research is needed to pinpoint genes responsible for causing this debilitating condition. Gene expression profiling of human anxiety-causing genes in hyperhidrotic sufferers will also help to devise new treatment modalities. This review highlights the current genetic studies on hyperhidrosis, which may prove to be helpful in understanding the molecular mechanism governing hyperhidrosis.
Collapse
Affiliation(s)
- Asia Parveen
- Department of Biochemistry, Faculty of Life Sciences, Gulab Devi Educational Complex, Lahore, Pakistan
| | - Sidra Abbas
- Department of Zoology, University of Jhang, Jhang, Pakistan
| | - Nasir Mehmood
- Department of Physical Therapy, The Islamia University of Bahawalpur, Pakistan
| | | | - Usman Wajid
- Department of Basic and Applied Chemistry, Faculty of Science and Technology, University of Central Punjab, Punjab, Pakistan
| | - Muhammad Luqman
- Department of Basic and Applied Chemistry, Faculty of Science and Technology, University of Central Punjab, Punjab, Pakistan
| | - Shafia Arshad
- University College of Conventional Medicine, Faculty of Medicine and Allied Health Sciences, The Islamia University of Bahawalpur, Pakistan
| |
Collapse
|
2
|
Yi KH, Lee JH, Hu H, Kim JH, Park HJ, Kim KB, Kim JH, Kim HJ. Anatomical proposal of local anesthesia injection for median nerve block in treating hyperhidrosis with botulinum neurotoxin. Surg Radiol Anat 2023; 45:1083-1087. [PMID: 37468725 DOI: 10.1007/s00276-023-03199-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Accepted: 06/28/2023] [Indexed: 07/21/2023]
Abstract
INTRODUCTION Hyperhidrosis, causing excessive sweat, can be treated with Botulinum neurotoxin injection. Botulinum toxin, an effective and safe treatment for hyperhidrosis, unfortunately involves significant pain due to multiple injections. This study aims to propose a more efficient and less painful approach to nerve blocks for relief, by identifying optimal injection points to block the median nerve, thereby enhancing palmar hyperhidrosis treatment. METHODS This study, involving 52 Korean cadaver arms (mean age 73.5 years), measured the location of the median nerve relative to the transverse line at the pisiform level to establish better nerve block injection sites. RESULTS In between the extensor carpi radialis and palmaris longus, the median nerve was located at an average distance of 47.39 ± 6.43 mm and 29.39 ± 6.43 mm from the transverse line at the pisiform level. DISCUSSION To minimize discomfort preceding the botulinum neurotoxin injection, we recommend the optimal injection site for local anesthesia to be located 4 cm distal to the transverse line of the pisiform, within the tendons of the palmaris longus and flexor carpi radialis muscles.
Collapse
Affiliation(s)
- Kyu-Ho Yi
- Division in Anatomy and Developmental Biology, Department of Oral Biology, Human Identification Research Institute, BK21 FOUR Project, Yonsei University College of Dentistry, 50-1 Yonsei-Ro, Seoul, 03722, Republic of Korea
- Maylin Clinic (Apgujeong), Seoul, 06005, Korea
| | - Ji-Hyun Lee
- Department of Anatomy and Acupoint, College of Korean Medicine, Gachon University, 1332, Seongnam-daero, Sujeong-gu, Seongnam-si, 13120, Republic of Korea
| | - Hyewon Hu
- Division in Anatomy and Developmental Biology, Department of Oral Biology, Human Identification Research Institute, BK21 FOUR Project, Yonsei University College of Dentistry, 50-1 Yonsei-Ro, Seoul, 03722, Republic of Korea
| | | | | | | | - Ji-Hyo Kim
- Misogain Dermatology Clinic, Gimpo, Republic of Korea
| | - Hee-Jin Kim
- Division in Anatomy and Developmental Biology, Department of Oral Biology, Human Identification Research Institute, BK21 FOUR Project, Yonsei University College of Dentistry, 50-1 Yonsei-Ro, Seoul, 03722, Republic of Korea.
| |
Collapse
|
3
|
Henning MAS, Barati F, Jemec GBE. Quality of life in individuals with primary hyperhidrosis: a systematic review and meta-analysis. Clin Auton Res 2023; 33:519-528. [PMID: 37507605 DOI: 10.1007/s10286-023-00954-w] [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: 03/26/2023] [Accepted: 05/18/2023] [Indexed: 07/30/2023]
Abstract
PURPOSE Hyperhidrosis can be a debilitating disease that leads to the deterioration of well-being. In this study, the objective was to compare the health-related quality of life (HRQOL) in individuals with and without hyperhidrosis by conducting a systematic review and meta-analysis. METHODS The Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement and the Meta-analysis Of Observational Studies in Epidemiology checklist were employed. We systematically searched Cochrane Library, Embase and PubMed. Two authors independently assessed the literature and extracted the data. The risk of bias was assessed using the Newcastle-Ottawa Scale. A random-effects model was employed. The heterogeneity was determined using I2. RESULTS Eleven studies met the eligibility criteria comprising 4297 and 147,604 participants with and without hyperhidrosis, respectively. The risk of bias ranged from high quality to very high risk of bias. The individuals with hyperhidrosis had a higher Dermatology Life Quality Index (mean difference 8.53; 95% confidence interval 3.47, 13.58; p = 0.0009) and a lower mental component summary of the short form-12 or -36 (mean difference -6.15; 95% confidence interval -9.00, -3.30; p < 0.0001) than the control individuals. No difference was found for the physical component summary score of the short form-12 or -36 (mean difference -0.88; 95% confidence interval -1.88, 0.12; p = 0.085). Studies using patient-reported outcomes, not included in the meta-analysis, showed similar results. CONCLUSION Individuals with hyperhidrosis experience a reduced HRQOL that is clinically meaningful and leads to perceivable deteriorations in their well-being. The evidence shows a high degree of heterogeneity, which warrants additional studies.
Collapse
Affiliation(s)
- Mattias A S Henning
- Department of Dermatology, Zealand University Hospital, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
| | - Farnam Barati
- Department of Dermatology, Zealand University Hospital, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Gregor B E Jemec
- Department of Dermatology, Zealand University Hospital, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| |
Collapse
|
4
|
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.
Collapse
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
| | | | | | | |
Collapse
|
5
|
The Impact of Hyperhidrosis on Quality of Life: A Review of the Literature. Am J Clin Dermatol 2023; 24:187-198. [PMID: 36622502 PMCID: PMC9838291 DOI: 10.1007/s40257-022-00743-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/15/2022] [Indexed: 01/10/2023]
Abstract
Hyperhidrosis is a condition of excessive sweating, which can have profound physical and mental effects. Hyperhidrosis is a significantly impactful and distressing illness that warrants equal attention as other more well-known dermatologic conditions. However, because of a lack of awareness among the public, stigma, and difficulty with access to treatments (due to cost or insurance coverage), patients are less likely to be diagnosed and treated. In hyperhidrosis, quality-of-life surveys can be useful for determining the magnitude of symptoms and to evaluate treatment outcomes. The purpose of this study was to conduct a narrative literature review to investigate the impact of hyperhidrosis on quality of life. A total of 49 articles investigating the impact of primary hyperhidrosis on quality of life were selected for the review. Hyperhidrosis is a potentially debilitating illness that affects multiple domains of patients' lives including their psychological, physical, and social functioning. Despite the significant impacts, patients with hyperhidrosis are less likely to seek care. Here, we explore these impacts, and disparities in care, in more detail.
Collapse
|
6
|
Henning M, Ibler K, Loft I, Jennum P, Didriksen M, Ullum H, Erikstrup C, Nielsen K, Bruun MT, Hjalgrim H, Sørensen E, Dinh K, Thørner LW, Jemec GB, Pedersen O. Hyperhidrosis is associated with sleep disturbances, daytime tiredness, stress, and depression: A retrospective cohort study from the Danish Blood Donor Study. J Am Acad Dermatol 2023; 88:196-197. [PMID: 35427682 DOI: 10.1016/j.jaad.2022.03.063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 03/04/2022] [Accepted: 03/29/2022] [Indexed: 11/20/2022]
Affiliation(s)
- Mattias Henning
- Department of Dermatology, Zealand University Hospital, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark.
| | - Kristina Ibler
- Department of Dermatology, Zealand University Hospital, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
| | - Isabella Loft
- Department of Clinical Immunology, Zealand University Hospital, Køge, Denmark
| | - Poul Jennum
- Danish Center for Sleep Medicine, Department of Clinical Neurophysiology, Copenhagen University Hospital, Glostrup, University of Copenhagen, Denmark
| | - Maria Didriksen
- Department of Clinical Immunology, Copenhagen University Hospital, Denmark
| | - Henrik Ullum
- Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark
| | | | - Kaspar Nielsen
- Department of Clinical Immunology, Aalborg University Hospital, Denmark
| | - Mie Topholm Bruun
- Department of Clinical Immunology, Odense University Hospital, Denmark
| | - Henrik Hjalgrim
- Danish Cancer Society Research Center, Copenhagen, Denmark; Department of Haematology, Copenhagen University Hospital Rigshospitalet, Denmark; Department of Medicine, Copenhagen University, Denmark
| | - Erik Sørensen
- Department of Clinical Immunology, Copenhagen University Hospital, Denmark
| | - Khoa Dinh
- Department of Clinical Immunology, Aarhus University Hospital, Denmark
| | | | - Gregor B Jemec
- Department of Dermatology, Zealand University Hospital, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
| | - Ole Pedersen
- Department of Clinical Immunology, Zealand University Hospital, Køge, Denmark
| |
Collapse
|
7
|
Henning M, Reguant R, Jørgensen I, Andersen R, Ibler K, Pedersen O, Jemec G, Brunak S. The temporal association of hyperhidrosis and its comorbidities - a nationwide hospital-based cohort study. J Eur Acad Dermatol Venereol 2022; 36:2504-2511. [PMID: 35735049 PMCID: PMC9796903 DOI: 10.1111/jdv.18351] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 05/05/2022] [Indexed: 01/07/2023]
Abstract
BACKGROUND Research on hyperhidrosis comorbidities has documented the co-occurrence of diseases but has not provided information about temporal disease associations. OBJECTIVE To investigate the temporal disease trajectories of individuals with hospital-diagnosed hyperhidrosis. METHODS This is a hospital-based nationwide cohort study including all patients with a hospital contact in Denmark between 1994 and 2018. International Classification of Diseases version-10 diagnoses assigned to inpatients, outpatients and emergency department patients were collected from the Danish National Patient Register. The main outcome was the temporal disease associations occurring in individuals with hyperhidrosis, which was assessed by identifying morbidities significantly associated with hyperhidrosis and then examining whether there was a significant order of these diagnoses using binomial tests. RESULTS Overall, 7 191 519 patients were included. Of these, 8758 (0.12%) patients had localized hyperhidrosis (5674 female sex [64.8%]; median age at first diagnosis 26.9 [interquartile range 21.3-36.1]) and 1102 (0.015%) generalized hyperhidrosis (606 female sex [59.9%]; median age at first diagnosis 40.9 [interquartile range 26.4-60.7]). The disease trajectories comprised pain complaints, stress, epilepsy, respiratory and psychiatric diseases. The most diagnosed morbidities for localized hyperhidrosis were abdominal pain (relative risk [RR] = 121.75; 95% Confidence Interval [CI] 121.14-122.35; P < 0.001), soft tissue disorders (RR = 151.19; 95% CI 149.58-152.80; P < 0.001) and dorsalgia (RR = 160.15; 95% CI 158.92-161.38; P < 0.001). The most diagnosed morbidities for generalized hyperhidrosis were dorsalgia (RR = 306.59; 95% CI 302.17-311.02; P < 0.001), angina pectoris (RR = 411.69; 95% CI 402.23-421.16; P < 0.001) and depression (RR = 207.92; 95% CI 202.21-213.62; P < 0.001). All these morbidities were diagnosed before hyperhidrosis. CONCLUSIONS This paper ascertains which hospital-diagnosed morbidities precede hospital-diagnosed hyperhidrosis. As hyperhidrosis mainly is treated in the primary health care sector, the trajectories suggests that these morbidities may lead to a worse disease course of hyperhidrosis that necessitates treatment in hospitals. Treating these morbidities may improve the disease course of hyperhidrosis.
Collapse
Affiliation(s)
- M.A.S. Henning
- Deptartment of DermatologyZealand University HospitalRoskildeDenmark
| | - R. Reguant
- Novo Nordisk Foundation Center for Protein ResearchUniversity of CopenhagenCopenhagenDenmark
| | - I.F. Jørgensen
- Novo Nordisk Foundation Center for Protein ResearchUniversity of CopenhagenCopenhagenDenmark
| | - R.K. Andersen
- Deptartment of DermatologyZealand University HospitalRoskildeDenmark
| | - K.S. Ibler
- Deptartment of DermatologyZealand University HospitalRoskildeDenmark
| | - O.B. Pedersen
- Department of Clinical ImmunologyZealand University HospitalKøgeDenmark
| | - G.B.E. Jemec
- Deptartment of DermatologyZealand University HospitalRoskildeDenmark
| | - S. Brunak
- Novo Nordisk Foundation Center for Protein ResearchUniversity of CopenhagenCopenhagenDenmark
| |
Collapse
|
8
|
Bidirectional association between hyperhidrosis and depressive disorders: A population-based cohort study. J Am Acad Dermatol 2022; 87:1402-1404. [PMID: 36113615 DOI: 10.1016/j.jaad.2022.09.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 09/07/2022] [Accepted: 09/09/2022] [Indexed: 11/23/2022]
|
9
|
Schote AB, Dietrich K, Linden AE, Dzionsko I, Molano Moreno LDLA, Winnikes U, Zimmer P, Domes G, Meyer J. Real sweating in a virtual stress environment: Investigation of the stress reactivity in people with primary focal hyperhidrosis. PLoS One 2022; 17:e0272247. [PMID: 35917298 PMCID: PMC9345359 DOI: 10.1371/journal.pone.0272247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2020] [Accepted: 07/16/2022] [Indexed: 12/04/2022] Open
Abstract
Background Hyperhidrosis (excessive sweating, OMIM %114110) is a complex disorder with multifactorial causes. Emotional strains and social stress increase symptoms and lead to a vicious circle. Previously, we showed significantly higher depression scores, and normal cortisol awakening responses in patients with primary focal hyperhidrosis (PFH). Stress reactivity in response to a (virtual) Trier Social Stress Test (TSST-VR) has not been studied so far. Therefore, we measured sweat secretion, salivary cortisol and alpha amylase (sAA) concentrations, and subjective stress ratings in affected and non-affected subjects in response to a TSST-VR. Method In this pilot study, we conducted TSST-VRs and performed general linear models with repeated measurements for salivary cortisol and sAA levels, heart rate, axillary sweat and subjective stress ratings for two groups (diagnosed PFH (n = 11), healthy controls (n = 16)). Results PFH patients showed significantly heightened sweat secretion over time compared to controls (p = 0.006), with highest quantities during the TSST-VR. In both groups, sweating (p < 0.001), maximum cortisol levels (p = 0.002), feelings of stress (p < 0.001), and heart rate (p < 0.001) but not sAA (p = 0.068) increased significantly in response to the TSST-VR. However, no differences were detected in subjective ratings, cortisol concentrations and heart rate between PFH patients and controls (pall > 0.131). Conclusion Patients with diagnosed PFH showed stress-induced higher sweat secretion compared to healthy controls but did not differ in the stress reactivity with regard to endocrine or subjective markers. This pilot study is in need of replication to elucidate the role of the sympathetic nervous system as a potential pathway involved in the stress-induced emotional sweating of PFH patients.
Collapse
Affiliation(s)
- Andrea B. Schote
- Department of Neurobehavioral Genetics, Institute of Psychobiology, University of Trier, Johanniterufer, Trier, Germany
| | - Katharina Dietrich
- Department of Neurobehavioral Genetics, Institute of Psychobiology, University of Trier, Johanniterufer, Trier, Germany
| | - Adrian E. Linden
- Department of Neurobehavioral Genetics, Institute of Psychobiology, University of Trier, Johanniterufer, Trier, Germany
| | - Inga Dzionsko
- Department of Neurobehavioral Genetics, Institute of Psychobiology, University of Trier, Johanniterufer, Trier, Germany
| | | | - Ulrike Winnikes
- Department of Neurobehavioral Genetics, Institute of Psychobiology, University of Trier, Johanniterufer, Trier, Germany
| | - Patrick Zimmer
- Department of Biological and Clinical Psychology, University of Trier, Johanniterufer, Trier, Germany
| | - Gregor Domes
- Department of Biological and Clinical Psychology, University of Trier, Johanniterufer, Trier, Germany
| | - Jobst Meyer
- Department of Neurobehavioral Genetics, Institute of Psychobiology, University of Trier, Johanniterufer, Trier, Germany
- * E-mail:
| |
Collapse
|
10
|
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.
Collapse
|
11
|
Henning MAS, Bouazzi D, Jemec GBE. Treatment of Hyperhidrosis: An Update. Am J Clin Dermatol 2022; 23:635-646. [PMID: 35773437 DOI: 10.1007/s40257-022-00707-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/31/2022] [Indexed: 11/30/2022]
Abstract
Hyperhidrosis is a dermatosis presenting as pathologically excessive focal or generalized sweating. The stigmatizing nature of hyperhidrosis may cause patients to feel embarrassment and apprehension about their symptoms and experience a significant decrease in well-being. Severe cases of hyperhidrosis can also increase the risk of developing psychiatric and somatic comorbidities. Conventional non-surgical treatments of hyperhidrosis include aluminum salts, iontophoresis, botulinum toxin injections, and oral glycopyrronium. In recent years, new topical anticholinergic medications and devices have emerged that may improve the patients' symptoms and even prevent the development of comorbidities. The treatment of hyperhidrosis can be a complex matter and may require the combination of several therapies. The purpose of this paper was to firstly review the literature on existing non-surgical treatment options for hyperhidrosis, and secondly provide a stepwise approach to investigating and treating patients with hyperhidrosis.
Collapse
Affiliation(s)
- Mattias A S Henning
- Department of Dermatology, Zealand University Hospital, Roskilde, Denmark.
- Department of Clinical Medicine, Faculty of Medical Health and Sciences, University of Copenhagen, Copenhagen, Denmark.
| | - Dorra Bouazzi
- Department of Dermatology, Zealand University Hospital, Roskilde, Denmark
- Department of Clinical Medicine, Faculty of Medical Health and Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Gregor B E Jemec
- Department of Dermatology, Zealand University Hospital, Roskilde, Denmark
- Department of Clinical Medicine, Faculty of Medical Health and Sciences, University of Copenhagen, Copenhagen, Denmark
| |
Collapse
|
12
|
Heiskanen SL, Niskala J, Jokelainen J, Tasanen K, Huilaja L, Sinikumpu SP. Hyperhidrosis Comorbidities and Treatments: A Register-based Study among 511 Subjects. Acta Derm Venereol 2022; 102:adv00656. [PMID: 35088873 PMCID: PMC9558338 DOI: 10.2340/actadv.v102.1061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Hyperhidrosis is a dermatological condition that causes psychosocial impairment and has a negative impact on patients’ quality of life. The epidemiology of hyperhidrosis is currently poorly understood. The aim of this study was to analyse comorbidities and treatments in 511 subjects with hyperhidrosis selected from the patient records of Oulu University Hospital. The mean age of patients with local hyperhidrosis was 27.9 years and the majority were female (62.7%). The most common anatomical site of symptoms in the youngest age group was the palms, whereas the axillae were a more common site in advanced age. Depression was a common comorbidity in both local (11.6%) and generalized hyperhidrosis (28.6%). Anxiety affected 12.7% of patients with generalized hyperhidrosis. In 36.8% of the patients with local hyperhidrosis there was a delay in diagnosis of more than 10 years. The most commonly used treatments included topical antiperspirants, iontophoresis and botulin toxin injections.
Collapse
Affiliation(s)
| | | | | | - Kaisa Tasanen
- Department of Dermatology and Medical Research Center Oulu, PEDEGO Research Unit, University of Oulu, Oulu University Hospital, Oulu, Finland.
| | | | | |
Collapse
|
13
|
Henning M, Hother CE, Banasik K, Ibler KS, Ostrowski SR, Erikstrup C, Nielsen KR, Ullum H, Hjalgrim H, Hansen TF, Kaspersen KA, Sørensen BS, Saekmose SG, Jemec GBE, Pedersen OB. Hyperhidrosis and human leucocyte antigens in the Danish Blood Donor Study. Scand J Immunol 2022; 95:e13150. [PMID: 35212011 DOI: 10.1111/sji.13150] [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: 10/14/2021] [Accepted: 01/31/2022] [Indexed: 11/26/2022]
Abstract
Familial clustering of the skin disease primary hyperhidrosis suggests a genetic component to the disease. The human leucocyte antigen (HLA) is implicated in a range of diseases, including many comorbidities to hyperhidrosis. No study has investigated whether the HLA genes are involved in the pathogenesis of hyperhidrosis. We, therefore, compared HLA alleles in individuals with and without hyperhidrosis in this study of 65,000 blood donors. In this retrospective cohort study, we retrieved information on individuals with and without hyperhidrosis using self-reported questionnaires, the Danish National Patient Registry and the Danish National Prescription Registry on participants recruited to the Danish Blood Donor Study between 2010 and 2019. Association tests using logistic regression were conducted for each HLA allele corrected for sex, age, body mass index, smoking and principal components. Overall, 145 of 65,795 (0.2%) participants had hospital diagnosed hyperhidrosis. Similarly, 1,379 of 15,530 (8.9%) participants had moderate-severe self-reported hyperhidrosis, of whom 447 (2.9%) had severe self-reported hyperhidrosis. Altogether 28 participants had both hospital diagnosed and moderate-severe self-reported hyperhidrosis. Severe self-reported hyperhidrosis was associated with HLA-A*80:01 (adjusted odds ratio 26.97; 95% confidence interval 5.32-136.70; n=7; p<0.001). Moderate-severe self-reported hyperhidrosis and hospital diagnosed hyperhidrosis were not associated with any HLA. The association between hyperhidrosis and HLA-A*80:01 was based on a very small number of cases and not replicated in other patient subsets, and therefore likely a chance finding. Thus, this study suggests that genes other than the HLA are involved in the pathogenesis of hyperhidrosis.
Collapse
Affiliation(s)
- Mattias Henning
- Department of Dermatology, Zealand University Hospital, Roskilde, Denmark
| | | | - Karina Banasik
- The Novo Nordisk Foundation Center for Protein Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Kristina S Ibler
- Department of Dermatology, Zealand University Hospital, Roskilde, Denmark
| | - Sisse R Ostrowski
- Department of Clinical Immunology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Christian Erikstrup
- Department of Clinical Immunology, Aarhus University Hospital, Aarhus, Denmark
| | - Kaspar R Nielsen
- Department of Clinical Immunology, Aalborg University Hospital, Aalborg, Denmark
| | | | - Henrik Hjalgrim
- Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark
| | - Thomas Folkmann Hansen
- The Novo Nordisk Foundation Center for Protein Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.,Department of Neurology, Danish Headache Center, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Kathrine Agergård Kaspersen
- Department of Clinical Immunology, Aarhus University Hospital, Aarhus, Denmark.,Danish Big Data Centre for Environment and Health (BERTHA), Aarhus University, DK-4000, Roskilde, Denmark
| | - Betina S Sørensen
- Department of Clinical Immunology, Aalborg University Hospital, Aalborg, Denmark
| | | | | | - Ole Birger Pedersen
- Department of Clinical Immunology, Zealand University Hospital, Køge, Denmark
| |
Collapse
|
14
|
The health-related quality of life in hyperhidrosis and co-morbidities. Qual Life Res 2022; 31:2331-2340. [DOI: 10.1007/s11136-022-03108-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/14/2022] [Indexed: 10/19/2022]
|
15
|
Reddy RK, Dutt A, Charles WN, Hoyos A, Khajuria A. The 100 Most-Cited Articles in Liposuction: A Bibliometric Analysis. Ann Plast Surg 2021; 87:615-622. [PMID: 34711726 DOI: 10.1097/sap.0000000000003030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Liposuction is one of the most common cosmetic surgical procedures performed worldwide. Despite previous citation analyses in plastic surgery, the most-cited works in liposuction have not yet been qualitatively or quantitatively appraised. We hypothesized that use of validated outcome measures and levels of evidence would be low among these articles. Thus, we performed a bibliometric analysis aiming to comprehensively review the most-cited liposuction literature, evaluating characteristics and quality of the top 100 articles. METHODS The 100 most-cited articles in liposuction were identified on Web of Science, across all available journals and years (1950-2020). Study details, including the citation count, main subject, and outcome measures, were extracted from each article by 2 independent reviewers. The level of evidence of each study was also assessed. RESULTS The 100 most-cited articles in liposuction were cited by a total of 4809 articles. Citations per article ranged from 602 to 45 (mean, 92). Most articles were level of evidence 4 (n = 33) or 5 (n = 35), representative of the large number of case series, expert-opinion articles, and narrative reviews. Ten articles achieved level of evidence 3, 22 articles achieved level of evidence 2, and none reached level 1. The main subject was operative technique in 63 articles, followed by outcomes in 32 articles. Five articles assessed the metabolic effects of liposuction. Only 1 article used a validated objective cosmetic outcome measure, and none used validated patient-reported outcome measures. CONCLUSIONS This analysis provides an overview of the top cited liposuction literature. Overall, level of evidence was low, and no articles achieved the highest level of evidence. Improving the quality of literature requires prioritization of better-designed studies and incorporation of validated outcome measures, which will increase patient satisfaction and ensure provision of excellent, reproducible clinical care.
Collapse
Affiliation(s)
- Rohin K Reddy
- From the Department of Surgery and Cancer, Imperial College London, London, United Kingdom
| | - Atul Dutt
- From the Department of Surgery and Cancer, Imperial College London, London, United Kingdom
| | - Walton N Charles
- From the Department of Surgery and Cancer, Imperial College London, London, United Kingdom
| | | | | |
Collapse
|
16
|
Nasser S, Farshchian M, Kimyai-Asadi A, Potts GA. Techniques to Relieve Pain Associated With Botulinum Injections for Palmar and Plantar Hyperhidrosis. Dermatol Surg 2021; 47:1566-1571. [PMID: 34743126 DOI: 10.1097/dss.0000000000003182] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Palmar and plantar hyperhidrosis (HH) is a common condition characterized by excessive sweating of the palms and soles. Botulinum neurotoxin (BTX) is a very effective and safe treatment. However, the associated intense injection pain is a major limiting factor deterring patients from selecting this treatment. OBJECTIVE The aim of this study was to review the numerous techniques used to minimize pain accompanying injections for palmoplantar HH. Additionally, the advantages and limitations of each modality will be discussed. MATERIALS AND METHODS The authors performed a comprehensive literature search in PubMed/MEDLINE, Embase, Cochrane Central, and Google Scholar on randomized controlled trials, cohort studies, and case series on techniques to relieve pain of BTX injections for treatment of palmar and plantar HH. RESULTS Current available techniques in reducing botulinum injection with merits and drawbacks are nerve blocks, Bier blocks, cryoanalgesia, needle-free anesthesia, topical anesthetics, and vibration anesthesia. CONCLUSION Topical anesthesia, ice, and vibration are the safest and most convenient noninvasive available methods to relieve pain associated with botulinum injection. Nerve blocks, Bier block, and needle-free anesthesia provide better anesthesia but are limited by the need for training and equipment.
Collapse
Affiliation(s)
- Sarah Nasser
- Wayne State University School of Medicine, Detroit, Michigan
| | - Mehdi Farshchian
- Department of Dermatology, Wayne State University, Dearborn, Michigan
| | | | - Geoffrey A Potts
- Department of Dermatology, Wayne State University, Dearborn, Michigan
| |
Collapse
|
17
|
Manav V, Türk CB, Kara Polat A, Erdil D, Baş S, Koku Aksu AE. Evaluation of the serum magnesium and vitamin D levels and the risk of anxiety in primary hyperhidrosis. J Cosmet Dermatol 2021; 21:373-379. [PMID: 33738914 DOI: 10.1111/jocd.14075] [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: 11/24/2020] [Revised: 01/13/2021] [Accepted: 03/01/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Excessive sweating is considered primary hyperhidrosis if it is triggered by emotional states without any thermogenic or other underlying disease from the eccrine glands. This may be due to dysfunction in the autonomic nervous system. AIMS To investigate the relationship between Vitamin D and Mg deficiency and the risk of anxiety and depression in patients with primary hyperhidrosis. PATIENTS/METHODS This cross-sectional, case-control study was conducted between July and October 2019. 49 primary hyperhidrosis patients in Group I and 47 age and gender matched healthy individuals in Group II were included in the study. RESULTS The mean 25 (OH) D and Mg levels in Group I were statistically significantly lower than in Group II (p < 0.001 and p = 0.002, respectively). Statistically significant differences were found between the groups in terms of anxiety and depression (p < 0.001 and p = 0.033, respectively). There was no significant relationship between the HADS-A / HADS-D scores and the severity of primary hyperhidrosis (r = -0.131, p = 0.096; correlation coefficient = 0.232, p = 0.447). However, a significant correlation was observed between HADS-A scores and serum Mg levels (r = -0.439, p = 0.007). CONCLUSION Anxiety and depression are common in patients with primary hyperhidrosis. As shown in this study, both anxiety and depression can be seen with low Mg levels in patients with primary hyperhidrosis. This could possibly be related to the pathological mechanism involving Vitamin D and Mg, which determines the common pathway affecting primary hyperhidrosis and anxiety/depression.
Collapse
Affiliation(s)
- Vildan Manav
- Department of Dermatology, İstanbul Training and Research Hospital, İstanbul, Turkey
| | - Cemre Büşra Türk
- Department of Dermatology, İstanbul Training and Research Hospital, İstanbul, Turkey
| | - Asude Kara Polat
- Department of Dermatology, İstanbul Training and Research Hospital, İstanbul, Turkey
| | - Duygu Erdil
- Department of Dermatology, İstanbul Training and Research Hospital, İstanbul, Turkey
| | - Soysal Baş
- Department of Plastic Reconstructive and Aesthetic Surgery, İstanbul Hamidiye Şişli Etfal Training and Research Hospital, İstanbul, Turkey
| | - Ayşe Esra Koku Aksu
- Department of Dermatology, İstanbul Training and Research Hospital, İstanbul, Turkey
| |
Collapse
|
18
|
Abusailik MA, Mustafa SMB, Alzboun HM, Al-issa HA, Oweis SW, Alshudeifat AY, Nawaiseh MB. Primary Hyperhidrosis: Prevalence, Severity, and Impact on Quality of Life among Jordanian Patients. Indian J Dermatol 2021; 66:573. [PMID: 35068527 PMCID: PMC8751713 DOI: 10.4103/ijd.ijd_812_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Primary hyperhidrosis (PHH) is characterized by idiopathic, focal, bilateral, and symmetrical excessive and exaggerated sweating with a major impact on the quality of life (QoL). To date, there are no studies about the prevalence of PHH in Jordan and in the Arab region. AIM To assess the prevalence, severity, and characteristics of PHH in the Jordanian population as well as its impact on QoL. MATERIAL AND METHODS This study was conducted in five hospitals in Jordan and included 4,500 attendants of outpatient clinics who were evaluated for the presence of PHH. To assess the severity of hyperhidrosis (HH), we used the Hyperhidrosis Disease Severity Scale (HDSS). To evaluate the impact of HH on QoL, the Dermatology Life Quality Index (DLQI) questionnaire was answered by our patients, either digitally or on paper. RESULTS The overall prevalence of PHH in the Jordanian population was 3.2% (n = 144). The most common site was the axillae (63%), either isolated or in association with other sites. Both sexes were affected equally. The overall mean age of onset was 14.7 years. Positive family history was found in 35% of the patients. Nearly two-thirds of the patients presented with HDSS of 3 or 4. The impact on QoL was substantial with a mean DLQI of 12.8. CONCLUSION PHH prevalence in the Jordanian population is 3.2%, which has a major impact on QoL. This raises the need for addressing this disease to reduce its burden on patient lives.
Collapse
Affiliation(s)
| | - Safa M. Bani Mustafa
- From the Department of Dermatology, Jordanian Royal Medical Services, Amman, Jordan
| | - Habes M. Alzboun
- From the Department of Dermatology, Jordanian Royal Medical Services, Amman, Jordan
| | - Hussam A. Al-issa
- From the Department of Dermatology, Jordanian Royal Medical Services, Amman, Jordan
| | - Sami W. Oweis
- From the Department of Dermatology, Jordanian Royal Medical Services, Amman, Jordan
| | - Anas Y. Alshudeifat
- From the Department of Dermatology, Jordanian Royal Medical Services, Amman, Jordan
| | - Mohammed B. Nawaiseh
- Internship, Jordanian Royal Medical Services, Amman, Jordan,Address for correspondence: Dr. Mohammed B. Nawaiseh, Jordanian Royal Medical Services, Jubaiha - 11941, Amman, Jordan. E-mail:
| |
Collapse
|
19
|
Kamikava DYF, Wolosker N, da Silva MFA, de Campos JRM, Puech-Leão P. Symptoms of anxiety and depression in patients with primary hyperhidrosis and its association with the result of clinical treatment with oxybutynin. Clinics (Sao Paulo) 2021; 76:e2892. [PMID: 34190853 PMCID: PMC8221552 DOI: 10.6061/clinics/2021/e2892] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Accepted: 05/24/2021] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES Studies have identified correlations between the psychological characteristics of individuals with primary hyperhidrosis (HH), the degree of sweating, and the quality of life (QoL). This study aimed to evaluate the prevalence of anxiety and depression symptoms in patients with HH before and after oxybutynin treatment. METHODS Data were collected from 81 patients. Palmar or axillary HH was the most frequent complaint (84.0%). All patients were evaluated before the medication was prescribed and after five weeks of treatment. The Beck Depression Inventory and Beck Anxiety Inventory were used to evaluate depression and anxiety. RESULTS Improvement in HH occurred in 58 patients (71.6%), but there was no improvement in 23 patients (28.4%). The QoL before treatment in all patients was either "poor" or "very poor." Patients who experienced improvement in sweating rates also experienced a greater improvement in QoL than patients who did not experience improvement in sweating at the main site (87.9% vs. 34.7%) (p<0.001). A total of 19.7% of patients showed an improvement in their level of depression, and a total of 46.9% of patients exhibited improvements in their level of anxiety. A significant correlation was observed between sweating and anxiety (p=0.015). CONCLUSION Patients with HH who experienced improvements in sweating immediately after treatment with oxybutynin exhibited small improvements in their levels of depression and significant improvements in their levels of anxiety and QoL.
Collapse
Affiliation(s)
- Débora Yumi Ferreira Kamikava
- Divisao de Psicologia, Instituto Central, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, BR
- *Corresponding author. E-mail:
| | - Nelson Wolosker
- Disciplina de Cirurgia Vascular e Endovascular, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, BR
- Hospital Israelita Albert Einstein, Sao Paulo, SP, BR
| | | | - José Ribas Milanez de Campos
- Hospital Israelita Albert Einstein, Sao Paulo, SP, BR
- Disciplina de Cirurgia Toracica, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, BR
| | - Pedro Puech-Leão
- Disciplina de Cirurgia Vascular e Endovascular, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, BR
| |
Collapse
|
20
|
Schote AB, Schiel F, Schmitt B, Winnikes U, Frank N, Gross K, Croyé MA, Tarragon E, Bekhit A, Bobbili DR, May P, Schick C, Meyer J. Genome-wide linkage analysis of families with primary hyperhidrosis. PLoS One 2020; 15:e0244565. [PMID: 33378362 PMCID: PMC7773265 DOI: 10.1371/journal.pone.0244565] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Accepted: 12/11/2020] [Indexed: 12/17/2022] Open
Abstract
Primary focal hyperhidrosis (PFH, OMIM %144110) is a genetically influenced condition characterised by excessive sweating. Prevalence varies between 1.0-6.1% in the general population, dependent on ethnicity. The aetiology of PFH remains unclear but an autosomal dominant mode of inheritance, incomplete penetrance and variable phenotypes have been reported. In our study, nine pedigrees (50 affected, 53 non-affected individuals) were included. Clinical characterisation was performed at the German Hyperhidrosis Centre, Munich, by using physiological and psychological questionnaires. Genome-wide parametric linkage analysis with GeneHunter was performed based on the Illumina genome-wide SNP arrays. Haplotypes were constructed using easyLINKAGE and visualised via HaploPainter. Whole-exome sequencing (WES) with 100x coverage in 31 selected members (24 affected, 7 non-affected) from our pedigrees was achieved by next generation sequencing. We identified four genome-wide significant loci, 1q41-1q42.3, 2p14-2p13.3, 2q21.2-2q23.3 and 15q26.3-15q26.3 for PFH. Three pedigrees map to a shared locus at 2q21.2-2q23.3, with a genome-wide significant LOD score of 3.45. The chromosomal region identified here overlaps with a locus at chromosome 2q22.1-2q31.1 reported previously. Three families support 1q41-1q42.3 (LOD = 3.69), two families share a region identical by descent at 2p14-2p13.3 (LOD = 3.15) and another two families at 15q26.3 (LOD = 3.01). Thus, our results point to considerable genetic heterogeneity. WES did not reveal any causative variants, suggesting that variants or mutations located outside the coding regions might be involved in the molecular pathogenesis of PFH. We suggest a strategy based on whole-genome or targeted next generation sequencing to identify causative genes or variants for PFH.
Collapse
Affiliation(s)
- Andrea B. Schote
- Department of Neurobehavioral Genetics, Institute of Psychobiology, University of Trier, Trier, Germany
| | - Florian Schiel
- Department of Neurobehavioral Genetics, Institute of Psychobiology, University of Trier, Trier, Germany
| | - Benedikt Schmitt
- Department of Neurobehavioral Genetics, Institute of Psychobiology, University of Trier, Trier, Germany
| | - Ulrike Winnikes
- Department of Neurobehavioral Genetics, Institute of Psychobiology, University of Trier, Trier, Germany
| | - Nicole Frank
- Department of Neurobehavioral Genetics, Institute of Psychobiology, University of Trier, Trier, Germany
| | - Katharina Gross
- Department of Neurobehavioral Genetics, Institute of Psychobiology, University of Trier, Trier, Germany
| | - Marie-Anne Croyé
- Department of Neurobehavioral Genetics, Institute of Psychobiology, University of Trier, Trier, Germany
| | - Ernesto Tarragon
- Department of Neurobehavioral Genetics, Institute of Psychobiology, University of Trier, Trier, Germany
| | - Adam Bekhit
- Institute for Medical Biometry, Epidemiology and Medical Informatics, Saarland University, Homburg, Germany
| | - Dheeraj Reddy Bobbili
- Bioinformatics Core, Luxembourg Centre for Systems Biomedicine, University of Luxembourg, Esch-sur-Alzette, Luxembourg
- Megeno, Esch-sur-Alzette, Luxembourg
| | - Patrick May
- Bioinformatics Core, Luxembourg Centre for Systems Biomedicine, University of Luxembourg, Esch-sur-Alzette, Luxembourg
| | | | - Jobst Meyer
- Department of Neurobehavioral Genetics, Institute of Psychobiology, University of Trier, Trier, Germany
| |
Collapse
|
21
|
Verhaegh AJFP, Kuijpers M, Boon M, DeJongste MJL, Bouma W, Mariani MA, Klinkenberg TJ. Thoracoscopic sympathicotomy for the treatment of intolerable palmar and axillary hyperhidrosis in children is associated with high recurrence rates. Pediatr Dermatol 2020; 37:987-992. [PMID: 32677080 PMCID: PMC7586985 DOI: 10.1111/pde.14273] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
BACKGROUND Treatment of palmar and axillary primary focal hyperhidrosis (PFH) in children up to 16 years using thoracoscopic sympathicotomy is supported by scarce evidence. Therefore, this study aimed to summarize the results of our standardized bilateral, one-stage, single-port sympathicotomy (BOSS) in children up to 16 years of age. METHODS Consecutive children (n = 14) up to 16 years of age undergoing BOSS between October 2011 and June 2015 in our institution were included in this retrospective study. RESULTS Recurrence of primary hyperhidrosis was noted in seven patients (50.0%), of whom five patients (35.7%) underwent reoperation. Reoperations were associated with placement of additional thoracoscopic ports (n = 1; 12.5%), intraoperative placement of pleural drains (n = 2; 25%), and prolonged air leak (n = 1; 12.5%). Despite the high recurrence and reoperation rates, overall patient satisfaction was high with a median satisfaction score of 7.5 (interquartile range of 1.75; range: 4-9). CONCLUSION Although the overall patient satisfaction score in our cohort was good, BOSS for the treatment of intolerable palmar and axillary PFH in children up to 16 years of age is associated with a high recurrence and reoperation rate.
Collapse
Affiliation(s)
- Arjan J F P Verhaegh
- Department of Cardiothoracic Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Michiel Kuijpers
- Department of Cardiothoracic Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Maartje Boon
- Department of Neurology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Mike J L DeJongste
- Department of Cardiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Wobbe Bouma
- Department of Neurology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Massimo A Mariani
- Department of Cardiothoracic Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Theo J Klinkenberg
- Department of Cardiothoracic Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| |
Collapse
|
22
|
Mantelakis A, Spencer H, Duval JL, Joshi A. Botulinum Toxin in the Management of Hyperhidrosis and Other Salivary Conditions. CURRENT OTORHINOLARYNGOLOGY REPORTS 2020. [DOI: 10.1007/s40136-020-00304-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
23
|
Kristensen JK, Vestergaard DG, Swartling C, Bygum A. Association of Primary Hyperhidrosis with Depression and Anxiety: A Systematic Review. Acta Derm Venereol 2020; 100:adv00044. [PMID: 31821514 PMCID: PMC9128995 DOI: 10.2340/00015555-3393] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/10/2019] [Indexed: 11/23/2022] Open
|
24
|
Genetic disposition to primary hyperhidrosis: a review of literature. Arch Dermatol Res 2019; 311:735-740. [DOI: 10.1007/s00403-019-01966-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Accepted: 06/15/2019] [Indexed: 01/11/2023]
|
25
|
Hajjar WM, Al-Nassar SA, Al-Sharif HM, Al-Olayet DM, Al-Otiebi WS, Al-Huqayl AA, Hajjar AW. The quality of life and satisfaction rate of patients with upper limb hyperhidrosis before and after bilateral endoscopic thoracic sympathectomy. Saudi J Anaesth 2019; 13:16-22. [PMID: 30692883 PMCID: PMC6329233 DOI: 10.4103/sja.sja_335_18] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Background: Hyperhidrosis is a functional disorder identified by excessive sweating. Its incidence is approximately 1% in any population. Bilateral endoscopic thoracic sympathectomy (BETS) intervention is the definitive treatment of choice for palmar and axillary hyperhidrosis. Aims and Objectives: The purpose of this study is to evaluate and compare the quality of life (QOL) and satisfaction rate of patients with upper limb hyperhidrosis before and after BETS surgery and the influence of compensatory hyperhidrosis (CH) on patients’ QOL after surgery. Settings and Design: This study is a cross-sectional study designed to generate longitudinal data. Subjects and Methods: This study is a cross-sectional study designed to generate longitudinal data pre- and postbilateral BETS prospectively. This study was conducted in the surgery department of University Hospital in Riyadh, Saudi Arabia. Hundred patients with upper limb hyperhidrosis who underwent BETS from 2014 to 2017 were included. A modified and validated QOL questionnaire for hyperhidrosis was completed by the patients themselves in order to compare the QOL for patients both before and after BETS. Patients’ satisfaction and the occurrence of CH were obtained postoperatively. Statistical Analysis Used: Data were analyzed using the SPSS® statistical package for social studies, version 22.0 (SPSS 22; IBM Corp., New York, NY, USA) for Windows®. Results: A total of 100 patients completed the questionnaire; 94% of patients had a positive QOL outcome after the surgery. The mean decrease in QOL scores was −42.0 points toward better QOL. The site of sweating had a significant effect on the patients’ QOL before and after the surgery (P value < 0.001). Moreover, 76% of patients reported a high satisfaction rate. Conclusion: Primary hyperhidrosis can negatively impair patients’ QOL in different domains. BETS showed to be an effective option for improving the QOL of patients and it provided both short- and long-term effectiveness in treating upper limb hyperhidrosis. CH did not interfere with the rate of patient satisfaction or their QOL postoperatively.
Collapse
Affiliation(s)
- Waseem M Hajjar
- Department of Surgery, Thoracic Surgery Division, College of Medicine, King Saud University, King Khalid University Hospital, Riyadh, Saudi Arabia
| | - Sami A Al-Nassar
- Department of Surgery, Thoracic Surgery Division, College of Medicine, King Saud University, King Khalid University Hospital, Riyadh, Saudi Arabia
| | - Heba M Al-Sharif
- Department of Surgery, Thoracic Surgery Division, College of Medicine, King Saud University, King Khalid University Hospital, Riyadh, Saudi Arabia
| | - Dana M Al-Olayet
- Department of Surgery, Thoracic Surgery Division, College of Medicine, King Saud University, King Khalid University Hospital, Riyadh, Saudi Arabia
| | - Wejdan S Al-Otiebi
- Department of Surgery, Thoracic Surgery Division, College of Medicine, King Saud University, King Khalid University Hospital, Riyadh, Saudi Arabia
| | - Alanoud A Al-Huqayl
- Department of Surgery, Thoracic Surgery Division, College of Medicine, King Saud University, King Khalid University Hospital, Riyadh, Saudi Arabia
| | - Adnan W Hajjar
- Department of Surgery, Thoracic Surgery Division, College of Medicine, King Saud University, King Khalid University Hospital, Riyadh, Saudi Arabia
| |
Collapse
|
26
|
López-López D, Becerro-de-Bengoa-Vallejo R, Losa-Iglesias ME, Rodríguez-Sanz D, Palomo-López P, Calvo-Lobo C. Relationship between depression scores and degree of skin perspiration: A novel cross-sectional study. Int Wound J 2018; 16:139-143. [PMID: 30251361 DOI: 10.1111/iwj.13004] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Revised: 09/05/2018] [Accepted: 09/07/2018] [Indexed: 11/29/2022] Open
Abstract
Primary hyperhidrosis (PH) is a common pathological condition related to excessive sweating. It may be associated with depression. Therefore, the main aim of this study was to analyse and compare depression scores between subjects without PH (degree-I) and patients with PH (degrees-II, -III, and -IV). The secondary aim was to describe and compare depression scores among subjects with different PH degrees (I-without perceptible perspiration, II-tolerable perspiration, III-hardly tolerable perspiration, and IV-intolerable perspiration). A sample of 100 subjects with a median age of 23.00 ± 6.00 years was recruited from an outpatient medical centre, where medical history data were registered. The degree of PH was determined using the Hyperhidrosis Disease Severity Scale from degrees I (mild) to IV (very severe). The depression scores were analysed using the Beck Depression Inventory (BDI). Statistically significant differences (P < 0.001) were observed for higher BDI scores in the patients with PH (degrees II, III, and IV) than in those without PH (degree-I). Kruskal-Wallis tests demonstrated statistically significant differences for BDI scores (P < 0.001), with higher values for degree-III with respect to degree-I and degree-IV with respect to degree-I. Patients with a greater degree (especially III/IV) of PH showed higher BDI scores compared with subjects without PH.
Collapse
Affiliation(s)
- Daniel López-López
- Research, Health and Podiatry Unit, Department of Health Sciences, Faculty of Nursing and Podiatry, Universidade da Coruña, Ferrol, Spain
| | | | | | - David Rodríguez-Sanz
- Facultad de Enfermería, Fisioterapia y Podología, Universidad Complutense de Madrid, Madrid, Spain.,Faculty of Sports Sciences, Universidad Europea de Madrid, Villaviciosa de Odón, Madrid, Spain
| | | | - César Calvo-Lobo
- Nursing and Physical Therapy Department, Institute of Biomedicine (IBIOMED), Faculty of Health Sciences, Universidad de León, Ponferrada, León, Spain
| |
Collapse
|
27
|
Rosen R, Stewart T. Results of a 10-year follow-up study of botulinum toxin A therapy for primary axillary hyperhidrosis in Australia. Intern Med J 2018; 48:343-347. [PMID: 29512329 DOI: 10.1111/imj.13727] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2017] [Revised: 05/24/2017] [Accepted: 05/24/2017] [Indexed: 11/28/2022]
Abstract
Primary hyperhidrosis has a prevalence of 3-5% in the United States. It is a psychosocially disabling condition leading to low self-esteem, chronic stress and depressive symptoms. Several medical and surgical treatments exist, including botulinum toxin A, which internationally, has been shown effectively and safely to treat this condition achieving high patient satisfaction. In Australia, botulinum toxin A has been available under the Medicare benefits scheme for axillary hyperhidrosis since 2013, but efficacy and treatment satisfaction had not been evaluated. We present the results of the first Australian study on efficacy and patient satisfaction with botulinum toxin A in primary axillary hyperhidrosis with evaluation of possible prognostic factors.
Collapse
Affiliation(s)
- Robert Rosen
- Southern Suburbs Dermatology, Sydney, New South Wales, Australia.,School of Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | - Thomas Stewart
- Southern Suburbs Dermatology, Sydney, New South Wales, Australia.,School of Medicine, University of New South Wales, Sydney, New South Wales, Australia
| |
Collapse
|
28
|
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]
|
29
|
Mavrogiorgou P, Juckel G. [Dermatological diseases and their importance for psychiatry]. DER NERVENARZT 2017; 88:254-267. [PMID: 26975652 DOI: 10.1007/s00115-016-0082-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
The relationship between skin and psychiatric disorders is not an uncommon occurrence in the clinical practice; however, there are only a few systematic studies and in addition knowledge about the neurobiological and immunological mechanisms is lacking. Impairments and disorders of the skin are often an (early) sign of a psychiatric disorder. In the sense of true psychosomatics, psychiatrists should also be aware of this relationship as far as possible. This review article focuses on the most important dermatological diagnoses in relation to the respective psychiatric comorbidities and presents the most important aspects of epidemiology, symptomatology, pathophysiology and treatment options.
Collapse
Affiliation(s)
- P Mavrogiorgou
- Klinik für Psychiatrie Psychotherapie und Präventivmedizin, LWL-Universitätsklinikum der Ruhr Universität Bochum, Alexandrinenstr.1, 44791, Bochum, Deutschland
| | - G Juckel
- Klinik für Psychiatrie Psychotherapie und Präventivmedizin, LWL-Universitätsklinikum der Ruhr Universität Bochum, Alexandrinenstr.1, 44791, Bochum, Deutschland.
| |
Collapse
|
30
|
Ersig AL, Starkweather AR. An Integrative Review of Biological Variants and Chronic Stress in Emerging Adults With Chronic Conditions. J Nurs Scholarsh 2017; 49:185-193. [PMID: 28166375 DOI: 10.1111/jnu.12281] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/09/2016] [Indexed: 11/26/2022]
Abstract
PURPOSE The purpose of this integrative review was to evaluate and synthesize studies that incorporated biological measures and examined their associations with chronic stress and anxiety in adolescents and emerging adults with chronic health conditions. DESIGN An integrative literature review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement to identify studies published between 2005 and 2015. METHODS Using key terms, three databases (PubMed/Medline, PsycInfo and the Cumulative Index to Nursing and Allied Health Literature) were searched by a research librarian. Additional publications with relevance to the topic were identified from citing and cited literature. The full text of 61 publications was reviewed. The final group of articles analyzed for this review included 36 peer-reviewed publications and meeting abstracts. FINDINGS Studies varied considerably in characteristics, theoretical frameworks, phenotypes of interest, and study measures. Few studies evaluated genomic variants; those that did often examined small samples and a limited number of biological factors. CONCLUSIONS Studies of chronic stress and anxiety in adolescents and emerging adults with chronic health conditions are currently limited in scope and impact. A more comprehensive approach will facilitate translation into practice to improve short- and long-term health outcomes. CLINICAL RELEVANCE Precision and genomic healthcare initiatives support the relevance of this work for nurses in all areas of clinical practice. Genomic testing is expanding to include individuals in all age groups, with and without diagnosed conditions. As psychological and behavioral phenotypes may influence self-management outcomes of adolescents and emerging adults with chronic health conditions, further research in this area is warranted.
Collapse
Affiliation(s)
- Anne L Ersig
- Gamma, Nurse Researcher, Center for Pediatric Nursing Research & Evidence Based Practice, The Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | | |
Collapse
|
31
|
Nasr MW, Jabbour SF, Haber RN, Kechichian EG, El Hachem L. Comparison of microwave ablation, botulinum toxin injection, and liposuction-curettage in the treatment of axillary hyperhidrosis: A systematic review. J COSMET LASER THER 2016; 19:36-42. [DOI: 10.1080/14764172.2016.1248438] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Marwan W. Nasr
- Department of Plastic and Reconstructive Surgery, Hotel Dieu de France University Hospital, Beirut, Lebanon
| | - Samer F. Jabbour
- Department of Plastic and Reconstructive Surgery, Hotel Dieu de France University Hospital, Beirut, Lebanon
| | - Roger N. Haber
- Department of Dermatology, Hotel Dieu de France University Hospital, Beirut, Lebanon
| | - Elio G. Kechichian
- Department of Dermatology, Hotel Dieu de France University Hospital, Beirut, Lebanon
| | - Lena El Hachem
- Department of Obstetrics and Gynecology, Lebanese American University Medical Center, Beirut, Lebanon
| |
Collapse
|
32
|
Bahar R, Zhou P, Liu Y, Huang Y, Phillips A, Lee TK, Su M, Yang S, Kalia S, Zhang X, Zhou Y. The prevalence of anxiety and depression in patients with or without hyperhidrosis (HH). J Am Acad Dermatol 2016; 75:1126-1133. [DOI: 10.1016/j.jaad.2016.07.001] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2016] [Revised: 06/28/2016] [Accepted: 07/05/2016] [Indexed: 11/26/2022]
|
33
|
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.
Collapse
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)
| |
Collapse
|
34
|
|
35
|
Semkova K, Gergovska M, Kazandjieva J, Tsankov N. Hyperhidrosis, bromhidrosis, and chromhidrosis: Fold (intertriginous) dermatoses. Clin Dermatol 2015; 33:483-91. [DOI: 10.1016/j.clindermatol.2015.04.013] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
36
|
Hashmonai M, Cameron AEP, Licht PB, Hensman C, Schick CH. Thoracic sympathectomy: a review of current indications. Surg Endosc 2015; 30:1255-69. [PMID: 26123342 DOI: 10.1007/s00464-015-4353-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2015] [Accepted: 06/16/2015] [Indexed: 01/09/2023]
Abstract
BACKGROUND Thoracic sympathetic ablation was introduced over a century ago. While some of the early indications have become obsolete, new ones have emerged. Sympathetic ablation is being still performed for some odd indications thus prompting the present study, which reviews the evidence base for current practice. METHODS The literature was reviewed using the PubMed/Medline Database, and pertinent articles regarding the indications for thoracic sympathectomy were retrieved and evaluated. Old, historical articles were also reviewed as required. RESULTS AND CONCLUSIONS Currently, thoracic sympathetic ablation is indicated mainly for primary hyperhidrosis, especially affecting the palm, and to a lesser degree, axilla and face, and for facial blushing. Despite modern pharmaceutical, endovascular and surgical treatments, sympathetic ablation has still a place in the treatment of very selected cases of angina, arrhythmias and cardiomyopathy. Thoracic sympathetic ablation is indicated in several painful conditions: the early stages of complex regional pain syndrome, erythromelalgia, and some pancreatic and other painful abdominal pathologies. Although ischaemia was historically the major indication for sympathetic ablation, its use has declined to a few selected cases of thromboangiitis obliterans (Buerger's disease), microemboli, primary Raynaud's phenomenon and Raynaud's phenomenon secondary to collagen diseases, paraneoplastic syndrome, frostbite and vibration syndrome. Thoracic sympathetic ablation for hypertension is obsolete, and direct endovascular renal sympathectomy still requires adequate clinical trials. There are rare publications of sympathetic ablation for primary phobias, but there is no scientific basis to support sympathetic surgery for any psychiatric indication.
Collapse
Affiliation(s)
- Moshe Hashmonai
- Faculty of Medicine, Technion-Israel Institute of Technology, PO Box 359, 30952119, Zikhron Ya'akov, Haifa, Israel.
| | | | - Peter B Licht
- Department of Cardiothoracic Surgery, Odense University Hospital, Odense, Denmark
| | | | | |
Collapse
|