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Preis S, Ziehfreund S, Biedermann T, Horster S, Zink A. A systematic review of sex and gender differences in treatment outcome of inflammatory skin diseases: Is it time for new guidelines? J Eur Acad Dermatol Venereol 2024. [PMID: 39078087 DOI: 10.1111/jdv.20256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 06/07/2024] [Indexed: 07/31/2024]
Abstract
Gender- and sex-specific differences in medicine were long-time disregarded. Despite numerous indications of gender- and sex-specific influences on the treatment of dermatological conditions, these have not yet been systematically investigated. To meet this unmet need, we conducted the present systematic review on the topic of gender and sex differences in the treatement outcome of skin diseases. Embase (via Ovid), PubMed Medline and Web of Science were searched, in between January 2001 and December 2022. English and german randomized controlled trials, prospective and retrospective cohorts and case-control studies that examined differences between men and women in treatment outcomes of skin diseases were included. Two authors independently screened the reports for eligibility, one extracted all data (the second double-checked) and critically appraised the quality and risk of bias of the studies. Eighty-three reports were included. The largest share of the identified publications focused on gender differences in psoriasis and psoriatic arthritis (n = 49), followed by melanoma (n = 8) and sporadic studies (n < 5) of inflammatory, infectious and autoimmune skin diseases. The main topics in which gender differences could be identified were choice of treatment, time to initiation of treatment, therapy response, adverse events, adherence and treatment satisfaction. For psoriasis, gender differences could be found in all aspects, while for the other skin diseases specific publications on gender differences are still missing. This systematic review shows numerous gender differences but also reveals major gaps in gender-specific care in dermatology which should be narrowed in the upcoming years to optimize a patient-centred, individualized, gender-equal healthcare. PROSPERO Registration: CRD42022306626.
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Affiliation(s)
- S Preis
- Department of Dermatology and Allergy, TUM School of Medicine and Health, Technical University of Munich, Munich, Germany
- Institute for Medical Information Processing, Biometry, and Epidemiology, Pettenkofer School of Public Health LMU Munich, Munich, Germany
| | - S Ziehfreund
- Department of Dermatology and Allergy, TUM School of Medicine and Health, Technical University of Munich, Munich, Germany
| | - T Biedermann
- Department of Dermatology and Allergy, TUM School of Medicine and Health, Technical University of Munich, Munich, Germany
| | - S Horster
- Department of Gastroenterology and Hepatology, University Hospital Munich, Munich, Germany
| | - A Zink
- Department of Dermatology and Allergy, TUM School of Medicine and Health, Technical University of Munich, Munich, Germany
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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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da Silva MFA, Louzada ACS, Teivelis MP, Stabellini N, Leiderman DBD, de Campos JRM, Amaro E, Wolosker N. Population-based analysis of the epidemiology of the surgical correction of hyperhidrosis in 1,216 patients over 11 years: a cross-sectional study. SAO PAULO MED J 2022; 140:775-780. [PMID: 36102451 PMCID: PMC9671571 DOI: 10.1590/1516-3180.2021.0773.r2.14022022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 02/14/2022] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Endoscopic thoracic sympathectomy is the definitive surgical treatment for hyperhidrosis and a nationwide study has suggested that cultural and socioeconomic factors play a role in the numbers of operations performed. Thus, there is a need to evaluate local data in order to understand the local epidemiology and trends in hyperhidrosis treatment. OBJECTIVE To study the epidemiology of sympathectomy for treating hyperhidrosis in São Paulo, the largest city in Brazil. DESIGN AND SETTING Population-based retrospective cross-sectional study. METHODS Data on sympathectomies for treating hyperhidrosis between 2008 and 2018 were assessed from the database of the Municipal Health Department of São Paulo, Brazil. RESULTS 65.29% of the patients were female, 66.2% were aged between 20 and 39 years and 37.59% had registered with addresses outside São Paulo. 1,216 procedures were performed in the city of São Paulo from 2008 to 2018, and 78.45% of them were in only two public hospitals. The number of procedures significantly declined over the years (P = 0.001). 71.63% of the procedures were associated with 2-3 days of hospital stay, only 78 intensive care unit days were billed and we did not observe any intra-hospital death. CONCLUSION The profile of patients operated on in São Paulo (young women) is similar to that described in other populations. Sympathectomy is a very safe procedure, with no mortality in our series. There was a decreasing trend in the number of surgeries over the years.
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Affiliation(s)
| | | | - Marcelo Passos Teivelis
- MD, PhD. Attending Professor, Faculdade Israelita de Ciências da Saúde Albert Einstein (FICSAE), Hospital Israelita Albert Einstein, São Paulo (SP), Brazil
| | - Nickolas Stabellini
- Undergraduate Medical Student, Faculdade Israelita de Ciências da Saúde Albert Einstein (FICSAE), Hospital Israelita Albert Einstein, São Paulo (SP), Brazil
| | - Dafne Braga Diamante Leiderman
- MD, PhD. Attending Physician, Department of Vascular and Endovascular Surgery, Hospital Israelita Albert Einstein, São Paulo (SP), Brazil
| | - José Ribas Milanez de Campos
- MD, PhD. Associate Professor, Department of Surgery, Faculdade de Medicina, Universidade de São Paulo (USP), São Paulo (SP), Brazil
| | - Edson Amaro
- MD, PhD. Associate Professor, Department of Radiology, Faculdade de Medicina, Universidade de São Paulo (USP), São Paulo (SP), Brazil
| | - Nelson Wolosker
- MD, PhD. Full Professor, Faculdade Israelita de Ciências da Saúde Albert Einstein (FICSAE), Hospital Israelita Albert Einstein, São Paulo (SP), Brazil
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Wolosker N, de Campos JRM, Kauffman P, da Silva MFA, Faustino CB, Tedde ML, Puech-Leão P, Fernandes PMP. Cohort study on 20 years' experience of bilateral video-assisted thoracic sympathectomy (VATS) for treatment of hyperhidrosis in 2431 patients. SAO PAULO MED J 2022; 140:284-289. [PMID: 35195234 PMCID: PMC9610237 DOI: 10.1590/1516-3180.2021.0078.r1.23072021] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Accepted: 07/23/2021] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Primary hyperhidrosis is a condition characterized by excessive sweating, inconsistent with the needs for thermoregulation. OBJECTIVE To assess the effectiveness and the change in the quality of life of patients undergoing bilateral VATS (video-assisted thoracoscopic sympathectomy) for treatment of hyperhidrosis, in a large case series. DESIGN AND SETTING Cohort study conducted in a tertiary hospital specializing in hyperhidrosis located in São Paulo, Brazil. METHODS A total of 2,431 patients who underwent surgery consisting of bilateral video-assisted thoracoscopic sympathectomy between January 2000 and February 2017 were retrospectively assessed in an outpatient clinic specializing in hyperhidrosis. The patients underwent clinical and quality of life assessments on two occasions: firstly, prior to surgery, and subsequently, one month after the operation. The presence or absence of compensatory hyperhidrosis (CH) and general satisfaction after the first postoperative month were also evaluated. RESULTS All the patients operated had poor or very poor quality of life before surgery. In the postoperative period, an improvement in the quality of life was observed in more than 90% of the patients. Only 10.7% of the patients did not present CH, and severe CH occurred in 22.1% of the patients in this sample. CONCLUSION Bilateral VATS is a therapeutic method that decreases the degree of sweating more than 90% of patients with palmar and axillary hyperhidrosis. It improves the quality of life for more than 90% of the patients, at the expense of development of CH in approximately 90% of the patients, but not intensely.
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Affiliation(s)
- Nelson Wolosker
- MD, PhD. Full Professor, Hospital Israelita Albert Einstein (HIAE), São Paulo (SP), Brazil; and Surgeon, Department of Surgery, Vascular and Endovascular Division, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, BR.
| | - José Ribas Milanez de Campos
- MD, PhD. Surgeon, Hospital Israelita Albert Einstein (HIAE), São Paulo (SP), Brazil; and Surgeon, Department of Surgery, Thoracic Surgery Division, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, BR.
| | - Paulo Kauffman
- MD, PhD. Surgeon, Hospital Israelita Albert Einstein (HIAE), São Paulo (SP), Brazil; and Surgeon, Department of Surgery, Vascular and Endovascular Division, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, BR.
| | - Marcelo Fiorelli Alexandrino da Silva
- MD. Surgeon, Hospital Israelita Albert Einstein (HIAE), São Paulo (SP), Brazil; and Surgeon, Department of Surgery, Vascular and Endovascular Division, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, BR.
| | - Carolina Brito Faustino
- MD. Surgeon, Hospital Israelita Albert Einstein (HIAE), São Paulo (SP), Brazil; and Surgeon, Department of Surgery, Vascular and Endovascular Division, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, BR.
| | - Miguel Lia Tedde
- MD, PhD. Surgeon, Department of Surgery, Thoracic Surgery Division, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, BR.
| | - Pedro Puech-Leão
- MD, PhD. Surgeon, Department of Surgery, Vascular and Endovascular Division, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, BR.
| | - Paulo Manuel Pêgo Fernandes
- MD, PhD. Full Professor, Thoracic Surgery Program, Instituto do Coração (InCor), Hospital das Clínicas (HC), Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo (SP), Brazil; and Cardiothoracic Surgeon, Hospital Beneficência Portuguesa (BP), São Paulo (SP), Brazil.
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Briatico G, Pampena R, Fulgione E, Babino G, Giorgio CM, D'Ambra I, Caccavale S, Longo C, Argenziano G. Real-life experience with oral oxybutynin long-term continuous therapy in severe hyperhidrosis and systematic review of the literature. Dermatol Ther 2021; 34:e14832. [PMID: 33527699 DOI: 10.1111/dth.14832] [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: 11/05/2020] [Revised: 11/28/2020] [Accepted: 01/23/2021] [Indexed: 11/28/2022]
Abstract
Hyperhidrosis is a disorder of excessive sweating severely impacting on patient's quality of life (Qol). Several studies have been published about oral oxybutynin, but no studies focused on the achievement of complete clinical and Qol response. The aim of this study was to report our real-life experience with oral oxybutynin in patients with severe hyperhidrosis significantly affecting their Qol. In this cohort retrospective study, we enrolled, in a 3-year period, patients affected by severe hyperhidrosis with poor Qol, continuously treated with oral oxybutynin. Our outcome was the obtainment of complete clinical and Qol improvement. A systematic review of the literature was also performed reporting efficacy and safety of oral oxybutynin for primary hyperhidrosis. We enrolled 62 patients, of which 53 (85.5%) received a mean daily dose of 10 mg and nine (15.5%) of 5 mg. Complete clinical response was achieved in 77.4% (48/62) of cases, while complete Qol improvement occurred in 51.6% (32/62) of cases. Adverse events were only reported as mild, with dry mouth being the most frequently observed (16.1%). Kaplan-Meier survival analysis highlighted that both median clinical and Qol complete responses were reached after 1 year of continuous therapy with oral oxybutynin. The main limitation of our study is the small number of patients enrolled. Long-term therapy with oral oxybutynin for severe hyperhidrosis, continuously administered at a mean daily dosage of 5 to 10 mg, allowed the majority of our patients to reach both clinical and Qol complete improvement, without significant adverse events.
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Affiliation(s)
- Giulia Briatico
- Dermatology Unit, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Riccardo Pampena
- Centro Oncologico ad Alta Tecnologia Diagnostica, Azienda Unità Sanitaria Locale-Istituto di Ricovero e Cura a Carattere Scientifico di Reggio Emilia, Reggio Emilia, Italy
| | | | - Graziella Babino
- Dermatology Unit, University of Campania "Luigi Vanvitelli", Naples, Italy
| | | | - Ilenia D'Ambra
- Dermatology Unit, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Stefano Caccavale
- Dermatology Unit, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Caterina Longo
- Centro Oncologico ad Alta Tecnologia Diagnostica, Azienda Unità Sanitaria Locale-Istituto di Ricovero e Cura a Carattere Scientifico di Reggio Emilia, Reggio Emilia, Italy.,Dermatology Unit, University of Modena and Reggio Emilia, Reggio Emilia, Italy
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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.
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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
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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: 1] [Impact Index Per Article: 0.3] [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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Wolosker N, Faustino CB, da Silva MFA, de Campos JRM, Kauffman P. Current treatment options for craniofacial hyperhidrosis. J Vasc Bras 2020; 19:e20190152. [PMID: 34211510 PMCID: PMC8218019 DOI: 10.1590/1677-5449.200152] [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] [Indexed: 11/22/2022] Open
Abstract
Hyperhidrosis (HH) is characterized by sweating exceeding the amount necessary to meet the thermal regulation and physiological needs of the body. Approximately 9.41% of individuals with HH have craniofacial hyperhidrosis (FH). The present study aims to review the most current data in the literature regarding craniofacial hyperhidrosis, including pathophysiology, diagnosis and clinical presentation, treatment options (clinical and surgical), and outcomes. VATS (videothoracoscopy sympathectomy) is considered the gold standard for definitive treatment of axillary or palmar hyperhidrosis. Recently, several studies have shown the usefulness of clinical treatment with oxybutynin hydrochloride, leading to clinical improvement of HH in more than 70% of users. Both clinical and surgical treatment of craniofacial hyperhidrosis have good results. However, surgical treatment of FH is associated with more complications. Clinical treatment with oxybutynin hydrochloride yields good results and can be the first therapeutic option. When the patient is not satisfied with this treatment and has good clinical conditions, surgical treatment can be used safely.
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Affiliation(s)
- Nelson Wolosker
- Hospital Israelita Albert Einstein, São Paulo, SP, Brasil.,Universidade de São Paulo - USP, Faculdade de Medicina, Departamento de Cirurgia Vascular e Endovascular, São Paulo, SP, Brasil
| | | | | | - José Ribas Milanez de Campos
- Hospital Israelita Albert Einstein, São Paulo, SP, Brasil.,Universidade de São Paulo - USP, Faculdade de Medicina, Departamento de Cirurgia Torácica, São Paulo, SP, Brasil
| | - Paulo Kauffman
- Hospital Israelita Albert Einstein, São Paulo, SP, Brasil.,Universidade de São Paulo - USP, Faculdade de Medicina, Departamento de Cirurgia Vascular e Endovascular, São Paulo, SP, Brasil
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Wolosker N, Kauffman P, de Campos JRM, Faustino CB, da Silva MFA, Teivelis MP, Puech‐Leão P. Long‐term results of the treatment of primary hyperhidrosis with oxybutynin: follow‐up of 1,658 cases. Int J Dermatol 2020; 59:709-715. [DOI: 10.1111/ijd.14872] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Revised: 02/21/2020] [Accepted: 03/09/2020] [Indexed: 11/29/2022]
Affiliation(s)
- Nelson Wolosker
- Department of Vascular and Endovascular Surgery Hospital Israelita Albert Einstein, Morumbi São Paulo Brazil
- Division of Vascular and Endovascular Department of Surgery Hospital das Clínicas da Faculdade de Medicina, Pinheiros University of São Paulo School of Medicine University of São Paulo São Paulo Brazil
| | - Paulo Kauffman
- Department of Vascular and Endovascular Surgery Hospital Israelita Albert Einstein, Morumbi São Paulo Brazil
- Division of Vascular and Endovascular Department of Surgery Hospital das Clínicas da Faculdade de Medicina, Pinheiros University of São Paulo School of Medicine University of São Paulo São Paulo Brazil
| | - José R. M. de Campos
- Division of Thoracic Surgery Hospital Israelita Albert Einstein, Morumbi São Paulo Brazil
- Division of Thoracic Surgery Department of Surgery University of São Paulo School of Medicine University of São Paulo Pinheiros, São Paulo Brazil
| | - Carolina B. Faustino
- Department of Vascular and Endovascular Surgery Hospital Israelita Albert Einstein, Morumbi São Paulo Brazil
- Division of Vascular and Endovascular Department of Surgery Hospital das Clínicas da Faculdade de Medicina, Pinheiros University of São Paulo School of Medicine University of São Paulo São Paulo Brazil
| | - Marcelo F. A. da Silva
- Department of Vascular and Endovascular Surgery Hospital Israelita Albert Einstein, Morumbi São Paulo Brazil
- Division of Vascular and Endovascular Department of Surgery Hospital das Clínicas da Faculdade de Medicina, Pinheiros University of São Paulo School of Medicine University of São Paulo São Paulo Brazil
| | - Marcelo P. Teivelis
- Department of Vascular and Endovascular Surgery Hospital Israelita Albert Einstein, Morumbi São Paulo Brazil
| | - Pedro Puech‐Leão
- Department of Vascular and Endovascular Surgery Hospital Israelita Albert Einstein, Morumbi São Paulo Brazil
- Division of Vascular and Endovascular Department of Surgery Hospital das Clínicas da Faculdade de Medicina, Pinheiros University of São Paulo School of Medicine University of São Paulo São Paulo Brazil
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10
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Wolosker N, Faustino CB, de Campos JRM, Kauffman P, Yazbek G, Fernandes PP, Cucato G. Comparative analysis of the results of videothoracoscopic sympathectomy in the treatment of hyperhidrosis in adolescent patients. J Pediatr Surg 2020; 55:418-424. [PMID: 32063368 DOI: 10.1016/j.jpedsurg.2019.11.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Revised: 08/25/2019] [Accepted: 11/12/2019] [Indexed: 10/25/2022]
Abstract
OBJECTIVE Several factors that could influence the efficacy and satisfaction of patients after bilateral thoracic sympathectomy (VATS) in the treatment of hyperhidrosis (HH) have been studied, but no studies in the literature have specifically analyzed the effectiveness of treatment and variations in the quality of life of adolescents patients compared to those of adult patients (18-40 years). METHODS We retrospectively analyzed 2431 hyperhidrosis patients who underwent bilateral VATS and divided the patients into the following groups: adolescents (472 patients) and adult group (1760 patients). Variables included quality of life prior to surgery, improvement in quality of life after surgery, clinical improvement in sweating, presence of severe compensatory hyperhidrosis and general satisfaction at one month after surgery. RESULTS We observed that all surgical patients presented with poor or very poor quality of life before surgery, with similar proportions in both groups. In the postoperative period, we observed improvement in quality of life in more than 90% of the patients, with no significant difference noted between the two groups of patients. We observed that all patients undergoing surgery presented poor or very poor quality of life before surgery; however, the two groups were statistically different. The quality of life of the ADOLESCENT group before surgery was statistically worse than that of the ADULT group. More than 90% of the patients in this series had great clinical improvement in the main hyperhidrosis site, with no significant difference between the two groups. Severe compensatory hyperhidrosis occurred in 23.8% of the patients in this series, with no significant difference between the two groups. CONCLUSIONS Adolescent patients benefit just as much as adult patients from VATS performed to treat primary hyperhidrosis, presenting excellent, significant surgical results. TYPE OF STUDY Clinical research. LEVELS OF EVIDENCE Level III.
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Affiliation(s)
- Nelson Wolosker
- Department of Vascular and Endovascular Surgery, Hospital Israelita Albert Einstein
| | | | - Jose Ribas Milanez de Campos
- Division of Thoracic Surgery, Hospital Israelita Albert Einstein; Department of Surgery, Thoracic Surgery Division, University of São Paulo School of Medicine
| | - Paulo Kauffman
- Department of Vascular and Endovascular Surgery, Hospital Israelita Albert Einstein
| | - Guilherme Yazbek
- Department of Vascular and Endovascular Surgery, A.C. Camargo Cancer Center, Fundação Antônio Prudente
| | - Paulo Pêgo Fernandes
- Department of Surgery, Thoracic Surgery Division, University of São Paulo School of Medicine
| | - Gabriel Cucato
- Department of Vascular and Endovascular Surgery, Hospital Israelita Albert Einstein
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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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Estevan FA, Wolosker MB, Wolosker N, Puech-Leão P. Epidemiologic analysis of prevalence of the hyperhidrosis. An Bras Dermatol 2018; 92:630-634. [PMID: 29166497 PMCID: PMC5674693 DOI: 10.1590/abd1806-4841.20175551] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2016] [Accepted: 07/10/2016] [Indexed: 11/21/2022] Open
Abstract
Background The present paper aims to study the prevalence of the various manifestations
of hyperhidrosis in patients who sought treatment in a specialized
ambulatory in the state of São Paulo. Objectives Opposite to previous studies, this paper studies the different combinations
of sweating sites, not being restricted to the main complaint site of the
patients, but taking into consideration secondary complaints patients may
present. Methods This was a retrospective approach of a database containing more than 1200
patients in which were mapped: combination of sweating sites, age of onset,
age spectrum, mean age, body mass index and gender of patients. Patients
were categorized into four groups based on their main sweating site -
palmar, plantar, axillary and facial. Results We concluded that hyperhidrosis appears frequently in more than one site,
being the main complaint that affects the most patients palmar
hyperhidrosis, which appears early in the patients during adolescence. When
there are two sites of sweating, the most frequent combination is palmar +
plantar, and when there are three sites of sweating the most frequent
combinations are palmar + plantar + axillary and axillary + palmar +
plantar. Study limitations This research has casuistics limited to a single care service for patients
with hyperhidrosis. Conclusion It is necessary to keep in mind that the disease manifests itself mainly in
more than one location, with different intensities in each of the patients,
generating a significant impairment of their quality of life.
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Affiliation(s)
| | - Marina Borri Wolosker
- School of Medicine of the Universidade de São Paulo (FMUSP) - São Paulo (SP), Brazil
| | - Nelson Wolosker
- Department of Surgery - Division of Vascular and Endovascular Surgery of the Clinics Hospital of the School of Medicine of the Universidade de São Paulo (HCFMUSP) - São Paulo (SP), Brazil.,Department of Vascular and Endovascular Surgery of the Hospital Israelita Albert Einstein - São Paulo (SP), Brazil
| | - Pedro Puech-Leão
- Department of Surgery - Division of Vascular and Endovascular Surgery of the Clinics Hospital of the School of Medicine of the Universidade de São Paulo (HCFMUSP) - São Paulo (SP), Brazil
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13
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Delort S, Marchi E, Corrêa MA. Oxybutynin as an alternative treatment for hyperhidrosis. An Bras Dermatol 2017; 92:217-220. [PMID: 28538882 PMCID: PMC5429108 DOI: 10.1590/abd1806-4841.201755126] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2015] [Accepted: 02/28/2016] [Indexed: 11/22/2022] Open
Abstract
Hyperhidrosis is the excessive production of sweating, which can be primary and focal or secondary to various pathologies. The exact cause of primary focal hyperhidrosis is still unknown, although a genetic basis is recognized, and its prevalence varies from 1% to 2.8%. The most affected sites are the armpits, palms, soles and face. It causes much discomfort, affects the quality of life, and is estimated to be undervalued by health professionals. Many treatment options are proposed, both clinical and surgical. The aim of this review is to focus on the treatment of hyperhidrosis with oxybutynin, an anticholinergic drug originally used to control overactive bladder.
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Affiliation(s)
- Sergio Delort
- Graduate program of the Faculdade de Medicina de Jundiaí (FMJ) - Jundiaí (SP), Brazil
| | - Evaldo Marchi
- Departament of Thoracic Surgery of the Faculdade de Medicina de Jundiaí (FMJ) - Jundiaí (SP), Brazil
| | - Marcos Antônio Corrêa
- Departament of Drugs and Medicines of the Universidade Estadual Paulista "Júlio de Mesquita Filho" (Unesp) - Botucatu (SP), Brazil
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14
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Cruddas L, Baker D. Treatment of primary hyperhidrosis with oral anticholinergic medications: a systematic review. J Eur Acad Dermatol Venereol 2017; 31:952-963. [DOI: 10.1111/jdv.14081] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2016] [Accepted: 11/30/2016] [Indexed: 11/30/2022]
Affiliation(s)
- L. Cruddas
- University College London Medical School; London UK
| | - D.M. Baker
- Department of Surgery; Royal Free Hospital; London UK
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15
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Del Boz J, Millán-Cayetano JF, Blázquez-Sánchez N, de Troya M. Individualized Dosing of Oral Oxybutynin for the Treatment of Primary Focal Hyperhidrosis in Children and Teenagers. Pediatr Dermatol 2016; 33:327-31. [PMID: 27122197 DOI: 10.1111/pde.12857] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND/OBJECTIVES Oral anticholinergic drugs, such as oxybutynin, are often used in the treatment of hyperhidrosis, but few studies have focused on dosing strategies for children. The objective was to assess the effectiveness and safety of individualized dosing regimens of oral oxybutynin for treating primary focal hyperhidrosis (PFH) in children and teenagers. METHODS A prospective study was performed including patients who initiated treatment for hyperhidrosis between November 2011 and November 2014. Response to treatment and adverse effects were evaluated using the Hyperhidrosis Disease Severity Scale at baseline and at 3 and 12 months. RESULTS Of 16 patients included in the study, 15 (93.8%) had responded to treatment at the 3-month follow-up (62.5% with excellent response). At the 12-month follow-up, the 11 patients who continued the treatment were still responding (63.6% with excellent response). Adverse effects were reported for 68.8% of the patients at 3 months and 54.5% at 12 months, with a predominance of oropharyngeal xerosis. No serious adverse effects were observed. CONCLUSION Dose individualization of oral oxybutynin according to clinical response and tolerance observed in each patient is a useful management strategy in children and teenagers.
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Affiliation(s)
- Javier Del Boz
- Dermatology Department, Hospital Costa del Sol, Marbella, Spain
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16
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Millán-Cayetano JF, del Boz J, Rivas-Ruiz F, Blázquez-Sánchez N, Hernández Ibáñez C, de Troya-Martín M. Oral oxybutynin for the treatment of hyperhidrosis: outcomes after one-year follow-up. Australas J Dermatol 2016; 58:e31-e35. [DOI: 10.1111/ajd.12473] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2015] [Accepted: 02/16/2016] [Indexed: 11/30/2022]
Affiliation(s)
| | - Javier del Boz
- Department of Dermatology; Hospital Costa del Sol; Marbella Spain
| | - Francisco Rivas-Ruiz
- Research Unit; Hospital Costa del Sol; Marbella Spain
- Red de Investigación en Servicios de Salud en Enfermedades Crónicas; Marbella Spain
| | | | | | - Magdalena de Troya-Martín
- Department of Dermatology; Hospital Costa del Sol; Marbella Spain
- Red de Investigación en Servicios de Salud en Enfermedades Crónicas; Marbella Spain
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17
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Wolosker N, Teivelis MP, Krutman M, de Paula RP, Schvartsman C, Kauffman P, de Campos JRM, Puech-Leão P. Long-Term Efficacy of Oxybutynin for Palmar and Plantar Hyperhidrosis in Children Younger than 14 Years. Pediatr Dermatol 2015; 32:663-7. [PMID: 25490865 DOI: 10.1111/pde.12385] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Oxybutynin for treating hyperhidrosis in children has been evaluated only in short-term studies. We aimed to investigate the long-term effects of oxybutynin in treating children with palmar and plantar hyperhidrosis who had not undergone surgery and who were monitored for at least 6 months (median 19.6 mos). A cohort of 97 patients was evaluated retrospectively, with particular attention to 59 children (ages 4-14 yrs) who were treated for longer than 6 months. Their quality of life (QOL) was evaluated using a validated clinical questionnaire before and after 6 weeks of pharmacologic therapy. A self-assessment of hyperhidrosis was performed after 6 weeks and after the last consultation. By their final office visit, more than 91% of the children with hyperhidrosis treated with oxybutynin experienced moderate or great improvement in their level of sweating and 94.9% experienced improvement in QOL. More than 90% of children reported improvement of hyperhidrosis at other sites. Dry mouth was the most common side effect. Oxybutynin appears to be an effective treatment option for children with hyperhidrosis, and positive results are maintained over the long term (median 19.6 mos).
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Affiliation(s)
- Nelson Wolosker
- Department of Vascular and Endovascular Surgery, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.,Vascular and Endovascular Division, Department of Surgery, School of Medicine, University of São Paulo, São Paulo, SP, Brazil
| | - Marcelo P Teivelis
- Department of Vascular and Endovascular Surgery, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil
| | - Mariana Krutman
- Department of Vascular and Endovascular Surgery, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil
| | - Rafael P de Paula
- Hospital das Clínicas, University of São Paulo, São Paulo, SP, Brazil
| | - Claudio Schvartsman
- Division of Pediatrics, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil
| | - Paulo Kauffman
- Department of Vascular and Endovascular Surgery, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil
| | - José R M de Campos
- Hospital das Clínicas, University of São Paulo, São Paulo, SP, Brazil.,Division of Thoracic Surgery, Hospital das Clinicas, University of São Paulo and Division of Thoracic Surgery, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil
| | - Pedro Puech-Leão
- Vascular and Endovascular Division, Department of Surgery, School of Medicine, University of São Paulo, São Paulo, SP, Brazil
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18
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Systemic Treatment of Hyperhidrosis. ACTAS DERMO-SIFILIOGRAFICAS 2015. [DOI: 10.1016/j.adengl.2015.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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19
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Tratamiento sistémico de la hiperhidrosis. ACTAS DERMO-SIFILIOGRAFICAS 2015; 106:271-7. [DOI: 10.1016/j.ad.2014.11.012] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2014] [Revised: 11/05/2014] [Accepted: 11/19/2014] [Indexed: 11/21/2022] Open
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20
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Wolosker N, Teivelis MP, Krutman M, Campbell TPDDA, Kauffman P, Campos JRD, Puech-Leão P. Long-term results of oxybutynin use in treating facial hyperhidrosis. An Bras Dermatol 2015; 89:912-6. [PMID: 25387496 PMCID: PMC4230660 DOI: 10.1590/abd1806-4841.20143272] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2013] [Accepted: 02/11/2014] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Facial hyperhidrosis can lead to serious emotional distress. Video-assisted thoracic sympathectomy resolves symptoms effectively, though it may be associated with compensatory hyperhidrosis, which may be more common in patients undergoing resection of the second thoracic ganglion. Oxybutynin has been used as a pharmacological approach to facial hyperhidrosis but the long-term results of this treatment are unclear. OBJECTIVE To evaluate the use of low oxybutynin doses in facial hyperhidrosis patients for at least six months. METHODS 61 patients were monitored for over six months and assessed according to the following variables: impact of hyperhidrosis on quality of life (QOL) before treatment and after six weeks, evolution of facial hyperhidrosis after six weeks and at the last consultation, complaints of dry mouth after six weeks and on last return visit, and improvement at other hyperhidrosis sites. RESULTS Patients were monitored for 6 to 61 months (median=17 months). Thirty-six (59%) were female. Age ranged from 17-74 (median:45). Pre-treatment QOL was poor/very poor in 96.72%. After six weeks, 100% of patients improved QOL. Comparing results after six weeks and on the last visit, 91.8% of patients maintained the same category of improvement in facial hyperhidrosis, 3.3% worsened and 4.9% improved. Dry mouth complaints were common but not consistent throughout treatment. More than 90% of patients presented moderate/great improvement at other hyperhidrosis sites. CONCLUSION Patients who had a good initial response to treatment maintained a good response long-term, did not display tachiphylaxis and experienced improvement on other hyperhidrosis sites.
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Affiliation(s)
| | | | | | | | - Paulo Kauffman
- Hospital Israelita Albert Einstein, São Paulo, SP, Brazil
| | | | - Pedro Puech-Leão
- Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
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21
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Campanati A, Gregoriou S, Kontochristopoulos G, Offidani A. Oxybutynin for the Treatment of Primary Hyperhidrosis: Current State of the Art. Skin Appendage Disord 2015; 1:6-13. [PMID: 27172124 DOI: 10.1159/000371581] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2014] [Accepted: 12/08/2014] [Indexed: 11/19/2022] Open
Abstract
Oxybutynin is an anticholinergic drug with an emerging role in the treatment of hyperhidrosis. Several recent studies have documented that it is effective both in focal and generalized hyperhidrosis and shows universally good response among different groups of patients regardless of age, gender, and weight. The most common adverse event is dry mouth reported by almost all patients treated. The way this might affect long-term compliance and tolerability should be better investigated in the future.
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Affiliation(s)
- Anna Campanati
- Dermatology Unit, Department of Clinical and Molecular Sciences, Polytechnic University of Marche, Ancona, Italy
| | - Stamatis Gregoriou
- 2nd Department of Dermatology and Venereology, University of Athens Medical School, Attikon Hospital, Athens, Greece
| | - George Kontochristopoulos
- Hyperhidrosis Clinic, Andreas Sygros Hospital, University of Athens Medical School, Attikon Hospital, Athens, Greece
| | - Annamaria Offidani
- Dermatology Unit, Department of Clinical and Molecular Sciences, Polytechnic University of Marche, Ancona, Italy
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22
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Wolosker N, Teivelis MP, Krutman M, de Paula RP, de Campos JRM, Kauffman P, Puech-Leão P. Long-term results of oxybutynin treatment for palmar hyperhidrosis. Clin Auton Res 2014; 24:297-303. [PMID: 25427685 DOI: 10.1007/s10286-014-0264-8] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2014] [Accepted: 10/27/2014] [Indexed: 02/06/2023]
Abstract
PURPOSE Palmar hyperhidrosis (PH) is a common illness that significantly impacts Quality of Life (QOL). Oxybutynin offers excellent short-term results, but long-term follow-up results are limited. We evaluated its effectiveness in a large group of patients who did not have surgery and who had at least 6 months of follow-up. METHODS Between September 2007 and September 2013, 570 consecutive patients were enrolled in our institutional protocol regarding the "pharmacological-first" treatment of primary PH with oxybutynin. Fifty-nine were lost to follow-up, and the data were available for 511 patients treated for at least 6 weeks. Data recorded at the start of the protocol, 6 weeks after beginning treatment, and during patients' final visits were analyzed. RESULTS 112 patients (21.9 %) did not improve and were referred for surgery (sympathectomy). Eight (1.56 %) developed significant side effects (e.g., dry mouth) and discontinued therapy. Thirty (5.9 %) preferred surgery over pharmacological treatment. 111 have not yet received treatment for 6 months. The 246 patients with more than 6 months of follow-up (median 16 months, range 6-72) were analyzed, as follows: 90.2 % experienced moderate or great improvement in their PH; 90.34 % experienced improvement at other sites of hyperhidrosis following a median of 16 months. CONCLUSION Among patients with good initial responses to oxybutynin, more than 90 % experienced moderate or great improvement in their palmar sweating, as well as in their hyperhidrosis in other sites, after 6 months. The results were particularly favorable in those patients with BMI <25 kg/m(2), and in those who noted an improved QOL after 6 weeks.
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Affiliation(s)
- Nelson Wolosker
- Hospital Israelita Albert Einstein, Av. Albert Einstein, 627 Room 423, A1 Building São Paulo, São Paulo, 05652-000, Brazil
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23
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Wolosker N, Krutman M, Teivelis MP, Paula RPD, Kauffman P, Campos JRMD, Puech-Leão P. Analysis of oxybutynin treatment for hyperhidrosis in patients aged over 40 years. EINSTEIN-SAO PAULO 2014; 12:42-7. [PMID: 24728245 PMCID: PMC4898238 DOI: 10.1590/s1679-45082014ao2841] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2013] [Accepted: 11/06/2013] [Indexed: 11/21/2022] Open
Abstract
Objective: Our aim was to analyze the effectiveness of oxybutynin for hyperhidrosis treatment in patients over 40 years. Methods: Eighty-seven patients aged over 40 years were divided into two groups. One group consisted of 48 (55.2%) patients aged between 40 and 49 years, and another was composed of 39 (44.8%) patients aged over 50 years (50 to 74 years). A comparative analysis of Quality of Life and level of hyperhidrosis between the groups was carried out 6 weeks after a protocol treatment with oxybutynin. A validated clinical questionnaire was used for evaluation. Results: In the younger age group, 75% of patients referred a “partial” or “great” improvement in level of hyperhidrosis after treatment. This number was particularly impressive in patients over 50 years, in which 87.2% of the cases demonstrated similar levels of improvement. Over 77% of patients in both groups demonstrated improvement in Quality of Life. Excellent outcomes were observed in older patients, in which 87.1% of patients presented “slightly better” (41%) or “much better” (46.1%) improvement. Conclusion: Patients aged over 40 years with hyperhidrosis presented excellent results after oxybutynin treatment. These outcomes were particularly impressive in the age group over 50 years, in which most patients had significant improvement in Quality of Life and in level of hyperhidrosis.
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Affiliation(s)
| | | | | | | | - Paulo Kauffman
- Hospital Israelita Albert Einstein, São Paulo, SP, Brazil
| | | | - Pedro Puech-Leão
- Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
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25
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26
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Wolosker N, Teivelis MP, Krutman M, de Paula RP, Kauffman P, de Campos JRM, Puech-Leão P. Long-term Results of the Use of Oxybutynin for the Treatment of Axillary Hyperhidrosis. Ann Vasc Surg 2014; 28:1106-12. [DOI: 10.1016/j.avsg.2013.12.024] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2013] [Revised: 12/12/2013] [Accepted: 12/15/2013] [Indexed: 11/24/2022]
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27
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Wolosker N, Krutman M, Teivelis MP, Campbell TP, Kauffman P, de Campos JRM, Puech-Leão P. Quality of Life before Hyperhidrosis Treatment as a Predictive Factor for Oxybutynin Treatment Outcomes in Palmar and Axillary Hyperhidrosis. Ann Vasc Surg 2014; 28:970-6. [DOI: 10.1016/j.avsg.2013.07.032] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2013] [Revised: 07/21/2013] [Accepted: 07/31/2013] [Indexed: 11/16/2022]
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