1
|
Ashton S, Winter S, Thomas C, Mughal A, Mughal F. Hyperhidrosis: assessment and management in general practice. Br J Gen Pract 2024; 74:236-238. [PMID: 38664047 PMCID: PMC11060811 DOI: 10.3399/bjgp24x737361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2024] Open
Affiliation(s)
| | | | | | - Avad Mughal
- Swansea Bay University Health Board; Hon. Associate Professor, Swansea University, Swansea
| | | |
Collapse
|
2
|
Kim WO. Treatment of Palmar Hyperhidrosis With Radiofrequency Microneedling-Based on Ultrasound Measurements. J Ultrasound Med 2024; 43:807-809. [PMID: 38149371 DOI: 10.1002/jum.16402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 10/31/2023] [Accepted: 12/02/2023] [Indexed: 12/28/2023]
Abstract
This study addresses the treatment of palmar hyperhidrosis, which has been difficult to manage. A new treatment has been developed using radiofrequency microneedling to reduce sweating non-surgically by ablating sweat glands. Based on ultrasound measurements of the dermis and precise microneedling damage, effective energy was applied to locate the sweat glands and disabled their function. Radiofrequency microneedling with ultrasound can safely and effectively treat hyperhidrosis in a minimally invasive way.
Collapse
Affiliation(s)
- Won Oak Kim
- Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Yonsei University College of Medicine and The Serantong Pain Clinic, Seoul, Korea
| |
Collapse
|
3
|
Tan Y, Huang W, Liu J, Duan Z, He X, Li Q, Yang Z. The application of microwaves in axillary hyperhidrosis: Curative effect observation of a pathological examination over 1 year. J Cosmet Dermatol 2024; 23:134-140. [PMID: 37547985 DOI: 10.1111/jocd.15909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 05/29/2023] [Accepted: 06/22/2023] [Indexed: 08/08/2023]
Abstract
BACKGROUND In Asia, axillary hyperhidrosis is a frequent problem for many people, and the consequent excessive sweating can seriously affect many aspects of daily life and even lead to mental disorders. Microwave therapy is a new, non-invasive treatment method for axillary hyperhidrosis, whose energy and long-term effectiveness still needs to be clinically validated. OBJECTIVE The aim of this study was to evaluate the clinical efficacy, safety, histological changes, and psychological status of microwave devices in the treatment of axillary hyperhidrosis and osmidrosis. METHOD We conducted a prospective self-controlled study in a top-tier Chinese hospital. After a 5/5 energy treatment session, a skin biopsy was taken to observe histological changes both before and after treatment. An iodine starch test was used to determine the sweating range. We evaluated symptoms of improved efficacy using the Hyperhidrosis Disease Severity Scale (HDSS) and assessed changes in life status with the DLQI. In the case of concurrent underarm odor, odor-5, VAS, and Young-Jin Park grading were used to assess odor relief. The effect of odor on psychology was assessed by using a psychological status symptom checklist (scl-90). The study period was 1 year. RESULTS We observed 20 patients in this study. Of those, 90% met the primary treatment endpoint of a decrease in axillary hyperhidrosis symptomatology to below grade 2 on the HDSS score (p < 0.001). Furthermore, 75% of patients achieved a treatment endpoint of at least 50% reduction in VAS (p < 0.001). 70% of patients achieved a treatment endpoint of at least 50% reduction in odor-5 (p < 0.001). The iodine starch test showed that the region decreased 99% from the baseline to 12 months after follow-up had ended (p < 0.001). Eight patients volunteered to undergo histological examination; their average light density of immunohistochemistry decreased from 1.04 (0.4-2.11) to 0.07 (0.04-0.46; p < 0.05). The immunohistochemical positive number for sweat glands was initially 104 (59.75-132.5) but was 41.5 (29.75-62) after the procedure. None of the patients experienced any serious adverse reactions. CONCLUSION The treatment demonstrated high effectiveness, safety, and short-lived adverse reactions.
Collapse
Affiliation(s)
- Yaxin Tan
- Department of Dermatology, Panzhou People's Hospital, Panzhou, China
| | - Wanxiao Huang
- Department of Dermatology, The First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Jianmeng Liu
- Department of Dermatology, Maternal and Child Health Care Hospital of Honghe State, Honghe Hani and Yi Autonomous Prefecture, China
| | - Zhiyi Duan
- Southern Central Hospital of Yunnan Province, Gejiu, China
| | - Xiaolin He
- Department of Dermatology, Yan' an Hospital of Kunming City, Kunming, China
| | - Qiongyan Li
- Department of Dermatology, The First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Zhi Yang
- Department of Dermatology, The First Affiliated Hospital of Kunming Medical University, Kunming, China
| |
Collapse
|
4
|
Muhaidat J, Al-Qarqaz F, Haje EAA, Al-Majali GN, Ahmed YB, Al-Bzour AN, Rawabdeh H, Alshiyab D. Compensatory Hyperhidrosis After Non-Surgical Treatment of Primary Focal Hyperhidrosis: Two-Year Single-Centered Prospective Study From Jordan. J Cutan Med Surg 2023; 27:584-588. [PMID: 37522712 DOI: 10.1177/12034754231191488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/01/2023]
Abstract
BACKGROUND Primary focal hyperhidrosis (PH) can be managed by a wide range of medical and surgical modalities. Compensatory hyperhidrosis (CH) is a well-documented complication of surgical treatment. We aimed to investigate the occurrence of compensatory hyperhidrosis (CH) in PH patients after nonsurgical treatment with botulinum toxin A (BTX- A) or iontophoresis. METHODOLOGY We carried out a unicentric prospective study on PH patients from King Abdullah University Hospital (KAUH) in Jordan. PH patients were evaluated after 1-month of nonsurgical treatment. Patients who developed CH were re-assessed after 3-6 months through a telephone-based interview. RESULTS A total of 86 patients with PH who underwent nonsurgical treatment with iontophoresis or botulinum toxin were recruited. Twenty-four (27.9%) patients developed subjective CH. It was mild in (75%), moderate in (21%), and severe in (4%) of patients affected, it was self-limiting within a few months in all patients. Patients with CH did not differ significantly in demographic or clinical variables from patients who did not develop CH except at the site of PH (p value = .05). CONCLUSION The findings of this study indicate that more than quarter (27.9%) of patients with PH may develop minor compensatory sweating, however this didn't affect satisfaction with treatment.
Collapse
Affiliation(s)
- Jihan Muhaidat
- Department of Dermatology, Jordan University of Science and Technology, Irbid, Jordan
| | - Firas Al-Qarqaz
- Department of Dermatology, Jordan University of Science and Technology, Irbid, Jordan
| | - Enas Abdullah Al Haje
- Department of Dermatology, Jordan University of Science and Technology, Irbid, Jordan
| | | | - Yaman B Ahmed
- Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Ayah N Al-Bzour
- Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Haya Rawabdeh
- Department of Dermatology, Jordan University of Science and Technology, Irbid, Jordan
| | - Diala Alshiyab
- Department of Dermatology, Jordan University of Science and Technology, Irbid, Jordan
| |
Collapse
|
5
|
López Sanz P, García Vázquez A, Gómez Sánchez ME, Escario Travesedo E. How We Do It: The Role of Infrared Thermography as a Supportive Technique in the Treatment of Hyperhidrosis. Dermatol Surg 2023; 49:1048-1049. [PMID: 37606642 DOI: 10.1097/dss.0000000000003910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/23/2023]
Affiliation(s)
- Pablo López Sanz
- Department of Dermatology, Hospital General Universitario de Albacete, Castilla-La Mancha, Spain
| | | | | | | |
Collapse
|
6
|
Oshima Y, Fujimoto T, Nomoto M, Fukui J, Ikoma A. Hyperhidrosis: A targeted literature review of the disease burden. J Dermatol 2023; 50:1227-1236. [PMID: 37519134 DOI: 10.1111/1346-8138.16908] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 06/23/2023] [Accepted: 07/12/2023] [Indexed: 08/01/2023]
Abstract
Hyperhidrosis is a chronic skin condition characterized by excessive sweating. It poses a burden on affected people, reducing their quality of life and productivity. We undertook a targeted literature review (TLR) to gather current evidence on the epidemiology as well as the human and economic burden posed on patients with hyperhidrosis. Searches were performed in Medline database (access via OVID interface) and ICHUSHI database. Articles published between January 2000 and September 2020 that analyzed at least 50 patients were included. Sixty-four publications were identified and 38 publications covering a unique domain were selected to inform this TLR. The incidence of hyperhidrosis ranged from 0.13% in the UK to 0.28% in the USA, with a higher rate in females. The prevalence of hyperhidrosis varied from 2.8%-4.8% in the US general population to 18.40% in Chinese inpatients, while the prevalence of axillary hyperhidrosis varied from 1.4% in the US general population to 5.75% in Japanese employees/students. Due to excessive sweating, hyperhidrosis was reported to be a moderate-to-extreme limitation at work for the US patients, with 33.5% feeling unhappy. Patients' satisfaction was high post-treatment. Considerable costs were related to the treatment with botulinum toxin and surgery. Hospital stays for surgery lasted from 10 h to 3 days. The percentage of patients who sought a medical consultation varied from 6.3% for Japanese patients with primary focal hyperhidrosis to 51% for the US general population with any type of hyperhidrosis. There is limited evidence of the hyperhidrosis burden, particularly among Japanese patients; however, the burden was high and limited patients' daily functioning. Future actions should include implementation of educational programs to raise awareness of the condition, conduct of larger studies, and generation of more evidence. Understanding the nature of hyperhidrosis and the burden it poses is of utmost importance.
Collapse
Affiliation(s)
- Yuichiro Oshima
- Department of Dermatology, Aichi Medical University School of Medicine, Aichi, Japan
| | - Tomoko Fujimoto
- Ikebukuro Nishiguchi Fukurou Dermatology Clinic, Tokyo, Japan
| | | | | | | |
Collapse
|
7
|
Fujimoto T, Inose Y, Nakamura H, Kikukawa Y. Questionnaire-based epidemiological survey of primary focal hyperhidrosis and survey on current medical management of primary axillary hyperhidrosis in Japan. Arch Dermatol Res 2023; 315:409-417. [PMID: 35768620 PMCID: PMC10020310 DOI: 10.1007/s00403-022-02365-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 05/15/2022] [Accepted: 06/10/2022] [Indexed: 11/02/2022]
Abstract
To obtain current epidemiological information on primary focal hyperhidrosis in Japan, a large epidemiological survey was conducted using a web-based questionnaire. The prevalence of primary focal hyperhidrosis was 10.0% and the site-specific prevalence was highest for primary axillary hyperhidrosis (5.9%). The proportion of respondents with primary focal hyperhidrosis who had consulted a physician was 4.6%, which was similar to the low prevalence reported previously in 2013 in Japan. A questionnaire survey for physicians and individuals with primary axillary hyperhidrosis on the current medical management of primary axillary hyperhidrosis showed that physicians recognized the existence of patients who were very worried about hyperhidrosis, but failed to provide active treatment. Regarding the information provided by patients to physicians at presentation, it was found that patients failed to provide sufficient information to the physicians about their worries in daily life. Among individuals who had sought medical care with primary axillary hyperhidrosis, 62.3% reported that they were not currently receiving treatment, highlighting a challenge to be addressed regarding continued treatment. Frequently chosen options leading to willingness to receive treatment were less expensive treatment and highly effective treatment as well as feeling free to consult a physician, suggesting a desire for an improved medical environment.
Collapse
Affiliation(s)
- Tomoko Fujimoto
- Ikebukuro Nishiguchi Fukurou Dermatology Clinic, 1-39-4 Nishi-Ikebukuro, Toshima-ku, Tokyo, Japan.
| | - Yuri Inose
- Maruho Co., Ltd., 1-5-22 Nakatsu, Kita-ku, Osaka, Japan
| | | | | |
Collapse
|
8
|
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: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [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
|
9
|
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] [What about the content of this article? (0)] [Affiliation(s)] [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
|
10
|
Chen SQ, Wang TT, Zhou Y, Li W, Man XY. Comparison of Long-Term Effectiveness and Safety of Microwave and Surgery in the Treatment of Axillary Osmidrosis: A Single-Center Retrospective Study. Dermatol Surg 2022; 48:126-130. [PMID: 34856594 PMCID: PMC8667791 DOI: 10.1097/dss.0000000000003276] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND A microwave-based device is a newly developed method for treating axillary osmidrosis. Few studies have compared the difference between microwave therapy and subcutaneous curettage for axillary osmidrosis. OBJECTIVE To compare the long-term effectiveness, complications, and recurrence of osmidrosis after microwave therapy and subcutaneous curettage. METHODS AND MATERIALS Medical records of 155 patients with osmidrosis treated with microwave therapy or subcutaneous curettage were reviewed retrospectively. Demographic data, visual analog scale for odor, hyperhidrosis disease scale, complications, and recurrence were analyzed. RESULTS Osmidrosis improved significantly in both treatment groups at 6 months. Effective improvement was observed in 90% and 23% of the patients in the surgery and microwave groups, respectively, after 3 years postoperatively. The recurrence rates were 39% and 21% in the microwave and surgery groups, respectively. The transient complication rate was higher in the microwave group, and long-term complications only occurred in the surgery group. CONCLUSION Subcutaneous curettage is a more effective approach for axillary osmidrosis. However, microwave therapy is recommended for patients with cosmetic concerns.
Collapse
Affiliation(s)
- Si-Qi Chen
- All authors are affiliated with the Department of Dermatology, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Ting-Ting Wang
- All authors are affiliated with the Department of Dermatology, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Yuan Zhou
- All authors are affiliated with the Department of Dermatology, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Wei Li
- All authors are affiliated with the Department of Dermatology, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Xiao-Yong Man
- All authors are affiliated with the Department of Dermatology, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| |
Collapse
|
11
|
Shayesteh A, Gerdsdorff F, Persson M, Brulin C, Nylander E. Navigating in the fog. Facing delays, rejection and ignorance when seeking help for primary hyperhidrosis. Int J Qual Stud Health Well-being 2021; 16:1930642. [PMID: 34053415 PMCID: PMC8168763 DOI: 10.1080/17482631.2021.1930642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/12/2021] [Indexed: 11/18/2022] Open
Abstract
Primary hyperhidrosis (PH) is a disease characterized by focal and excessive sweating.Purpose: The aim of this study was to describe the experiences of men and women with PH when seeking help for their condition.Method: A qualitative interview study with 30 men and women diagnosed with PH was conducted. Data was inductively analysed using manifest and latent content analysis.Results: The analysis resulted in a theme: Navigating in the fog, based on the categories doubtful encounters with health care professionals, helpful encounters with health care professionals, delays due to inadequate knowledge, and supported urge for help.Conclusions: Deficient knowledge and understanding about PH create a sense of resignation in individuals, resulting in delay of seeking treatment. Support from others, life-changing events, and finding information about PH were important motivating factors in seeking help and demanding access to treatment. A holistic approach towards patients with PH is important to reduce stigma and acknowledge the problems that are encountered in their daily lives. Educating health care professionals and students so that patients can be identified and assessed without delay and making information available about PH in schools and pharmacies could improve the general knowledge and facilitate obtaining treatment for individuals with PH.
Collapse
Affiliation(s)
- Alexander Shayesteh
- Department of Public Health and Clinical Medicine, Dermatology and Venereology, Umeå University, Umeå, Sweden
| | - Fredrik Gerdsdorff
- Department of Public Health and Clinical Medicine, Dermatology and Venereology, Umeå University, Umeå, Sweden
| | | | | | - Elisabet Nylander
- Department of Public Health and Clinical Medicine, Dermatology and Venereology, Umeå University, Umeå, Sweden
| |
Collapse
|
12
|
Lannan FM, Powell J, Kim GM, Hansen CR, Pasquina PF, Smith DG. Hyperhidrosis of the residual limb: a narrative review of the measurement and treatment of excess perspiration affecting individuals with amputation. Prosthet Orthot Int 2021; 45:477-486. [PMID: 34723907 DOI: 10.1097/pxr.0000000000000040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 07/27/2021] [Indexed: 02/03/2023]
Abstract
BACKGROUND Hyperhidrosis (HH) is a relatively common disorder involving excessive sweating, typically of the palms or axilla. HH can also frequently occur after limb amputation, where the remaining residual limb excessively perspires, leading to an increased risk of dermatological disorders and functional limitations, such as the inability to comfortably or safely wear a prosthesis. Although many treatments have been proposed to treat HH within the dermatology community, they are not widely known by healthcare providers typically involved in caring for individuals with acquired limb loss. OBJECTIVES To appraise the current state of quantitative and qualitative assessment of HH within the residual limb and examine existing and future treatment strategies for this problem. STUDY DESIGN Narrative Literature Review. METHODS A literature review focused on the assessment and treatment of excessive sweating of residual limbs. RESULTS There is currently no objective or subjective standard to assess or diagnose HH of the residual limb. Conventional therapies for HH do not always translate to the population of individuals with limb loss. Emerging modalities for treating HH show promise toward a permanent resolution of excess perspiration but require additional studies within people with amputation. CONCLUSIONS Further research is needed to quantify standard values to objectively and subjectively assess and diagnose hyperhidrosis of the residual limb. New and developing treatments for hyperhidrosis require additional studies to assess efficacy and safety in the residual limb.
Collapse
Affiliation(s)
- Ford M Lannan
- Department of Dermatology, Walter Reed National Military Medical Center, Bethesda, Maryland
| | - Jordan Powell
- Physical Medicine and Rehabilitation, Walter Reed National Military Medical Center, Bethesda, Maryland
- Uniformed Services University of the Health Sciences, Bethesda, Maryland
| | - Gabriel M Kim
- Physical Medicine and Rehabilitation, Walter Reed National Military Medical Center, Bethesda, Maryland
- Uniformed Services University of the Health Sciences, Bethesda, Maryland
| | - Colby R Hansen
- Division of Physical Medicine and Rehabilitation, University of Utah, Salt Lake City, Utah
| | - Paul F Pasquina
- Physical Medicine and Rehabilitation, Walter Reed National Military Medical Center, Bethesda, Maryland
- Uniformed Services University of the Health Sciences, Bethesda, Maryland
| | - Douglas G Smith
- Physical Medicine and Rehabilitation, Walter Reed National Military Medical Center, Bethesda, Maryland
- Uniformed Services University of the Health Sciences, Bethesda, Maryland
- Department of Orthopaedic Surgery at the University of Washington, Seattle, Washington
| |
Collapse
|
13
|
Abstract
Hyperhidrosis (HH) is defined as perspiration beyond the level required to maintain temperature regulation. HH affects nearly 4.8% of the population in the United States. It can have a great impact on patient’s quality of life by disturbing daily activity, performance, confidence, social interactions, and mental health. In the majority of patients with HH (93%), the etiology of excess sweating is idiopathic, which classifies it as primary focal HH. Mild HH may be controlled with topical antiperspirants and lifestyle modifications. Based on the location of involvement, iontophoresis and botulinum toxin may be considered if the patient does not respond to topical therapies. Despite minimizing sweating, chronic use of systemic anticholinergics, in particular oxybutynin, may result in detrimental adverse effects such as dementia. Local surgery, radiofrequency, microwave, and lasers are other potential modalities for HH. Sympathectomy can be a last resort for the treatment of focal HH of the palmar, plantar, axillary, and craniofacial areas after failure of less invasive therapeutic options. In this review, we conducted a comprehensive search in the PubMed electronic database to summarize an algorithmic approach for the treatment of HH. This can help broaden options for managing this difficult disease. J Drugs Dermatol. 20(5): doi:10.36849/JDD.5774.
Collapse
|
14
|
Gorelick J, Friedman A. Diagnosis and Management of Primary Hyperhidrosis: Practical Guidance and Current Therapy Update. J Drugs Dermatol 2021; 19:704-710. [PMID: 32726555 DOI: 10.36849/jdd.2020.5162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Hyperhidrosis is a chronic medical condition characterized by excessive sweating beyond that which is necessary for thermoregulatory homeostasis. It is estimated to occur in 4.8% of the U.S. population (~15.3 million people) but is both underreported and underdiagnosed. With the busy practitioner and dermatology resident in mind, we provide here a disease state primer for hyperhidrosis, a top-line review of the breadth of literature underscoring the overall burden of the disease, a practical guide to differential diagnosis, and an update on current treatment approaches, including for the most common form of the condition, primary axillary hyperhidrosis. In addition, a case study is presented to provide a real-life perspective from the clinic on the importance of early and effective management strategies for those suffering with hyperhidrosis. J Drugs Dermatol. 2020;19(7): doi:10.36849/JDD.2020.5162.
Collapse
|
15
|
Chen W, Zhang X, Zhang L, Xu Y. Treatment of axillary bromhidrosis in adolescents by combining electrocauterization with ultrasound-guided botulinum toxin type A injection. J Plast Reconstr Aesthet Surg 2021; 74:3114-3119. [PMID: 34238698 DOI: 10.1016/j.bjps.2021.03.089] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 01/27/2021] [Accepted: 03/13/2021] [Indexed: 11/18/2022]
Abstract
The aim of this study is to investigate the efficacy of treatment-combined electrocauterization after removal of apocrine sweat glands with ultrasound-guided (BOTOX) injection for adolescents with axillary bromhidrosis. From January 2015 to January 2018, 90 adolescents with axillary bromhidrosis were recruited and randomly divided into three groups (group A, B, and C). Patients in group A underwent electrocauterization after removal of apocrine sweat glands, patients in group B received ultrasound-guided BOTOX injection, and patients in group C had electrocauterization after the removal of apocrine sweat glands followed by ultrasound-guided BOTOX administration after two weeks. All patients were followed up for one year. The percentages of axillary malodor score at twelve months after treatments compared with pre-operation for group A, group B, and group C were 20.2%, 27.5%, and 12.5%, respectively. Significant statistical differences were observed in changes of axillary malodor score among the three groups at three, six, nine and twelve months postoperatively. Satisfaction rates of group A, group B, and group C were 90.0%, 93.3%, and 96.7%, respectively. The side effects after surgery in group A were similar to group C, and no side effect was observed in group B. One-year postoperative scar formation rate of group A was 16.7%, which was significantly higher than that of group B (0) and group C (6.66%). Combination of electrocauterization after removal of apocrine sweat glands with ultrasound-guided BOTOX injection showed better treatment effects.
Collapse
Affiliation(s)
- Wanying Chen
- Department of Plastic Surgery, The Third Hospital of Jilin University, No.126, Xiantai Street, Erdao District, Changchun, Jilin 130000, China
| | - Xiaoyu Zhang
- Department of Gastrointestinal and Colorectal Surgery, The Third Hospital of Jilin University, No.126, Xiantai Street, Erdao District, Changchun, Jilin 130000, China
| | - Lianbo Zhang
- Department of Plastic Surgery, The Third Hospital of Jilin University, No.126, Xiantai Street, Erdao District, Changchun, Jilin 130000, China.
| | - Yingying Xu
- Department of Ultrasound, The Third Hospital of Jilin University, No.126, Xiantai Street, Erdao District, Changchun, Jilin 130000, China.
| |
Collapse
|
16
|
Zuzelo PR. Responding Holistically to the Person Living With Hyperhydrosis. Holist Nurs Pract 2021; 35:108-110. [PMID: 33555724 DOI: 10.1097/hnp.0000000000000437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- Patti Rager Zuzelo
- Chair, PhD in Nursing Program and DNP Project Coordinator, College of Nursing & Health Professions, Drexel University, Philadelphia, Pennsylvania
| |
Collapse
|
17
|
Mostafa TAH, Hamed AA, Mohammed BM, El Sheikh NA, Shama AAA. C-Arm Guided Percutaneous Radiofrequency Thoracic Sympathectomy for Treatment of Primary Palmar Hyperhidrosis in Comparison with Local Botulinum Toxin Type A Injection, Randomized Trial. Pain Physician 2019; 22:591-599. [PMID: 31775406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
BACKGROUND Hyperhidrosis is a disorder associated with detrimental effects on patients' quality of life, occupational activities, and social interactions. OBJECTIVES This study compares C-arm guided percutaneous radiofrequency (RF) ablation of the second and third thoracic sympathetic ganglions and local intradermal botulinum toxin type A (BTX-A) injection for the treatment of primary palmar hyperhidrosis. It focuses on clinical effectiveness, patient satisfaction, quality of life, safety, and the time at which repetition of the procedure is needed over one-year follow-up. STUDY DESIGN This is a randomized single-blinded trial. SETTING This study took place in a single hospital. METHODS Eighty patients with primary palmar hyperhidrosis were randomly assigned to one of 2 interventions: local intradermal BTX-A injection (n = 40) or C-arm guided percutaneous RF ablation (n = 40). The Dermatology Life Quality Index (DLQI) questionnaire and the Hyperhidrosis Disease Severity Scale (HDSS) were used for assessment at one week, one month, and 2, 6, and 12 months after intervention. The number of patients who required repetition of the procedure later on and the time at which they needed it were recorded, and possible side effects were assessed. RESULTS HDSS scores in the RF group were statistically significantly lower than in the BTX-A group at one week, one month, and 2, 6, and 12 months of follow-up. DLQI scores in the RF group were statistically significantly lower than in the BTX-A group at 6- and 12-month follow-up, whereas at one week, one month, and 2 months of follow-up, there was no statistically significant difference between both groups. The number of patients who required that the procedure be repeated was statistically significantly lower in the RF group than in the BTX-A group. The time at which patients needed repetition of the procedure in the BTX-A group was about 3 to 7 months after the first intervention. All patients in this group showed an increase in HDSS scores within this one-year follow-up. In the RF group, however, only one patient complained of increased HDSS scores after 8 months. There was no statistically significant difference in side effects between both groups. LIMITATIONS The first limitation of this study is that results were based on subjective scales. The second is the radiation exposure associated with the technique described. CONCLUSIONS This study supports percutaneous C-arm guided RF ablation of the second and third thoracic sympathetic ganglions and local intradermal BTX-A injection as safe, effective options and rapid lines of treatment of primary palmar hyperhidrosis. However, percutaneous RF ablation proved to be more effective, with longer effectiveness time and better patient satisfaction, compared to local intradermal BTX-A injection. KEY WORDS Botulinum toxin, hyperhidrosis, quality, radiofrequency ablation.
Collapse
Affiliation(s)
- Tarek A H Mostafa
- Anesthesia, Intensive Care and Pain Medicine Department, Faculty of Medicine, Tanta University, Egypt
| | - Abdel A Hamed
- Anesthesia, Intensive Care and Pain Medicine Department, Faculty of Medicine, Tanta University, Egypt
| | - Basma M Mohammed
- Dermatology and Venerology Department, Faculty of Medicine, Tanta University, Egypt
| | - Nabil A El Sheikh
- Departments of Anesthesiology and Surgical Intensive Care, Faculty of Medicine, Tanta University, Egypt
| | - Ahmed A A Shama
- Anesthesia, Intensive Care and Pain Medicine Department, Faculty of Medicine, Tanta University, Egypt
| |
Collapse
|
18
|
Hasimoto FN, Cataneo DC, Hasimoto EN, Ximenes AMG, Cataneo AJM. Radiofrequency in the treatment of primary hyperhidrosis: systematic review and meta-analysis. Clin Auton Res 2019; 30:111-120. [PMID: 31552511 DOI: 10.1007/s10286-019-00640-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2019] [Accepted: 09/13/2019] [Indexed: 11/25/2022]
Abstract
PURPOSE To evaluate, via a systematic review, the effectiveness of radiofrequency (RF) for treatment of primary hyperhidrosis (PH). METHODS Experimental or observational studies were included where RF treatment (ablation or microneedling) was performed, comparing the periods before and after treatment. RESULTS Nine studies were considered eligible and included for analysis. In seven of nine studies, patients were subjected to RF only, and in two of nine studies RF was compared to video-assisted thoracoscopic sympathectomy (VATS). There was a reduction in the severity of PH in microneedling (three studies, mean difference -1.24, 95% CI -1.44 to -1.03). In a study that performed sympathetic RF ablation there was a greater reduction in PH severity compared to studies that performed microneedling (-2.42, 95% CI -2.55 to -2.29). There was improvement in the quality of life (QoL) after sympathetic RF ablation (two studies, mean difference -15.92, 95% CI -17.61 to -14.24). Regarding the microneedling procedure, there was a lower improvement in QoL, (two studies, -9.0, 95% CI -9.15 to -8.85). One study comparing sympathetic RF ablation with VATS applied the QoL questionnaire, and the VATS showed superior results. One of the two studies comparing compensatory sweating in RF ablation with VATS showed that compensatory hyperhidrosis was higher in VATS; however, the other study did not observe this difference. One study compared the recurrence of symptoms between VATS and RF ablation; symptom recurrence was shown to be higher in RF. CONCLUSIONS RF is effective for PH treatment, with superior results obtained with sympathetic ablation compared to microneedling.
Collapse
Affiliation(s)
- Fabio Nishida Hasimoto
- Post-Graduation Program on General Basis of Surgery, School of Medicine, São Paulo State University-UNESP, Botucatu, SP, CEP 18618-970, Brazil
| | - Daniele Cristina Cataneo
- Division of Thoracic Surgery, Botucatu School of Medicine, São Paulo State University-UNESP, Botucatu, SP, CEP 18618-970, Brazil
| | - Erica Nishida Hasimoto
- Division of Thoracic Surgery, Botucatu School of Medicine, São Paulo State University-UNESP, Botucatu, SP, CEP 18618-970, Brazil
| | - Aglaia Moreira Garcia Ximenes
- Post-Graduation Program on Medicine, Botucatu School of Medicine, São Paulo State University-UNESP, Botucatu, SP, CEP 18618-970, Brazil
| | - Antônio José Maria Cataneo
- Division of Thoracic Surgery, Botucatu School of Medicine, São Paulo State University-UNESP, Botucatu, SP, CEP 18618-970, Brazil.
| |
Collapse
|
19
|
Ribeiro Santos Morard M, Betanho Martins R, Lopes Ribeiro AC, Guimarães Rocha Lima P, dos Santos Carvalho B, Junior JCBS. Primary hyperhidrosis prevalence and characteristics among medical students in Rio de Janeiro. PLoS One 2019; 14:e0220664. [PMID: 31518360 PMCID: PMC6744157 DOI: 10.1371/journal.pone.0220664] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Accepted: 07/19/2019] [Indexed: 11/24/2022] Open
Abstract
Background Hyperhidrosis is a pathological condition defined by excessive sweating beyond thermoregulatory physiological needs, which can cause substantial psychological impact and impairment of daily activities. Studies regarding its prevalence, however, are scarce and vary widely in their findings. The population of medical students is a particularly interesting subset for its recurring demand of physical contact during patient examination or procedures, and the potential for professional adversity. We aimed at furthering the comprehension of this disease prevalence and characteristics among medical students. Methods Questionnaires inquiring about the presence and characteristics of Primary Hyperhidrosis (PH) were applied through either written or digital means to all eligible medical students enrolled in three Medical Schools in the State of Rio de Janeiro who agreed to take part in the study. Demographic data regarding gender, ethnicity, current age, weight and height was collected in addition to clinical data (sweat site, age of onset, familial history, severity and previous treatments). Severity was evaluated through the Hyperhidrosis Disease Severity Scale (HDSS) and a symptoms survey. Findings Our response rate was roughly 1/3 of all eligible students (900/2700). PH prevalence was 20.56% (185/900). It was similar between men and women (23.08% and 19.41%, respectively) and strongly associated with family history of the disease (Prevalence Ratio of 4.27). Regarding ethnicity, of the total sample 73.78% (664/900) self-declared white, among which 19.28% (128/664) had PH. Mixed-race and other ethnicities encompassed 26.22% (236/900) of the sample, among which 24.15% (57/236) had PH. Most positive subjects (64.32%) presented associated forms of PH. Overall involvement of each site (both associated and isolated) was: 63.78% axillary, 50.81% palmar, 43.24% plantar, 20.54% craniofacial, 18.38% facial flushing and 2.16% gustatory sweating. Mean current age was 23.11(±4.04) years for PH patients, and age of onset was ≤18 years in 93.94% of cases. Regarding body mass index (BMI), 71.09% of PH patients had BMI<25kg/m2 and only 4.69% presented BMI≥30kg/m2, none ≥35kg/m2. Some degree of life quality impairment was reported by 89.20% of PH patients, and 23.89% had HDSS 3 or 4 (moderate to severe). Conclusions PH prevalence among Rio de Janeiro medical students was 20.56%, similar between men and women, predominating associated presentations, axillary, palmar and plantar sites, strong familial history, age of onset before 18 years, and some degree of life impairment.
Collapse
Affiliation(s)
- Maria Ribeiro Santos Morard
- UNIRIO—Universidade Federal do Estado do Rio De Janeiro, Rio de Janeiro, RJ, Brazil
- UNESA—Universidade Estácio de Sá, Rio de Janeiro, RJ, Brazil
- * E-mail: (MRSM); (RBM)
| | - Ricardo Betanho Martins
- UNIRIO—Universidade Federal do Estado do Rio De Janeiro, Rio de Janeiro, RJ, Brazil
- * E-mail: (MRSM); (RBM)
| | | | - Pedro Guimarães Rocha Lima
- UNIRIO—Universidade Federal do Estado do Rio De Janeiro, Rio de Janeiro, RJ, Brazil
- FMP–Faculdade de Medicina de Petrópolis, Petrópolis, RJ, Brazil
| | | | | |
Collapse
|
20
|
Verbeek JGE, Atema V, Mewes JC, van Leeuwen M, Oldenburg HSA, van Beurden M, Hunter MS, van Harten WH, Aaronson NK, Retèl VP. Cost-utility, cost-effectiveness, and budget impact of Internet-based cognitive behavioral therapy for breast cancer survivors with treatment-induced menopausal symptoms. Breast Cancer Res Treat 2019; 178:573-585. [PMID: 31451978 PMCID: PMC6817759 DOI: 10.1007/s10549-019-05410-w] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2019] [Accepted: 08/13/2019] [Indexed: 11/24/2022]
Abstract
Purpose Internet-based cognitive behavioral therapy (iCBT), with and without therapist support, is effective in reducing treatment-induced menopausal symptoms and perceived impact of hot flushes and night sweats (HF/NS) in breast cancer survivors. The aim of the current study was to evaluate the cost-utility, cost-effectiveness, and budget impact of both iCBT formats compared to a waiting list control group from the Dutch healthcare perspective. Methods A Markov model was constructed with a 5-year time horizon. Costs and health outcomes were measured alongside a randomized controlled clinical trial and included quality-adjusted life years (QALYs), overall levels of menopausal symptoms, and perceived impact of HF/NS. Uncertainty was examined using probabilistic and deterministic sensitivity analyses, together with a scenario analysis incorporating a different perspective. Results iCBT was slightly more expensive than the waiting list control, but also more effective, resulting in incremental cost-utility ratios of €23,331/QALY and €11,277/QALY for the guided and self-managed formats, respectively. A significant reduction in overall levels of menopausal symptoms or perceived impact of HF/NS resulted in incremental costs between €1460 and €1525 for the guided and €500–€753 for the self-managed format. The estimated annual budget impact for the Netherlands was €192,990 for the guided and €74,592 for the self-managed format. Conclusion Based on the current trial data, the results indicate that both guided and self-managed iCBT are cost-effective with a willingness-to-pay threshold of well below €30,000/QALY. Additionally, self-managed iCBT is the most cost-effective strategy and has a lower impact on healthcare budgets.
Collapse
Affiliation(s)
- Joost G E Verbeek
- Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, P.O. Box 90203, 1006 BE, Amsterdam, The Netherlands
- Department of Health Technology and Services Research, Unveristy of Twente, Enschede, The Netherlands
| | - Vera Atema
- Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, P.O. Box 90203, 1006 BE, Amsterdam, The Netherlands
| | | | - Marieke van Leeuwen
- Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, P.O. Box 90203, 1006 BE, Amsterdam, The Netherlands
| | - Hester S A Oldenburg
- Department of Surgical Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Marc van Beurden
- Department of Gynecology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Myra S Hunter
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, London, UK
| | - Wim H van Harten
- Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, P.O. Box 90203, 1006 BE, Amsterdam, The Netherlands
- Department of Health Technology and Services Research, Unveristy of Twente, Enschede, The Netherlands
| | - Neil K Aaronson
- Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, P.O. Box 90203, 1006 BE, Amsterdam, The Netherlands
| | - Valesca P Retèl
- Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, P.O. Box 90203, 1006 BE, Amsterdam, The Netherlands.
- Department of Health Technology and Services Research, Unveristy of Twente, Enschede, The Netherlands.
| |
Collapse
|
21
|
Measles Vaccine, Acute Appendicitis, Screening for Heart Disease, Abdominal Pain, Hyperhidrosis. Am Fam Physician 2019; 99:675. [PMID: 31150185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
|
22
|
Patient Perspectives: What is hyperhidrosis? Pediatr Dermatol 2019; 36:377-8. [PMID: 31099925 DOI: 10.1111/pde.13878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
23
|
Wechter T, Feldman SR, Taylor SL. The Treatment of Primary Focal Hyperhidrosis. Skin Therapy Lett 2019; 24:1-7. [PMID: 30817880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Primary focal hyperhidrosis is a relatively common disease that has a significant impact on afflicted patient’s quality of life. The pathogenesis of the disease is thought to stem from increased cholinergic activity on eccrine sweat glands. Topical aluminum chloride based antiperspirants are good first-line agents for all affected body sites. Anticholinergic agents are emerging as effective topical alternatives. Iontophoresis passes an electrical current through the skin and is an excellent treatment option for palmoplantar disease. Botulinum toxin type A injections remain a mainstay second-line treatment. Local procedural advances including microwave thermolysis, laser therapy and focused ultrasound are emerging as safe and effective alternatives for refractory disease. Oral anticholinergics are generally well tolerated and can also be used for intractable disease. Last-line interventions include local surgical options and sympathectomy, though some patients may prefer permanent treatment. Further investigation of novel treatments as well as ways to optimize existing therapeutic options are needed.
Collapse
Affiliation(s)
- Todd Wechter
- Stony Brook University School of Medicine, Stony Brook, NY, USA
| | - Steven R Feldman
- Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Sarah L Taylor
- Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, NC, USA
| |
Collapse
|
24
|
Abstract
Acupuncture was used to treat a 60–year old woman with unexplained sweating associated with inoperable lung cancer that prevented her from sharing a bed with her husband. Other measures failed to improve her sweating, but she responded well to a course of acupuncture allowing her to continue sharing the marital bed.
Collapse
|
25
|
Mohamoud AA, Bygum A, Hansen J. [Not Available]. Ugeskr Laeger 2018; 180:V69946. [PMID: 30520716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
|
26
|
Jacob CI. Examining hyperhidrosis: an update on new treatments. Am J Manag Care 2018; 24:S496-S501. [PMID: 30589249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Primary hyperhidrosis is a debilitating condition that causes significant distress and financial burden for affected patients, triggering them to seek medical care for their excessive sweating. Once a diagnosis of primary hyperhidrosis has been established, treatment is initiated to help control sweat production and increase quality of life. While there are no current guidelines in the United States for the treatment of primary hyperhidrosis, there are International Hyperhidrosis Society guidelines that clinicians can use. Currently, a step-therapy approach with the least invasive treatments prioritized first is recommended; the patient's reported disability should also be taken into consideration when selecting a first-line treatment. This update will discuss new treatment modalities, surgical procedures, associated comorbidities, and the impact on managed care of hyperhidrosis, so clinicians can tailor therapy, improve outcomes, and increase patient satisfaction.
Collapse
Affiliation(s)
- Carolyn I Jacob
- Director, Chicago Cosmetic Surgery and Dermatology; affiliate clinical instructor, Northwestern University Feinberg School of Medicine, Chicago, IL.
| |
Collapse
|
27
|
Chilukuri S, Robb CW, Weiner SF, Grossman J. Primary Axillary Hyperhidrosis Treatment Using High Intensity Focused Fractional Radiofrequency Microneedling. J Drugs Dermatol 2018; 17:745-748. [PMID: 30005096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Primary axillary hyperhidrosis (PAH), or excessive sweating limited to the axillary area, is a debilitating disease that severely and negatively impacts social and psychological well-being. Several treatment options are available for PAH; however, these options have been shown to provide varying effectiveness. Recent studies have suggested another treatment alternative offering an effective PAH treatment option with reported long-term results. High intensity focused fractional radiofrequency (HIFRF) microneedling is FDA cleared for the treatment of facial wrinkles. The system is designed with a unique technology that is safe for use on patients presenting with all skin types. Based on its unique design and the clinical trial experience reported in the literature by Kim, et al1 and others,2,5 we offer it to our patients as a beneficial treatment option for primary axillary hyperhidrosis (PAH). We present here a clinical experience summary from three US centers providing hyperhidrosis treatments using the high-intensity radio-frequency device, including treatment parameters, clinical outcomes, and pre- and post-treatment images. J Drugs Dermatol. 2018;17(7):745-748.
Collapse
|
28
|
McConaghy JR, Fosselman D. Hyperhidrosis: Management Options. Am Fam Physician 2018; 97:729-734. [PMID: 30215934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Hyperhidrosis is excessive sweating that affects patients' quality of life, resulting in social and work impairment and emotional distress. Primary hyperhidrosis is bilaterally symmetric, focal, excessive sweating of the axillae, palms, soles, or craniofacial region not caused by other underlying conditions. Secondary hyperhidrosis may be focal or generalized, and is caused by an underlying medical condition or medication use. The Hyperhidrosis Disease Severity Scale is a validated survey used to grade the tolerability of sweating and its impact on quality of life. The score can be used to guide treatment. Topical aluminum chloride solution is the initial treatment in most cases of primary focal hyperhidrosis. Topical glycopyrrolate is first-line treatment for craniofacial sweating. Botulinum toxin injection (onabotulinumtoxinA) is considered first- or second-line treatment for axillary, palmar, plantar, or craniofacial hyperhidrosis. Iontophoresis should be considered for treating hyperhidrosis of the palms and soles. Oral anticholinergics are useful adjuncts in severe cases of hyperhidrosis when other treatments fail. Local microwave therapy is a newer treatment option for axillary hyperhidrosis. Local surgery and endoscopic thoracic sympathectomy should be considered in severe cases of hyperhidrosis that have not responded to topical or medical therapies.
Collapse
Affiliation(s)
- John R McConaghy
- The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Daniel Fosselman
- The Ohio State University Wexner Medical Center, Columbus, OH, USA
| |
Collapse
|
29
|
Excessive Sweating (Hyperhidrosis). Am Fam Physician 2018; 97:Online. [PMID: 30215948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
|
30
|
Balić A, Bukvić Mokos Z, Marinović B, Ledić Drvar D. Tatami Mats: A Source of Pitted Keratolysis in a Martial Arts Athlete? Acta Dermatovenerol Croat 2018; 26:68-70. [PMID: 29782305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Dear Editor, Pitted keratolysis (PK), also known as keratosis plantaris sulcatum, is a non-inflammatory, bacterial, superficial cutaneous infection, characterized by many discrete superficial crateriform ''pits'' and erosions in the thickly keratinized skin of the weight-bearing regions of the soles of the feet (1). The disease often goes unnoticed by the patient, but when it is noticed it is because of the unbearable malodor and hyperhidrosis of the feet, which are socially unacceptable and cause great anxiety to many of the patients. PK occurs worldwide, with the incidence rates varying based on the environment and occupation. The prevalence of this condition does not differ significantly based on age, sex, or race. People who sweat profusely or wash excessively, who wear occlusive footwear, or are barefoot especially in hot and humid weather are extremely prone to this condition (2). Physicians commonly misdiagnose it as tinea pedis or plantar warts. Treatment is quite simple and straightforward, with an excellent expected outcome if treated properly. We report a case of a 32-year-old male patient with skin changes of approximately one-year duration diagnosed as plantar verrucae, who was referred to our Department for cryotherapy. The patient presented with asymptomatic, malodorous punched-out pits and erosions along with hyperkeratotic skin on the heel and metatarsal region of the plantar aspect of both feet. The arches, toes, and sides of the feet were spared (Figure 1). Except for these skin changes, the patient was healthy and denied any other medical issues. He was an athlete active in martial arts and had a history of sweating of feet and training barefoot on the tatami mat for extended periods of time. The diagnosis of PK was established based on the clinical findings (crateriform pitting and malodor), negative KOH test for hyphae, and a history of prolonged sweating in addition to contact of the skin with tatami mats, which are often a source of infection if hygiene measures are not adequately implemented. Swabs could have been helpful to identify causative organisms, but they were not crucial for the diagnosis and treatment. The patient was prescribed with general measures to prevent excessive sweating (cotton socks, open footwear, and proper hygiene), antiseptic potassium permanganate foot soaks followed by clindamycin 1% and benzoyl peroxide 5% in a gel vehicle twice daily. At the one-month follow-up visit, the skin changes, hyperhidrosis, and malodor were entirely resolved (Figure 2). Pitted keratolysis is common among athletes (3,4). The manifestations of PK are due to a superficial cutaneous infection caused by several bacterial Gram-positive species including Corynebacterium species, Kytococcus sedentarius, Dermatophilus congolensis, Actynomices keratolytica, and Streptomyces that proliferate and produce proteinase and sulfur-compound by-products under appropriate moist conditions (5-7). Proteinases digest the keratin and destroy the stratum corneum, producing the characteristic skin findings, while sulfur compounds (sulfides, thiols, and thioesters) are responsible for the malodor. Athletes and soldiers who wear occlusive footwear for prolonged periods of time or even barefooted people that sweat extensively and spend time on wet surfaces such as laborers, farmers, and marine workers are more prone to this problem (3,4,8-11). Martial arts athletes are at greater risk of skin infections due to the constant physical contact that can lead to transmission of viral, bacterial, and fungal pathogens directly but also indirectly through contact with the mat and the skin flora of an another infected individual. A national survey of the epidemiology of skin infections among US high school athletes conducted by Ashack et al. supported the prevalent theory that contact sports are associated with an increased risk of skin infections. In this study, wrestling had the highest skin infection rate of predominantly bacterial origin (53.8%), followed by tinea (35.7%) and herpetic lesions (6.7%), which is consistent with other literature reporting (12). Being barefoot on the tatami mat in combination with excessive sweating and non-compliance with hygiene measures makes martial arts athletes more susceptible to skin infections, including PK. The diagnosis is clinical, by means of visual examination and recognition of the characteristic odor. Dermoscopy can be useful, revealing abundant pits with well-marked walls that sometimes show the bacterial colonies (13). Cultures, if taken, show Gram-positive bacilli or coccobacilli. Because of the ease of diagnosis on clinical findings, biopsy of pitted keratolysis is rarely performed. Skin scraping is often performed to exclude tinea pedis, which is one of the main differential diagnosis, the others including verrucae, punctate palmoplantar keratoderma, keratolysis exfoliativa, circumscribed palmoplantar hypokeratosis, and basal cell nevus syndrome. If unrecognized and left untreated, skin findings and smelly feet can last for many years. Sometimes, if unrecognized, PK can be mistreated with antifungals, or even with aggressive treatment modalities such as cryotherapy. Appropriate treatment includes keeping feet dry with adequate treatment of hyperhidrosis, preventive measures, and topical antibiotic therapy. Topical forms of salicylic acid, sulfur, antibacterial soaps, neomycin, erythromycin, mupirocin, clindamycin and benzoyl peroxide, clotrimazole, imidazoles, and injectable botulinum toxin are all successful in treatment and prevention of PK (14,15). Topical antibiotics are the first line of medical treatment, among which fusidic acid, erythromycin 1% (solution or gel), mupirocin 2%, or clindamycin are the most recommended (14). As in our case, a fixed combination of two approved topical drugs - clindamycin 1%-benzoyl peroxide 5% gel, had been already demonstrated by Vlahovich et al. as an excellent treatment option with high adherence and no side-effect (16). The combined effect of this combination showed significantly greater effect due to the bactericidal and keratolytic properties of benzoyl peroxide. Additionally, this combination also lowers the risk of resistance of causative microorganisms to clindamycin. Skin infections are an important aspect of sports-related adverse events. Due to the interdisciplinary nature, dermatologists are not the only ones who should be aware of the disease, but also family medicine doctors, sports medicine specialists, and occupational health doctors who should educate patients about the etiology of the skin disorder, adequate prevention, and treatment. Athletes must enforce the disinfecting and sanitary cleaning of the tatami mats and other practice areas. Keeping up with these measures could significantly limit the spread of skin infections that can infect athletes indirectly, leading to significant morbidity, time loss from competition, and social anxiety as well.
Collapse
Affiliation(s)
| | | | | | - Daniela Ledić Drvar
- Daniela Ledić Drvar, MD, PhD, University Hospital Centre Zagreb, Department of Dermatology and Venereology, School of Medicine University of Zagreb, Šalata 4, 10000 Zagreb, Croatia;
| |
Collapse
|
31
|
Maguire SC, Fleming CA, O'Brien G, McGreal G. Lumbar sympathectomy can improve symptoms associated with ischaemia, vasculitis, diabetic neuropathy and hyperhidrosis affecting the lower extremities-a single-centre experience. Ir J Med Sci 2018. [PMID: 29516399 DOI: 10.1007/s11845-018-1775-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Lumbar sympthectomy (LS) was traditionally performed for intermittent claudication but is now eclipsed by revascularisation for that indication. However, it retains a role in the management of critical limb ischaemia and other conditions causing lower limb pain with or without ischaemia. We report the role of LS in modern surgical practice when revascularisation and pain management options have been exhausted. METHODS A medical chart review was performed on all patients who underwent LS in our unit from 2005 to 2016 (inclusive). Symptomatology, surgical indications and patient outcomes were reported. RESULTS Twenty-seven cases were performed in total (21 unilateral, 3 bilateral). Underlying diagnoses were as follows: PAD [59.3% (n = 16)], hyperhidrosis [18.5% (n = 5)] and equal numbers of complex regional pain syndrome, diabetic neuropathy and vasculitis [7.4% (n = 2) each]. Overall, 85.2% (n = 23) had improvement or resolution of symptoms at 1 month and 70.3% (n = 19) had persistent improvement of symptoms at 1 year. Non-PAD patients had superior outcomes with 90.9% (n = 10) reporting improved symptomatology at 1 month and nearly three quarters [72.8% (n = 8)] maintaining this improvement at 1 year. Only four patients required subsequent major amputation, all in the severe PAD group. CONCLUSION Lumbar sympathectomy can improve symptoms associated with ischaemia, vasculitis, diabetic neuropathy and hyperhidrosis. Non-PAD patients have the greatest benefit.
Collapse
Affiliation(s)
- Sean C Maguire
- Department of Vascular Surgery, Mercy University Hospital, Cork, Ireland.
| | | | - Gavin O'Brien
- Department of Vascular Surgery, Mercy University Hospital, Cork, Ireland
| | - Gerald McGreal
- Department of Vascular Surgery, Mercy University Hospital, Cork, Ireland
| |
Collapse
|
32
|
de Quintana-Sancho A, Conde Calvo MT. Treatment of Palmar Hyperhidrosis by Peripheral Nerve Block at the Wrist With Botulinum Toxin. Actas Dermosifiliogr 2017; 108:947-949. [PMID: 28711166 DOI: 10.1016/j.ad.2017.05.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2017] [Revised: 05/22/2017] [Accepted: 05/25/2017] [Indexed: 11/18/2022] Open
|
33
|
Menzinger S, Quenan S. [Evaluation and management of hyperhidrosis]. Rev Med Suisse 2017; 13:710-714. [PMID: 28722382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Hyperhidrosis is excessive sweating beyond what is expected for thermoregulatory needs. Nearly 3 % of the population has hyperhidrosis. It may be primary or secondary to medications or general medical conditions, including diabetes mellitus, hyperthyroidism, Parkinson disease, etc. History taking and clinical examination are essential to differentiate primary from secondary origins. Blood tests and a consultation with a specialist (endocrinologist, neurologist) is sometimes necessary to establish the diagnosis. The management of secondary hyperhidrosis involves the treatment of the underlying cause. For primary hyperhidrosis, it depends on its severity and the sites affected. This article will review the treatments for primary hyperhidrosis.
Collapse
Affiliation(s)
| | - Sandrine Quenan
- Service de dermatologie et vénéréologie, HUG, 1211 Genève 14
| |
Collapse
|
34
|
Romero FR, Haddad GR, Miot HA, Cataneo DC. Palmar hyperhidrosis: clinical, pathophysiological, diagnostic and therapeutic aspects. An Bras Dermatol 2016; 91:716-725. [PMID: 28099590 PMCID: PMC5193180 DOI: 10.1590/abd1806-4841.20165358] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2015] [Accepted: 12/16/2015] [Indexed: 11/22/2022] Open
Abstract
Palmar hyperhidrosis affects up to 3% of the population and inflict significant impact on quality of life. It is characterized by chronic excessive sweating, not related to the necessity of heat loss. It evolves from a localized hyperactivity of the sympathetic autonomic system and can be triggered by stressful events. In this study, the authors discuss clinical findings, pathophysiological, diagnostic and therapeutic issues (clinical and surgical) related to palmar hyperhidrosis.
Collapse
Affiliation(s)
- Flávio Ramalho Romero
- Universidade Estadual Paulista "Júlio de
Mesquita Filho"BotucatuSPBrazilUniversidade Estadual Paulista "Júlio de
Mesquita Filho" (Unesp) – Botucatu (SP), BrazilUniversidade Estadual
Paulista
| | - Gabriela Roncada Haddad
- Universidade Estadual Paulista "Júlio de
Mesquita Filho"BotucatuSPBrazilUniversidade Estadual Paulista "Júlio de
Mesquita Filho" (Unesp) – Botucatu (SP), BrazilUniversidade Estadual
Paulista
| | - Hélio Amante Miot
- Universidade Estadual Paulista "Júlio de
Mesquita Filho"BotucatuSPBrazilUniversidade Estadual Paulista "Júlio de
Mesquita Filho" (Unesp) – Botucatu (SP), BrazilUniversidade Estadual
Paulista
| | - Daniele Cristina Cataneo
- Universidade Estadual Paulista "Júlio de
Mesquita Filho"BotucatuSPBrazilUniversidade Estadual Paulista "Júlio de
Mesquita Filho" (Unesp) – Botucatu (SP), BrazilUniversidade Estadual
Paulista
| |
Collapse
|
35
|
Abstract
Primary focal hyperhidrosis is a disease of unknown cause with profuse perspiration of local sites (head, face, palms, soles of feet, and axillae) that adversely affects daily life. Guidelines have been proposed in the USA [<citeref rid="ref1">1</citeref>], Canada [<citeref rid="ref2">2</citeref>], and Japan [<citeref rid="ref3">3</citeref>]. The symptoms impair quality of life, with significant negative effects on daily existence and personal relationships. The current goal in medical practice for patients with hyperhidrosis is to provide guidance and encourage coping skills for a normal daily life, as well as give appropriate advice regarding treatment options. On occasion, in order to improve quality of life, it is necessary to recommend surgical therapy when conservative treatment fails; this requires an understanding of the mechanisms of available treatments and their effects. This paper reviews theories of primary focal hyperhidrosis with regard to pathology, epidemiology, and treatment.
Collapse
Affiliation(s)
- Tomoko Fujimoto
- Department of Dermatology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| |
Collapse
|
36
|
Hamm H. [Severely impaired quality of life. "My sweating is intolerable."]. MMW Fortschr Med 2016; 158:46-50. [PMID: 27324004 DOI: 10.1007/s15006-016-8445-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Affiliation(s)
- Henning Hamm
- Klinik und Poliklinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Würzburg, Josef-Schneider-Str. 2, D-97080, Würzburg, Deutschland.
| |
Collapse
|
37
|
Pace S, Kentosh J. Managing residual limb hyperhidrosis in wounded warriors. Cutis 2016; 97:401-403. [PMID: 27416083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Residual limb dermatologic problems are a common concern among young active traumatic amputee patients who strive to maintain an active lifestyle. Hyperhidrosis of residual limbs is a recognized inciting factor that often contributes to residual limb dermatoses and is driven by the design of the prosthetic liner covering the residual limb. Treatment of hyperhidrosis in this population presents a unique challenge. Several accepted treatments of hyperhidrosis can offer some relief but have been limited by lack of results or side-effect profiles. Microwave thermal ablation has presented an enticing potential for residual limb hyperhidrosis.
Collapse
Affiliation(s)
- Sarah Pace
- Madigan Army Medical Center, Tacoma, Washington, USA
| | - Joshua Kentosh
- Walter Reed National Military Medical Center, Bethesda, Maryland, USA
| |
Collapse
|
38
|
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] [What about the content of this article? (0)] [Affiliation(s)] [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
|
39
|
Swartling C, Rystedt A, Brismar K, Naver H, Norman P, Dizdarevic A. [Hyperhidrosis is a silent handicap]. Ugeskr Laeger 2016; 178:V04150291. [PMID: 26857409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Hyperhidrosis affects 2.8% of the population and has severe negative influence on life quality. The disease is represented in many specialties but can unfortunately be incorrectly treated or not treated at all. Primary hyperhidrosis is the most common form. Secondary hyperhidrosis is most often excluded by a few anamnestic data. Botulinum toxin and anticholinergics are adequate treatment options when aluminium chloride is insufficient. This article describes the disease from the physician's as well as the patient's perspective. Furthermore, examination procedures and treatment procedures are presented.
Collapse
|
40
|
Salava A, Jousimaa J. [Treatment of hyperhidrosis (excessive sweating)]. Duodecim 2016; 132:247-252. [PMID: 26951029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Hyperhidrosis can be localized or generalized and may cause the patient significant discomfort. Localized hyperhidrosis is usually primary, often begins in adolescence and is partly based on genetic dispositions. As a rule it does not necessitate investigations for secondary causes (e.g. endocrine or neurologic conditions). Generalized hyperhidrosis is commonly associated with environmental or lifestyle factors, and sometimes physiological factors. In new-onset generalized sweating of unclear origin, it may be appropriate to consider secondary causes (underlying diseases, medications, infections). Relatively effective symptomatic treatments are available in localized hyperhidrosis. The treatment of generalized hyperhidrosis is almost always directed against the underlying factors.
Collapse
|
41
|
Al-Khalil O, Stöwhas AC, Hoetzenecker W. [Hyperhidrosis]. Praxis (Bern 1994) 2015; 104:1365-1372. [PMID: 26649952 DOI: 10.1024/1661-8157/a002201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
- Omar Al-Khalil
- 1 Klinik und Poliklinik für Innere Medizin, Universitätsspital Zürich
| | | | | |
Collapse
|
42
|
Abstract
This article reviewed some of the more common diseases of the skin appendages that are encountered in medicine: hyperhidrosis, acne, AA, FPHL, AGA, and TE. The pathophysiology behind the conditions and their treatments were discussed so that the clinician can make logical therapeutic choices for their affected patients.
Collapse
Affiliation(s)
- Jay C Vary
- Division of Dermatology, Department of Medicine, University of Washington, Box 354697, 4225 Roosevelt Way Northeast, 4th Floor, Seattle, WA 98105-6920, USA.
| |
Collapse
|
43
|
Abstract
BACKGROUND Primary craniofacial hyperhidrosis (CH) can have a profoundly negative impact on quality of life. No comprehensive review of its management exists. OBJECTIVE The objective of this review is to present the best clinical evidence to guide CH management. METHODS A systematic review was performed using PRISMA guidelines. MEDLINE and EMBASE were searched from 1966 to 2014 for articles using the MeSH terms "Hyperhidrosis", "Head", "Neck" and synonymous text words. Inclusion criteria were experimental and observational studies addressing CH treatment. Two reviewers independently assessed study quality and analysed data. RESULTS Of 833 references yielded, 27 met inclusion criteria and were analysed. Twenty-two studies evaluated T2 sympathetic ablation (Level III evidence). Outcome measures were subjective and mean follow-up was 29 months. Reported efficacy was high (70-100%), recurrence rates were generally low (0-8%) and complications largely transient (e.g. pneumothorax 0-1%). However, 8-95.4% experienced troubling compensatory sweating. One randomised controlled trial and one observational study evaluated botulinum toxin A (Level Ib and III, respectively). Both employed objective outcome measures and demonstrated similar findings. Efficacy was 100%, lasted a median of 5-6 months and frontalis muscle inhibition was the main adverse effect (50-100%). Three studies evaluated anticholinergic therapy: topical glycopyrrolate demonstrated high efficacy (96%) with minimal adverse effects (Level Ib) and oral oxybutynin demonstrated relatively high efficacy (80-100%) but with noticeable adverse effects (76.6-83.6%) (Level III). CONCLUSION There are few quality studies evaluating CH treatment. Based on available evidence, we recommend topical glycopyrrolate, oral oxybutynin and intradermal botulinum toxin A as first-line therapies due to their efficacy and safety. T2 sympathectomy should be considered for patients refractory to first-line therapy.
Collapse
Affiliation(s)
- Rebecca Nicholas
- Department of Surgery, Royal Free Hospital, Pond St, London, NW3 2QG, UK.
| | - Ayyaz Quddus
- Department of Surgery, Royal Free Hospital, Pond St, London, NW3 2QG, UK.
| | - Daryll M Baker
- Department of Surgery, Royal Free Hospital, Pond St, London, NW3 2QG, UK.
| |
Collapse
|
44
|
Stiefelhagen P. [Axillary perspiration, facial acne]. MMW Fortschr Med 2015; 157:22-23. [PMID: 26012666 DOI: 10.1007/s15006-015-3014-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
|
45
|
Nahaloni E, Iancu I. [Hyperhidrosis and social anxiety disorder--the same old thing under a different cloak?]. Harefuah 2014; 153:595-624. [PMID: 25518078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Hyperhidrosis is a reason for treatment by many specialists in medicine, such as dermatologists, family medicine doctors, surgeons and also psychiatrists. Hyperhidrosis causes considerable distress and disability. Despite the fact that the condition has been known for thousands of years, it is yet unclear whether excessive sweating derives from emotional" activation of the central nervous system, whether the emotional symptoms evolve due to local dysfunction of the sweat glands, or a combination of the two problems. In this article, we will present two conditions: hyperhidrosis and Social Anxiety Disorder, a mental condition with anxiety and avoidanrce in social settings that is frequently accompanied by sweating. We will discuss the similarities and differences between these disorders and the various treatments available for these conditions. Research shows that social anxiety does not explain hyperhidrosis, but that excessive sweating reduces the threshold for social anxiety. Among people with hyperhidrosis, the functional disability and the emotional problems are mediated by the social anxiety. We propose treating the symptoms of hyperhidrosis and social anxiety disorder in combination in order to achieve maximal improvement in these patients.
Collapse
|
46
|
Liu Q, Yang ZB, Wang CG. [Case of primary hyperhidrosis]. Zhongguo Zhen Jiu 2014; 34:1040. [PMID: 25543448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
|
47
|
Xie L, Yang RD, Huang QL. [Rustic opinions on the theory of the therapeutic method of sweating disease by using Hegu (LI 4) and Fuliu (KI 7)]. Zhongguo Zhen Jiu 2014; 34:781-782. [PMID: 25335258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
|
48
|
Sarnoff DS. Therapeutic update on hyperhidrosis. J Drugs Dermatol 2014; 13:896-897. [PMID: 25116963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
|
49
|
Hessam S, Bechara FG. [Hyperhidrosis]. MMW Fortschr Med 2014; 156:46. [PMID: 24930231 DOI: 10.1007/s15006-014-3076-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
|
50
|
Yao J. [Ninety-five cases of perspiration syndrome treated by acupuncture on acupoint group of enriching qi and yin]. Zhongguo Zhen Jiu 2014; 34:405-406. [PMID: 24946653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
|