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At least 487 records · Page 27Linked to original sources
PubMed2000

Needlescopic surgery for palmar hyperhidrosis.

OBJECTIVE: The aim of this study was to develop a less invasive technique for video-assisted thoracic sympathectomy. METHODS: A newly designed trocar was used. A skin incision of 2.0 to 2.5 mm in length was made in the third or fourth intercostal space at the midaxillary line. After insertion of the trocar, thoracic sympathectomy with electrocautery was carried out at the level of the second and third ribs. RESULTS: From October 1998 to March 1999, 180 patients with palmar hyperhidrosis underwent this technique. No complications related to the technique occurred, and within 1 week the operative wound had almost completely disappeared. There were recurrences necessitating reapplication of the technique. CONCLUSION: The technique allowed healing without a scar and improved the patient's cosmesis.

Adolescent↗
PubMed1998

Endoscopic transthoracic sympathectomy with a fine (2-mm) thoracoscope in palmar hyperhidrosis: a case report.

Endoscopic transthoracic sympathectomy (ETS) is a minimally invasive method, causing only small injuries and few complications, and requires only a short period of hospitalization. Therefore, this method has been applied to patients with palmar hyperhidrosis to whom the conventional transthoracic sympathectomy, which is much more invasive, or thoracic sympathetic blockade, which often causes complications, cannot be applied. Conventional thoracoscopes, such as a resectoscope 8 mm in diameter for urological operations, or a thoracoscope 5 mm in diameter, were usually used for this purpose, but they cause operative injuries. We performed ETS using a thoracoscope 2 mm in diameter (MiniSite 2 mm 0 degrees, USSC171303). Its visual field and handling were not inferior to those of conventional thoracoscopes, and the operative injuries were only 2 mm in size. For the patient, a small scar of this size means virtually no scar.

Adolescent↗
PubMed1987

Surgical treatment of axillary hyperhidrosis.

In the human axilla, the proportion of eccrine and apocrine sweat glands is 1:1. The former are in the dermis, while most of the latter are in the subcutaneous cellular tissue. After studying the difficult methods that have been described for the surgical treatment of axillary hyperhidrosis, we concluded that the treatment should be as radical as possible and deal with both types of glands. The technique described here is a combined method which removes en bloc the skin and subcutaneous cellular tissue of more than half the area of sweating and the subcutaneous cellular tissue of the rest, leaving an S-shaped scar that follows the main axis of the axilla. Problems with this method have been minimal. Follow-up studies carried out up to 3 years after the operation have indicated excellent results.

Apocrine Glands↗
PubMed1987

Treatment of bilateral axillary hyperhidrosis by suction-assisted lipolysis technique.

Axillary hyperhidrosis, although not life-threatening, is a troublesome condition which produces a personal and social handicap of great significance to patients for many years before they seek a cure. Treatment has consisted of application of topical antiperspirants, systemic anticholinergic medications, excision and primary closure of the involved axillary skin, subdermal shaving of the subcutaneous fat pad containing the hypersecreting sweat glands, and combinations of all of the above. Medical treatment is frequently inadequate and surgical techniques so far described may carry significant morbidity. We have used the technique of suction-assisted lipolysis as an alternative method of treatment for this condition. The procedure has been employed successfully in one patient with no recurrence after one year of follow-up. The operation is done as an outpatient procedure under general or local anesthesia. Suction is carried out through a 1-cm incision in the anterior axillary fold and the entire surface of the dermis is fully "vacuumed" in all directions with 15 to 20 strokes, using a 5- or 7-mm diameter cannula. The area treated includes the area of maximal axillary hair growth and 5 to 6 cm beyond. Routine dressings are removed five days posteroperatively, with the patient generally resuming all activities within one week.

Adipose Tissue↗
PubMed1977

Palmar hyperhidrosis and its surgical treatment: a report of 100 cases.

One hundred patients with primary palmar hyperhidrosis (HH) underwent bilateral upper dorsal sympathectomy (UDS) by the supraclavicular approach. Pre-operative epidemiological and clinical data are described. The immediate and late results, as well as the complications and side-effects are detailed. Follow-up was completed on 93 patients between four and 50 months after the operation (average 18 months). Of 93 patients, 91 had drying of the hands. In 58% some moisture returned to the hands but in no case did the hyperhidrotic state recur. Subjective patient evaluation was excellent or good in 83 patients (89%) and only one patient (a technical failure) was completely dissatisfied. Reasons for some degree of dissatisfaction with operation were mainly compensatory HH in non denervated areas, and Horner's syndrome. Compensatory HH usually decreased with passage of time and, permanent Horner's syndrome occurred in 8% of patients (4% of procedures). Technical failure can be avoided by use of frozen section examination intraoperatively. For severe cases of palmar HH that cause social, professional and emotional embarassment, bilateral simultaneous UDS by the supraclavicular approach is the procedure of choice: Morbidity is small, and almost all patients enjoy improved quality of life after the operation.

Adolescent↗
PubMed1977

Axillary hyperhidrosis.

The literature of axillary hyperhidrosis is reviewed. For treatment, we present a technique of radical glandular clearance, converting the flaps to attached "skin grafts". The extent of the area may be varied, according to the degree of excessive sweating.

Axilla↗
PubMed1998

Endoscopic transthoracic dorsal sympathectomy for the treatment of upper extremity hyperhidrosis: a new minimally invasive approach.

Palmar and axillary hyperhidrosis are best treated surgically by endoscopic transthoracic upper dorsal sympathectomy. At present, this methodology relies on (at least) double trocar insertion (per side), carbon dioxide insufflation, or both. We present a new minimally invasive endoscopic transthoracic technique, performed by a single-entry specifically modified thoracoscope and without the need for carbon dioxide insufflation, with the aim to reduce the drawbacks associated with the above-mentioned, currently adopted endoscopic technique. In our opinion, this "single-entry" technique, compared with the other reported approaches, should theoretically minimize any damage to the intercostal neurovascular bundle, while avoiding the complications related to carbon dioxide insufflation.

Adolescent↗
PubMed2003

Pediatric nonenvironmental hypothermia presenting to the emergency department: Episodic spontaneous hypothermia with hyperhidrosis.

Cases of pediatric nonenvironmental hypothermia are uncommon. When presenting to the emergency department, these patients are often evaluated for possible sepsis/shock, brain tumors, endocrine disorders, and drug ingestions. We report a case of a 5-year-old girl who presented to the pediatric emergency department on two occasions with hypothermia and lethargy. She was found to have an unusual cause of her symptoms: episodic spontaneous hypothermia with hyperhidrosis.

Child, Preschool↗
PubMed2006

Surgical treatment of axillary hyperhidrosis: a study comparing liposuction cannulas with a suction-curettage cannula.

BACKGROUND: Suction-curettage is a minimally invasive surgical approach for the treatment of focal axillary hyperhidrosis. Studies comparing the efficacy of different surgical cannulas are missing. Therefore, we gravimetrically compared a specially designed cannula versus 2 standard liposuction cannulas. METHODS: Axillary suction-curettage was performed in 42 patients (n = 42). Fourteen patients (n = 14) were operated with a 1-hole liposuction cannula, 14 patients (n = 14) with a larger 3-hole liposuction cannula, and 14 (n = 14) with a sharp suction-curettage cannula. Sweat rates in mg/min were measured by gravimetry before and 6 months after surgery. RESULTS: Sweat rate in the 1-hole liposuction cannula group was significantly reduced from 57.65 +/- 5.85 mg/min to 32.58 +/- 4.64 mg/min (P < 0.001), corresponding to a reduction of 44.15%. Patients operated with the larger 3-hole liposuction cannula showed a significant reduction of sweat rate from 63.95 +/- 8.25 mg/min to 33.14 +/- 6.25 mg/min (P < 0.001), corresponding to a reduction of 49.19%. The largest reduction of sweat rates (63.07%) was achieved with the suction-curettage cannula (61.85 +/- 9.03 mg/min to 21.27 +/- 4.42 mg/min (P < 0.001). No severe side effects were observed. CONCLUSION: Due to the higher efficacy we recommend performing suction-curettage with a sharp suction-curettage cannula.

Adult↗
PubMed1992

The role of metal allergy and local hyperhidrosis in the pathogenesis of pompholyx.

Pompholyx (Dyshidrosis) is a disease of unknown etiology presenting as symmetrical, vesicular hand and foot dermatitis. To clarify the pathogenetic role of sweat and metal allergy, twenty five patients with pompholyx were examined with respect to their perspiration volume using equipment that continuously recorded the local perspiration volume. Patients were also examined for metal allergy by patch testing and oral challenge tests. The perspiration volumes were measured using recently developed equipment for continuous recording of local perspiration volume (Kenz-Perspiro oss-100). The perspiration volume of pompholyx patients was found to be 2.5 times higher than that of age-matched normal controls. Twenty percent of the patients showed sensitivity to chromate, 16% to cobalt, and 28% to nickel on patch testing. Six patients with positive results were challenged orally in a controlled trial with 2.5 mg nickel, 1 mg cobalt, or 2.5 mg chromium. Four of them (67%) showed vesicular reactions on their hands with challenge testing. These results indicated a sensitivity to metal compounds which, in combination with local hyperhidrosis, may contribute to the development of vesicular lesions in pompholyx.

Adolescent↗
PubMed1977

Tap water iontophoresis in palmo-plantar hyperhidrosis.

Plain tap water iontophoresis as a method of treatment of idiopathic palmo-plantar hyperhidrosis was evaluated. In the present study, different strengths of current were used for varying periods of time and the treatment was given 6 days a week, until the patients became euhidrotic. Whereas previous workers have used the two electrodes in separate pans, we, in one study, placed them in the same pan of tap water, so that electrolysis occurred at the electrodes on which palms or soles were resting, the current passing through the medium. It was observed that, irrespective of the method used, euhidrosis of palms or soles were achieved. The time and the amount of current required to produce euhidrosis were significantly greater with the single pan technique (average 14-1 sittings in Group I) as compared to the separate pan method (average 7-09 sittings in group II) (t = 3-41, P less than 0.01). The euhidrosis persisted for between 6 and 8 months (average 6-26 months). In our study 90% of the patients treated developed anhidrosis on both the anode and cathode treated palms or soles. In 10% of the subjects, the effect was, however, greater on the anodal side.

Adolescent↗
PubMed1980

Use of biofeedback in treating chronic hyperhidrosis: a preliminary report.

Preliminary findings attesting to the successful therapeutic use of biofeedback training in reducing symptoms of chronic hyperhidrosis are reported. Eleven of the fourteen adult patients trained with biofeedback were able to demonstrate clinical improvement in their excessive sweating 6 weeks after termination of treatment. Relaxation was suggested as the active ingredient in the biofeedback treatment effect. These findings support a recent report of the successful use of biofeedback in treating patients with dyshidrotic eczema.

Adult↗
PubMed2005

Psychosocial aspects of patients with focal hyperhidrosis. Marked reduction of social phobia, anxiety and depression and increased quality of life after treatment with botulinum toxin A.

BACKGROUND: Primary focal hyperhidrosis (PFH) is defined as excessive sweating typically localized to specific body areas such as axillae, hands and feet. An association between PFH and anxiety as well as depressive syndromes has been suggested. OBJECTIVES: To investigate a possible association between PFH and anxiety, depression, social phobia and quality of life, and to study the effect of treatment with botulinum toxin A on these factors. METHODS: PFH was confirmed clinically and by gravimetry. To measure anxiety and depressive syndromes several German versions of standardized questionnaires were used: State-Trait Anxiety Inventory G Form X2 (STAI), Social Phobia Scale (SPS), Symptom Checklist of Derogatis (SCL-90-R), subscales 'Social Insecurity', 'Depression', 'Anxiety' and 'Phobia', and Hospital Anxiety and Depression Scale (HADS-D). Quality of life was assessed using Skindex. Two analyses were performed. The first analysis included all patients with PFH, the second analysis only patients with PFH who were treated with botulinum toxin A. In the latter group the questionnaires were repeated 2-4 weeks after treatment. RESULTS: For the total group at baseline the values for STAI, SCL-90-R, HADS-D and SPS were well within the normal range. However, in the group of patients treated with botulinum toxin A, the mean +/- SD SPS score was 17.6 +/- 15.5, i.e. above the normal range. Quality of life was impaired, with a mean +/- SD Skindex score of 24.3 +/- 5.7 at baseline. Treatment with botulinum toxin A led to a significant reduction in all investigated symptoms. CONCLUSIONS: Despite an impaired quality of life, patients with PFH in general do not show increased symptoms of anxiety, depression or social phobia. Only in the subgroup of patients treated with botulinum toxin A was the SPS increased at baseline. Treatment with botulinum toxin A led to a marked improvement in all factors investigated.

Adult↗
PubMed1996

Botulinum toxin--a possible new treatment for axillary hyperhidrosis.

The inhibitory action of botulinum toxin is not limited to the neuromuscular junction. The toxin also blocks the autonomic cholinergic fibres, including the sympathetic fibres to sweat glands. We have previously demonstrated that the toxin produces localized anhidrosis. To determine the dosage, pattern and duration of the anhidrotic effect of botulinum toxin and to test the efficacy of axillary injections, we further studied seven healthy volunteers. Two individuals had subcutaneous injections of botulinum toxin (20 mouse units, Dysport-Porton Products) in the dorsum of the hand. Five healthy volunteers had 15-50U of botulinum toxin A (Botox) injected in one axilla. A circular area of complete anhidrosis on the dorsum of the hand was evident on day 2 and persisted for 11 months. By day 3, two of the axillae (injected with 50 U each) were totally dry and in one (injected with 30 U) the sweating was substantially reduced. The effect persisted for 6-8 months before wearing off. No effect was appreciated in two axillae (injected with 15 and 20 U). No significant side-effects were encountered. Subcutaneous injections of botulinum toxin causes chemodenervation of the sweat glands. In normal individuals axillary sweating can be abolished by 50 U of botulinum toxin A (Botox). The results offer a possible novel treatment for severe cases of axillary hyperhidrosis.

Adult↗
PubMed1990

Aluminum chloride hexahydrate versus palmar hyperhidrosis. Evaporimeter assessment.

The efficacy of topical aluminium chloride hexahydrate 20% W/W ethanol (ACH) in the treatment symptomatic palmar hyperhidrosis was studied in 12 patients. A half-sided control single blind (assessor blind) study was done. Patients applied ACH on one palm daily for 4 weeks. The response to treatment was measured objectively with an evaporimeter. There was significant fall of skin water vapor loss (SVL) on treated palms compared with untreated palms. The basal mean SVL of treated palms and untreated palms were 79.9 and 77.9 g water/m2/h, respectively (n.s.). The mean SVLs of treated vs. untreated palms at week 1, 2, 3, and 4 were 66.4 vs. 79.7 (p less than 0.05), 56.6 vs. 72.2 (p less than 0.001), 58.2 vs. 72.5 (p = 0.1), and 51.4 vs. 72.7 (p less than 0.001) g water/m2/h, respectively. The mean SVL of treated palms returned near basal rate within 1 week of stopping treatment. Four patients developed skin irritation from ACH; in three this disappeared after 1 week and they were able to continue with treatment; one withdrew from the study because of the severe irritation. All patients reported that the ACH reduced palmar sweating within 48 hours of application; its effect disappeared within 48 hours after stopping treatment. ACH appeared to be useful in rapid control of palmar hyperhydrosis.

Administration, Cutaneous↗
PubMed1982

Digital clubbing, hyperhidrosis, acro-osteolysis and osteoporosis. A case resembling pachydermoperiostosis.

We report a Cambodian girl with digital clubbing, profuse hyperhidrosis, and joint and leg pain and swelling. She also had extensive acro-osteolysis of distal phalanges as well as generalized osteoporosis. There was no other affected person in the family, but her parents were first cousins. Although the X-ray changes are unusual, this patient probably represents a case of pachydermoperiostosis, either occurring as a new mutation or inherited as an autosomal recessive syndrome.

Bone Resorption↗