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At least 19 recordsLinked to original sources

PubMed1979

Hyperhidrosis and the sympatho-adrenal system.

Some disorders in which excessive sweating, hyperhidrosis, is a symptom are also characterized by increased sympatho-adrenal activity. Such disorders are hypotension, hypoglycemia, pheochromocytoma and hyperthyroidism. Sweat glands are controlled by a cholinergic innervation but can also be stimulated by adrenergic agents whose effects can be blocked by both alpha- and beta-receptor blocking drugs. An adrenergic innervation has also been demonstrated. There is evidence that the adrenergic component of sweating particularly secretion of the adrenal medulla, is responsible for the enhancement of sweating during exercise but not for the hyperhidrosis present in these disorders since sweating in these circumstances can be effectively blocked by cholinergic blocking compounds. Cutaneous vasoconstriction due to elevated plasma catecholamines reduces the rate of evaporation of sweat and allows sweat to accumulate on the skin. It is suggested that in the case of hypotension and insulin hypoglycemia sweating results from general sympathetic stimulation and that adrenal medullary hormones are not an essential component of the response. Hyperhidrosis in pheochromocytoma may be due to central activation of heat loss mechanisms resulting from the passage of plasma catecholamines across the blood-brain barrier combined with increased thermogenesis and cutaneous vasoconstriction. The hyperhidrosis of hyperthyroidism is probably due to increased thermogenesis.

Adrenal Gland Neoplasms↗

PubMed1976

Hyperhidrosis and hypohidrosis.

Sweating has an important physiological function concerned with both temperature and fluid balance. Hypohidrosis is uncommon and rarely recognized by the patient. It usually represents damage to the central nervous system or peripheral nerves. Hyperhidrosis may be a feature of general medical diseases such as thyrotoxicosis and fevers. It may also be due to damage of the central of peripheral sympathetic nerves. Localized hyperhidrosis tends to occur on the palms, the soles, the axillae and, to a lesser extent, the face. Treatment of local hyperhidrosis with topical aluminium salts, or with topical or oral anticholinergics, may help some patients but surgery may be indicated in those with severe hyperhidrosis.

Age Factors↗

PubMed2026

Efficacy and safety of rib-guided percutaneous thoracic sympathetic radiofrequency thermocoagulation at two different targets for primary palmar hyperhidrosis: a randomized controlled trial.

OBJECTIVES: To compare the efficacy and safety of computed tomography-guided percutaneous thoracic sympathetic radiofrequency thermocoagulation (RFT) targeting the upper versus lateral margin of the fourth rib head for severe primary palmar hyperhidrosis (PPH). METHODS: Patients with severe PPH were randomly divided into Group U (upper margin target) and Group L (lateral margin target). Outcome measures included 1-year recurrence rate, Hyperhidrosis Disease Severity Scale (HDSS), Dermatology Life Quality Index (DLQI), palm skin temperature, finger perfusion index (PI), compensatory hyperhidrosis and patient satisfaction. RESULTS: Both groups (n = 55 each, 110 sides) successfully underwent RFT. No preprocedural PI differences were found (p > 0.05). Immediately post-RFT, PI in Group L was significantly higher than in Group U (left p = 0.025, right p = 0.013). No significant differences in HDSS grades were observed between groups before and at 1 day, 2 weeks, 1 month and 3 months post-procedure. However, at 6 and 12 months, Group L showed significantly lower HDSS grades (left p = 0.033 and 0.016; right p = 0.039 and 0.025) and lower DLQI scores (p = 0.037 and 0.024) than Group U. Patient satisfaction did not differ within 6 months, but Group L had significantly higher satisfaction at 12 months (p = 0.036). CONCLUSIONS: Targeting the lateral margin of the fourth rib head for RFT achieved greater efficacy, better quality of life and higher patient satisfaction compared to the upper margin target.

Humans↗

PubMed1979

Thermoregulatory sweating in palmar hyperhidrosis before and after upper thoracic sympathectomy.

To assess thermoregulatory sweating in palmar hyperhidrosis, the authors determined the responses of three groups of normal, hyperhidrotic, and denervated subjects to a variety of ambient temperatures (TA's), 22 degrees, 28 degrees, and 41 degrees C. The normal group had no hyperhidrosis, with intact T2-3 ganglia, the hyperhidrotic group had palm hyperhidrosis with intact T2-3 ganglia, and the denervated group had hyperhydrosis treated with T2-3 ganglionectomy. Both groups of hyperhidrotic and denervated subjects maintained oral and mean skin temperatures within normal limits displayed by the normal group over a wide range of TA's tested. The local sweating rate (LSR) of both the palms and the soles of the feet in the hyperhidrotic group was decreased to a minimal level by either the T2-3 ganglionectomy or the subcutaneous administration of atropine sulfate. Furthermore, the denervated group had a significantly lower LSR of both the forehead and the upper chest regions, but showed a higher LSR or both the ventral thigh and the lateral lumbar regions at a TA of 41 degrees C when compared to the LSR of either the normal or the unoperated hyperhidrotic group. The data demonstrate that the surgical removal of both the T-2 and the T-3 ganglia, although producing no alterations in the thermal balance, does produce abnormalities in quantitative distribution of thermoregulatory sweating in man.

Atropine↗

PubMed1978

Thoracic endoscopic sympathectomy in palmar and axillary hyperhidrosis.

An endoscopic technique is described for thoracic sympathectomy. After establishment of a pneumothorax, the thoracoscope is introduced into the pleural cavity. The telescope is equipped with a wire electrode, a grasping forceps, and a suction coagulation probe for endoscopic electroresection of the sympathetic trunk. In 63 patients, 124 endoscopic sympathectomies were performed. All patients were relieved of sweating in the hands; 18.6% still had some perspiration of the axilla. Side effects of thoracic sympathectomy were compensatory and gustatory sweating that, in four patients, were more embarrassing than the original form of hyperhidrosis. Fifty-five patients were highly satisfied with the result of endoscopic sympathectomy, which is considered the appropriate minor procedure for the treatment of upper limb hyperhidrosis, causing minimal discomfort to the patient and almost invisible scars.

Adolescent↗

PubMed1979

The surgical treatment of axillary hyperhidrosis.

Axillary hyperhidrosis is a common condition and young people often suffer unnecessarily for many years in spite of the availability of good surgical methods for cure. We describe our own modification of Pettersson and Strömbäck's (1970) method of excision of the sweat glands. During the years 1972-6 218 axillary operations have been performed on 109 patients at the surgical clinic in Västerås for axillary hyperhidrosis. We reviewed 104 of these and found that 71 patients were completely satisfied and only 7 unsatisfied. Twelve patients wanted to be reoperated either because they still sweated or because they were unhappy with their scars. Thus, we found that overall the surgical methods are safe, simple and give good results.

Adolescent↗

PubMed1978

Radical operation to stop axillary odor and hyperhidrosis.

We have developed a subcutaneous tissue shaver for the radical treatment of hircismus and hyperhidrosis. With this shaver the sweat glands can be removed from the undersurface of the axillary skin through a small incision. We report 3,000 cases of hircismus and hyperhidrosis treated by our method. The postoperative scar has been minimal, healing has been quick, and good results were achieved by this method.

Axilla↗

PubMedDate not supplied

Treatment of hyperhidrosis with topical methenamine.

Idiopathic palmar and plantar hyperhidrosis is a relatively common disorder of eccrine sweat gland function. Treatment with glutaraldehyde of formaldehyde, although successful, may cause undesirable side effects. Methenamine is a polycyclic organic compound which release ammonia and formaldehyde at acid pH. Five per cent methenamine in a firm stick gel, applied daily to one palmar or plantar surface of 109 patients with hyperhidrosis, resulted in significantly less sweating after one month. No patients were sensitized to formaldehyde.

Chemical Phenomena↗

PubMed1978

Axillary hyperhidrosis treated with alcoholic solution of aluminium chloride hexahydrate.

Sixty-five patients with axillary hyperhidrosis took part in a trial of treatment with a solution of 20% aluminium chloride hexahydrate in absolute alcohol, applied topically each night for a week and then whenever the patient thought it necessary. Excellent control of sweating was achieved in 64 patients, and occlusion of the area was found to be unnecessary. No troublesome side effects were reported. The results of this study indicate that 20% aluminium chloride hexahydrate in absolute alcohol is the treatment of first choice for patients with axillary hyperhidrosis.

Administration, Topical↗

PubMed1979

Transaxillary sympathectomy in the treatment of hyperhidrosis of the upper limb.

Idiopathic (primary) hyperhidrosis is a common and distressing condition. Excessive axillary sweating responds to local excision of the eccrine glands. In severe cases, sympathectomy may be indicated to deal with hyperhidrosis of the hands and feet. The surgical anatomy of transthoracic sympathectomy is described.

Adolescent↗

PubMed1978

[Surgical treatment of hyperhidrosis axillaris].

Radical sweat gland excision is the treatment of choice in axillary hyperhidrosis. After a review of the common surgical techniques the own technique is discribed. It consists of a vertical excision of the hyperhidrotic skin area and primary wound closure. No recurrences of hyperhidrosis were seen in the follow up period.

Adult↗

PubMed1979

'Rusters'. The corrosive action of palmar sweat: II. Physical and chemical factors in palmar hyperhidrosis.

When measuring sweating rates, close correspondence was found with the clinical estimation of hyperhidrosis. Corrosion was seen to increase with increasing sweat rates, reaching its maximum after an assumed rise in the actual sodium chloride concentration on the skin surface due to evaporation of water. The findings confirm that hyperhidrosis is of primary importance in the constitution of a 'ruster', and are also in good agreement with experimental reports. The small variations in palmar skin pH had no influence on the degree of corrosion; nor had the character of the metal surface. Of the two types of metal studied. corrosion was much more severe on the type having the lowest concentration of copper, thus confirming that increasing copper concentrations have a positive effect in reducing corrosion rates. At 50--60% relative humidity (RH) corrosion increased as time elapsed, whereas at 40% RH no corrosion developed on a sweat-contaminated plate. When exposed to 75% RH, metal samples became severely corroded in the course of a few days. Protective methods for the avoidance of rust are mentioned, with special emphasis on frequent handwashing.

Adolescent↗

PubMed1978

Unilateral segmental hyperhidrosis. Response to 20% aluminum chloride solution and plastic wrap.

A young woman had unilateral dermatomal hyperhidrosis documented by a starch-iodine technique. Evaluation failed to reveal any associated causative conditions. She was treated with 20% aluminum chloride hexahydrate solution in absolute alcohol (Drysol) with a favorable response. With recurrent use, however, she developed miliaria following exertion. Aluminum chloride hexahydrate was shown to be an effective agent to treat this unusual condition, but miliaria with exertion secondary to its use may be a limiting factor.

Adult↗

PubMed1977

Surgical management of hyperhidrosis.

Sixty-five patients with severe disabling hyperhidrosis were subjected to operation. Eighty-nine sympathectomies and 42 axillary skin excisions were performed to abolish sweating. Almost 90% of these patients were extremely satisfied with the outcome of surgery which resulted in a change for the better in their social and working lives. When conservative therapy fails, we recommend these procedures, which often alleviate this most distressing symptom.

Adolescent↗

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↗

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↗

PubMed1979

Management of hyperhidrosis axillaris.

To many people, particularly women, hyperhidrosis of the axillae is a personal discomfort and a social handicap. Previously practiced topical and internal medicinal measures and surgical techniques of management are reviewed and a modified surgical technique is described.

Axilla↗