Effects of Medical Drugs According to Sweating Localization in Primary Hyperhidrosis

Background: Primary hyperhidrosis is excessive sweating localized to different parts of the body, mostly on the hands. It is exact cause unknown, negatively affects the psychosocial structure of the person and a clinically important health problem. Aims: In the study, it was aimed to examine the effects of drugs used on primary hyperhidrosis. Study Design: The drugs used by the patients who applied to the thoracic surgery clinic with the complaint of sweating and their effects were analyzed retrospectively. Ersin Arslan Training and Research Hospital Thoracic Surgery Clinic between January 1, 2015, and September 30, 2021 (outcomes of seven years). Methodology: A total of 120 patients(45 female, 75 male and age range 8-67) with sweating complaints were identified. Age, gender, sweating localization and drugs used were examined. Statistically, data were analyzed with 95% confidence interval(CI) and Chi Square test. Results: A total of 120 patients were analyzed. 37.5% were female and 62.5% male.The mean age was 27.1±1.54 years.Patients were use 23.4% Aluminum hydrochloride cream),20.8% Bornaprine hydrochloride, 20% Hyoscine-N-butylbromide.According to sweating localizations;42.6% palmar only, 18.7% palmar and axilla, 18.7% palmar and craniofacial, 7.8% palmar and plantar, 5.9% diffuse, 4.5% cranial, 1.8% palmar and abdomen.It is more often between ages of 21-30 and in male.According to the complaints of patients with a history of using medical treatment; there were 34.5% partial response and 20.2% complete response, and no response to medical treatment in 45.3%. Conclusion: In the study; according to the localization of sweating;Aluminum hydrochloride cream reduces sweating on the palmar, and Hyoscine-N-butylbromide reduces axillary and palmar sweating. Bornaprine hydrochloride reduces sweating on all localizations except craniofacial and abdomen, and is related with a complete response on palmar sweating.According to sweating localizations; although there are localizations where all three drugs used are effective, it has been concluded that these drugs used in primary hyperhidrosis do not respond fully at a high rate.

A Case Report of Hyperhidrosis with Sympathicotonia Detected by Iris Diagnosis

Objective: The aim of this case study was to describe a case of iris diagnosis of primary hyperhidrosis and the use of Korean medicine.Methods: A patient with symptoms of hyperhidrosis was diagnosed as having Taeeumin after assessment using the four basic Korean diagnostic methods. Iris diagnosis was used for further examination. The images obtained showed a remarkably defined collarette and increased nerve rings, which suggested an overactive sympathetic nerve system. Under the diagnosis of Taeeum, a Korean herbal medicine was prescribed with additional herbs to help alleviate the hyperactivity of the sympathetic nervous system.Results: The patient had been receiving treatment for hyperhidrosis for >30 years, with various medical attempts to relieve her symptoms, which were ineffective. She showed signs of improvement from day 4 into the treatment, and 80% of her symptoms were improved after completing a 6-week treatment course.Conclusion: The herbal medicine prescribed to the patient proved effective for reducing her chronic symptoms that had been unresponsive to previous medical treatments.

BOTULINUM TOXIN EFFECTIVENESS IN PRIMARY HYPERHIDROSIS PATIENTS

Hyperhidrosis represents pathology of eccrine sweat glands and is manifested by the skin excessive sweating. For patients, living along with hyperhidrosis represents a big challenge, which has a significant impact on numerous aspects of everyday life, as well as on the social and professional lifestyle and psycho-emotional health.

VATS Sympathectomy for the management of Primary Hyperhidrosis: An experience at Aseer Central Hospital, Saudi Arabia.

Background: Hyperhidrosis is bilateral, symmetrical and profuse sweating beyond physiological limits of the body. It is an important disease that causes social and emotional disturbances. Conservative treatment has poor results and most of the patients end up in surgical remedy eventually. The choice of operation is Bilateral Sympathectomy which has excellent results. Objective: The aim of this study was to assess the demographic features of patients and to evaluate the outcome of VATS Sympathectomy. Study Design: Prospective Study. Setting: Aseer Central Hospital, Saudi Arabia. Period: September 2017 to March 2020. Material & Methods: Bilateral VATS with resection of sympathetic chain from T2 to T5 was done depending upon the area involved in hyperhidrosis. Results: 28 (58.3%) male and 20(41.6%) female patients with mean age 21 years (range 19 to 53) were documented. 40% of the patients related their condition to be familial. Most common site of involvement was combined Palmer Plant and Axillary in 26(54%) whereas isolated facial hyperhidrosis was the least involved area. Complication rate was 12% with no mortality recorded. Excellent results with 98% patient’s satisfaction was found. Conclusion: Bilateral VATS sympathectomy is the gold standard surgical treatment for Primary Hyperhidrosis with excellent results.

‘Excessive sweating is not a feminine thing’: A qualitative study of women’s experiences suffering from primary hyperhidrosis

Background Primary hyperhidrosis, excessive focal sweating is a common disease equally affecting men and women. Women tend to seek care more often and assess being more affected by hyperhidrosis in their daily life. The aim of this study was to explore experiences of living with primary hyperhidros in a sample of 15 women. Methods Individual, semi-structured interviews with a purposive sample of 15 women diagnosed with primary hyperhidrosis and analysed by qualitative content analysis utilising an inductive approach. Results The analysis resulted in a theme, constantly guarding the female image, based on three categories, misfitting the feminine norms, avoiding the attention of others and passing like any woman. Primary hyperhidrosis in women disrupted the ideal feminine appearance. Wearing clothes that concealed hyperhidrosis and distancing from social gatherings, in combination with negative remarks by others, created stress and anxiety and had a negative effect on self-esteem. Women felt poorly understood by others regarding the extent of their sweating and were misunderstood in intimate situations while trying to reduce the sweat production. Choices regarding education and career opportunities were affected, since being exposed and receiving attention due to primary hyperhidrosis was unwanted. Treatment with botulinum toxin liberated women from excessive sweating and removed a social handicap they described living with. Conclusion Primary hyperhidrosis in women disrupts the feminine appearance, lowers self-esteem and hinders social interactions. Clinicians assessing primary hyperhidrosis need to be aware that women may report the impairments from primary hyperhidrosis as being more associated with body image and appearance than with functional reductions in daily life. Educating patients, providing accurate information regarding the disease via media and cooperating with patient groups are important for increasing awareness and achieving progress in care for women with primary hyperhidrosis.

The Effect of T3 versus T4 Thoracoscopic Sympathectomy on Hyperhidrosis

Background: Primary hyperhidrosis is a disorder characterized by excessive sweating. However, surgical therapy is the most effective treatment for patients with primary hyperhidrosis. In between all different surgical approaches, video assisted thoracoscopic surgery (VATS) sympathectomy has been considered as a safe and minimally invasive procedure for palmer and axillary hyperhidrosis. The aim of this study was to evaluate the effectiveness of T3 vs. T4 sympathectomy regarding postoperative complications, recurrence and compensatory hyperhidrosis (CH) on 6 months follow up. Methods: This prospective randomized study was conducted over 20 patients undergoing VATS sympathectomy diagnosed with palmar hyperhidrosis and failed medical treatment and undergoing thoracoscopic sympathectomy. Patients were divided randomly into two groups; group A (T3 sympathectomy) and group B (T4 sympathectomy). Results: There was no significant difference between the two groups regarding the degree of treatment success, compensatory hyperhidrosis after one month and after 6 months. There was non-significant difference between the two groups regarding the recurrence, late postoperative complications and satisfaction. Conclusions: Video-assisted T3 or T4 sympathectomy is a safe and effective procedure for treatment of palmar hyperhidrosis and T3 or T4 sympathectomy had no difference regarding to dryness and Compensatory Hyperhidrosis in follow-up for 6 months. Both techniques were effective for treating palmar hyperhidrosis with high rates of success and no recurrence for 6 months.

Botulinum Toxins in Medical and Cosmetic Dermatology

Background: Botulinum toxin (BoNT), a bacterially produced neurotoxin, is a mainstay in the dermatologic armamentarium. Although BoNT is commonly used to treated rhytides associated with ageing, it can be employed for a variety of other cosmetic purposes and medical disorders. Objective: In this review, the authors aim to describe the multitude of uses for BoNT in the dermatologic field. Materials and Methods: This manuscript was designed as a retrospective review of the on- and off-label applications of BoNT in dermatology.Results: In addition to treatment of rhytides, BoNT has been shown to decrease rosacea, menopause-associated flushing, and facial sebum production, while improving patient confidence in their appearance. Furthermore, BoNT has been successfully used to treat primary hyperhidrosis, hair loss, aberrant scarring, Raynaud’s phenomenon-associated vasospasm, as well as a variety of skin diseases. Side effects of BoNT include pain or discomfort associated with injections during treatment, bruising, asymmetry, and swelling. Patients are generally satisfied with clinical results after BoNT treatment. Conclusion: Dermatologists should be aware of all on- and off-label applications of BoNT to provide patients with timely and appropriate medical care. Further research must be completed to fully characterise the safety and use of BoNT for off-label purposes.