Hyperhidrosis

Primary palmar hyperhidrosis in children and adolescents may be severe enough to affect school and physical activities, causing emotional problems, stress in the patient's life, and a compromised quality of life. Nine patients with palmar hyperhidrosis underwent treatment with botulinum A. Before the session, and in the 1-, 3-, 6-, 9-, and 12-month post-session follow-ups, the patients were administered the Minor test, gravimetry, the Scales of Frequency and Severity, and the Questionnaire of Quality of Life. The mean age was 11 years, with seven girls and two boys. Each patient was administered at least one treatment of botulinum toxin in the palm of the hands (75-150 U for palm), with the mean number of sessions 2.2 (range: 1-4). All sessions in the patients resulted in drying of the hands, with a mean duration of effect of 7 months. Botulinum toxin A controls excessive sweat in the palms of children and adolescents who have primary palmar hyperhidrosis, with an improvement in the quality of life. The therapy is safe and effective in this pediatric group and can be considered before surgical interventions.

Compensatory sweating after sympathectomy does not have a satisfactory, free-of-secondary-effects treatment. Glycopyrrolate has been successfully used to treat other types of hyperhidrosis. Compensatory sweating after sympathectomy could respond to the topical application of glycopyrrolate. Ten patients were selected with compensatory sweating after sympathectomy. One milliliter of a 2% water solution of topical glycopyrrolate was applied once a day over the affected area and massaged for 30 seconds. Treatment was maintained for 6 weeks. The results were rated using a scale from 1 to 10 of satisfaction at the end of the study. Eight of the 10 treated patients dramatically improved with the topical application of glycopyrrolate. Two patients quit the treatment due to secondary effects (accommodative failure and dry mouth). The results of the study demonstrated that local application of glycopyrrolate might be the treatment of choice for compensatory hyperhidrosis.

A perspective from someone who has suffered from hyperhidrosis and insomnia for most of his life. Abstract Hyperhidrosis should be classified in the Psychological DSM V manual as a " stress disorder dysfunction. " Hyperhidrosis is triggered by a dephosphorylation of cAMP response element binding (CREB) or the non-activation of CREB in hyperhidrosis patient interpretation of a stressful event. The combination of stress and dephosphorylation of CREB results in the stimulation of already existing accumulated levels of acetaldehyde in human plasma caused by a mutation/ malfunction in the aldehyde dehydrogenase (ALDH) metabolic pathway. The elevated levels of acetaldehyde crosses the blood brain barrier causing toxic encephalopathy and inflammation of the pituitary gland, resulting in exacerbation of HPA axis. Ingesting of food or breathing air containing trace amounts of acetaldehyde produces elevated levels of Malondialdehyde (MDA) which is an indication of lipid peroxidation. This process causes oxidative stress and cellular antioxidants to be out of sequence, such as high levels of superoxide dismutase (SOD), and low levels of catalase (CAT), glutathione peroxidase (GSH-px), as this antioxidant imbalance attempts to restore homeostasis. The free radical damage that occurs due to " churned up " levels of acetaldehyde produces accumulated levels of hydrogen peroxide (H2O2), these antioxidants are overwhelmed by the volume of H2O2 in the human plasma as ROS exceeds antioxidant capacity. The excess H2O2 is broken down into water and passes through the highest concentration of sweat glands, resulting in hyperhidrosis. Conclusion: hyperhidrosis patients are detoxifying every day through excessive sweating. _____________________________________________________________________________________ Methods I performed my searches on www.pubmed.gov and on the internet using key words and phrases. I researched many articles, and abstracts of articles, to form the basis for my theory.

Thoracic sympathetic nervous system (TSNS) surgery has increased in importance in the last few years, generating great expectations among the general population and the scientific community. This has been due to the excellent results obtained by videothoracoscopy-assisted thoracic sympathectomy in the treatment of essential hyperhidrosis and other TSNS disorders.This minimally invasive surgical technique has been shown to be effective, and

Background.  Laser-assisted hair removal has become a popular treatment for eradication of body hair. Many studies have been published concerning the safety and efficacy of several laser systems. Adverse events are hyperpigmentation, hypopigmentation, erythema, oedema, scarring, pain and blistering. Changes in sweating have not previously been reported.Aim.  To investigate the effects on axillary sweating of hair removal by a 1064-nm neodymium:yttrium–aluminium–garnet (Nd:YAG) laser.Methods.  The sweating function of both axillae was evaluated objectively by the iodine starch test for planimetry measurement and subjectively using a visual analogue scale (VAS) before the treatment, and 1 month and 1 year after the last session.Results.  The difference in hyperhidrotic activity before and after treatment was significant (P < 0.05), and these differences persisted 1 year after the last evaluation.Conclusions.  The results of this study confirm that treatment of axillary hair using the 1064-nm Nd:YAG laser can cause hyperhidrosis, and this effect is not transient. We did not evaluate the eccrine glands histologically, which is a limitation of the study.

BACKGROUND Different formulations of botulinum toxin type A (BoNTA) may have different diffusion characteristics.OBJECTIVE The objective was to compare the diffusion characteristics of two formulations of BoNTA.MATERIALS AND METHODS A total of 20 patients with forehead hyperhidrosis received four injections of BoNTA in their forehead (one medial and lateral injection of one formulation randomly assigned to one forehead side, one medial and lateral injection of the other formulation to the other forehead side). Patients received 3 U/injection of BoNTA1 (BOTOX, Allergan, Inc.) and were randomly assigned to receive BoNTA2 (Dysport, Ipsen Ltd.) at a dose ratio of 1:2.5, 1:3, or 1:4. The area of anhidrosis was highlighted using iodine and starch and determined by software from standardized photography.RESULTS During the 6 months after treatment, the area of anhidrosis was larger with BoNTA2 in 93% (195/210) of medial-medial or lateral-lateral comparisons of the two products and at all dose ratios. The smaller area of anhidrosis with BoNTA1 did not compromise its efficacy in inhibiting contraction of frontalis muscle.CONCLUSION BoNTA2 has a greater area of diffusion in the forehead than BoNTA1, even with identical injection volumes. This may hinder accurate localization of clinical effect, thereby increasing the potential for adverse effects.

To evaluate the effectiveness and patient satisfaction with the use of oxybutynin for treating axillary hyperhidrosis in a large series of patients. One hundred two patients with axillary hyperhidrosis were treated with oxybutynin. During the first week, patients received 2.5 mg of oxybutynin once a day in the evening. From the 8th to the 42nd day, they received 2.5 mg twice a day, and from the 43rd day to the end of the 12th week, they received 5 mg twice a day. All of the patients underwent two evaluations: before and after (12 weeks) the oxybutynin treatment, using a clinical questionnaire; and a clinical protocol for quality of life (QOL). More than 80% of the patients experienced an improvement in axillary hyperhidrosis; 36.3% of them presented a great improvement, and half of the patients showed improvements at all hyperhidrosis sites. Most of the patients showed improvements in the QOL (67.5%). The patients with very poor QOL before the treatment presented greater satisfactio...

Pitted keratolysis is a common and problematic skin condition affecting the feet caused by the keratolytic activity of Corynebacterium, Micrococcus, Dermatophilus. Skin lesions are characterized by crater-like pits of the epidermis accompanied by a burning sensation, itching, pain and malodor. The purpose of the present paper was to characterise the disease&#39;s clinical features and possibilities for the therapy. Due to its interdisciplinary nature, not only dermatologists ought to be familiar with the disease, but also physicians, pediatricians, surgeons, orthopedists, military doctors and occupational health doctors.