Facial – Page 2 – Hyperhidrosis Research . org

June 15, 2022

Ipsilateral Facial Hyperhidrosis in a Patient With Squamous Cell Carcinoma of the Lung

Cureus. 2022 May 8;14(5):e24832. doi: 10.7759/cureus.24832. eCollection 2022 May.

ABSTRACT

While anhidrosis in Horner’s Syndrome is a well-documented result of apical lung malignancies impinging on the sympathetic pathway traveling through the upper lobe of the lung, its opposite effect, hyperhidrosis, is a seldom reported consequence. Hyperhidrosis occurs as a result of irritation of the sympathetic nervous system near the superior cervical ganglion. In this report, we examine a patient with known Stage IIIB squamous cell carcinoma of the lung presenting with right hemifacial hyperhidrosis, dyspnea, and right upper extremity swelling. Computed tomography angiography (CTA) of the chest re-demonstrated the intrathoracic neoplasm encroaching on his mediastinum. During admission, the patient had his first cycle with carboplatin and paclitaxel. His hyperhidrosis, as well as dyspnea and swelling improved post-treatment, and the patient was stable for discharge to follow up outpatient with oncology and radiation oncology to continue further treatment. As hemifacial hyperhidrosis is rarely reported, it becomes important to recognize this as a likely indicator of mediastinal invasion from malignancy.

PMID:35702464 | PMC:PMC9177234 | DOI:10.7759/cureus.24832

February 15, 2022

Minimally Invasive Sympathicotomy for Palmar Hyperhidrosis and Facial Blushing: Current Status and the Hyperhidrosis Expert Center Approach

J Clin Med. 2022 Jan 31;11(3):786. doi: 10.3390/jcm11030786.

ABSTRACT

Hyperhidrosis, the medical term for excessive sweating beyond physiological need, is a condition with serious emotional and social consequences for affected patients. Symptoms usually appear in focal areas such as the feet, hands, axillae and face. Non-surgical treatment options such as topical antiperspirants or systemic medications are usually offered as a first step of treatment, although these therapies are often ineffective, especially in severe and intolerable cases of hyperhidrosis. In the treatment algorithm for patients suffering from hyperhidrosis, surgical thoracoscopic sympathicotomy offers a permanent solution, which is particularly effective in the treatment of palmar hyperhidrosis and facial blushing. In this review, we describe the current status of thoracoscopic sympathicotomy for palmar hyperhidrosis and facial blushing. In addition, we share the specific treatment approach, technique and results of our Hyperhidrosis Expert Center. Last, we share recommendations to ensure an effective, reproducible and safe application of single-port thoracoscopic sympathicotomy for palmar hyperhidrosis and facial blushing, based on our extensive experience.

PMID:35160238 | DOI:10.3390/jcm11030786

February 21, 2021

Rib-oriented Thoracoscopic Sympathetic Surgery for Hyperhidrosis: Prospective Long-term Results and Quality of Life.

Rib-oriented Thoracoscopic Sympathetic Surgery for Hyperhidrosis: Prospective Long-term Results and Quality of Life.

Surg Laparosc Endosc Percutan Tech. 2021 Feb 16;:

Authors: Nachira D, Meacci E, Congedo MT, Petracca-Ciavarella L, Zanfrini E, Iaffaldano A, Vita ML, Chiappetta M, Griffo R, Lococo F, Margaritora S

Abstract
BACKGROUND: The optimal thoracoscopic sympathetic surgery for primary palmar and/or axillary hyperhidrosis (PPAH) is still unclear because of lack of uniform technique and qualitative/quantitative scales for definition of results. The aims of this study were to compare long-term outcomes based on the surgical technique and the level of sympathetic trunk interruption by clipping and to assess postoperative compensatory sweating (CS), patients’ satisfaction, and quality of life (QoL).
MATERIALS AND METHODS: Between September 2009 and April 2016, 94 patients who underwent 2-stage bilateral thoracoscopic rib-oriented (R) sympathetic clipping were prospectively followed up through the administration of standardized preoperative and postoperative questionnaires.Thirty-four (36.2%) patients underwent single-port transaxillary access instead of the standard two 5-mm incisions. The level of sympathetic clipping for PPAH was R3+4(top and bottom); in patients who complained associated facial or plantar hyperhidrosis R2-bottom and R5-top were clipped, respectively. Seventy-five patients completed bilateral surgery.
RESULTS: There were no significant differences between single-port and biportal video-assisted thoracoscopic surgery in terms of operative times and postoperative results. At a mean follow-up of 72 (SD: 26) months, CS was reported in 42 (56%) patients, severe only in 6 (8%). It was higher in the case of R2-bottom clipping (P=0.03). Thirty-one of 60 (51.6%) patients who had a plantar hyperhidrosis declared an improvement of feet sweating after surgery. Postoperative satisfaction was excellent (86.11% on a 0 to 100 scale) and 95.4% of patients declared an improvement in QoL, which was statistically significant in all evaluated parameters. These results were not related to the level of clipping.
CONCLUSION: Thoracoscopic R3 to R4 clipping appears to be a safe and effective treatment for PPAH. Although postoperative CS was common and higher after R2-bottom clipping, this did not seem to affect patients’ satisfaction and improvement in QoL.

PMID: 33605681 [PubMed – as supplied by publisher]

December 12, 2020

Craniofacial hyperhidrosis: clinical characteristics and response to treatment in a cohort of 97 patients treated with oral oxybutynin.

Craniofacial hyperhidrosis: clinical characteristics and response to treatment in a cohort of 97 patients treated with oral oxybutynin.

Dermatol Ther. 2020 Dec 10;:

Authors: García-Souto F, Del Boz J, Colmenero-Sendra M, Polo-Padillo J

Abstract
The term craniofacial hyperhidrosis (HH) refers to HH that affects the face and/or scalp. Few studies have focused on this specific location, and even fewer distinguish between the two areas. Our study aims are to describe the clinical characteristics of patients with craniofacial HH, specifying whether the condition affects the scalp, face or both, and to compare these cases with those recorded at other locations. As secondary objectives, we determine the effectiveness and adverse effects of oral oxybutynin (OOx), and assess patients’ adherence to treatment. This prospective observational study was carried out with respect to the period 2007-2019. All patients diagnosed with HH of the scalp and/or face and who were treated with OOx at our HH unit were included in the study group. Of 292 patients treated with OOx, 97 (33.2%) had craniofacial HH. Of these, four (4.1%) presented HH exclusively on the scalp, 56 (57.7%) exclusively on the face and 37 (38.1%) in both locations. The patients in the latter category (compared to those with exclusively facial HH) were significantly older than the others, had a later onset of HH, a greater frequency of secondary HH, less simultaneous involvement of the classical areas of primary focal HH (the palms, soles and armpits) and greater generalised HH and of the trunk. No significant differences were observed between the three locations (face, scalp or both) regarding the efficacy and side effects of OOx. The patients with exclusively facial HH presented greater adherence to treatment. This article is protected by copyright. All rights reserved.

PMID: 33301207 [PubMed – as supplied by publisher]

November 28, 2020

Differences in subjective and objective evaluation of hyperhidrosis. Study among medical students.

Differences in subjective and objective evaluation of hyperhidrosis. Study among medical students.

Postepy Dermatol Alergol. 2020 Oct;37(5):700-704

Authors: Dobosz Ł, Stefaniak T, Halman J, Piekarska A

Abstract
Introduction: Hyperhidrosis is a condition that significantly impairs patients’ quality of life. Qualification for treatment in most cases is based only on subjective evaluation of symptoms without objective confirmation.
Aim: To evaluate the differences between subjective and objective evaluation of sweating among medical students.
Material and methods: There were 179 participants involved in the study. Subjective evaluation of sweating was conducted using the Hyperhidrosis Disease Severity Scale and Numeric Rating Scale in 4 body areas: the face, palms, armpits and abdomino-lumbar area. Objective evaluation of sweating was performed using gravimetry.
Results: The prevalence of hyperhidrosis in gravimetric measures was 1.12%. In subjective evaluation hyperhidrosis (HDSS 3 or 4) was present in 11.17% of cases. There was no significant difference in subjective evaluation of hyperhidrosis between men and women (15% vs. 9.24%; p = 0.32). In gravimetry men showed a higher perspiration rate on the face (5.85 vs. 3.38; p < 0.05) and in the armpits (17.27 vs. 9.12; p < 0.05). Individuals with body mass index ≥ 25 kg/m2 reported hyperhidrosis more often (28% vs. 8.44%; p < 0.05); however, in gravimetric evaluation, beside the facial area, no significant differences in above-mentioned groups were observed.
Conclusions: There is a discrepancy between subjective and objective methods of evaluating sweating.

PMID: 33240009 [PubMed]

October 20, 2020

Can we predict the compensatory hyperhidrosis following a thoracic sympathectomy?

Can we predict the compensatory hyperhidrosis following a thoracic sympathectomy?

Indian J Thorac Cardiovasc Surg. 2019 Apr;35(2):190-195

Authors: Kara M, Kose S, Cayirci CE, Koksal A

Abstract
Background: Primary hyperhidrosis is a functionally and socially disabling condition resulting in social embarrassment and low quality of life. Thoracic sympathectomy is a definitive choice of treatment with favorable results. However, patients may face another embarrassing condition following surgery as compensatory hyperhidrosis which has no definitive treatment. The predictors of compensatory hyperhidrosis are controversial and remain unclear.
Patients and methods: A total of 74 patients underwent a videothoracoscopic sympathectomy for primary hyperhidrosis. We statistically analyzed our patients with correlations and uni-multivariate logistic regression models to outline the possible predictors of compensatory hyperhidrosis.
Results: A total of 45 (60.8%) patients had compensatory hyperhidrosis. The correlations showed that patients, with age greater than 21 years (P = 0.018), with body mass index (BMI) greater than 22 kg / m2 (P = 0.045), with isolated facial hyperhidrosis (P = 0.044), and with smoking status (P = 0.015), had significantly greater rates of compensatory hyperhidrosis. Similarly, the significant univariate predictors of compensatory hyperhidrosis were age > 21 (P = 0.020), BMI > 22 kg / m2 (P = 0.048), and the presence of smoking status (P = 0.015). Multivariate analysis revealed only smoking as a predictor within the threshold of significance (P = 0.078).
Conclusion: The clinical predictors of compensatory hyperhidrosis following a thoracic sympathectomy appear as older age, greater body mass index, and smoking.

PMID: 33061004 [PubMed]

September 30, 2020

Oxybutynin in primary hyperhidrosis: a long-term real-life study.

Oxybutynin in primary hyperhidrosis: a long-term real-life study.

Dermatol Ther. 2020 Sep 27;:e14344

Authors: Almeida ART, Ferrari F, Restrepo MVS, Rocha VB

Abstract
Hyperhidrosis is a condition of excessive sweating beyond physiological parameters that can seriously impair quality of life. This study aims to evaluate the oral oxybutynin effectiveness in hyperhidrosis, besides its tolerance and safety. In a real-life long-term study, thirty patients with primary hyperhidrosis and Hyperhidrosis Disease Severity Scale (HDSS) with score of at least two were submitted to a questionnaire to assess demographic data, HDSS and side effects of oxybutynin. Most patients were women (n = 23, 76.7%), median age was 40y (range 12-70, SD 17.5) and 17(56.7%) had family history of hyperhidrosis. The most common hyperhidrosis form was axillary (n = 15, 50.0%), followed by palmoplantar (n = 8, 26.7%), cranio-facial (n = 11, 36.7%) and trunk (n = 5, 16.7%). Median duration of treatment was 2.4y (range 1-6y, SD 1.3). Thus, all patients used oxybutynin for at least one year, 30% for two years, 20% three years, 17% four years and 3% six years. There was a significant improvement in HDSS score of patients (P < 0.001). This real life study suggests that oxybutynin is effective and safe for treatment of hyperhidrosis, both in children and adults, with mild and tolerable side effects, with significant improvement in HDSS. This article is protected by copyright. All rights reserved.

PMID: 32981151 [PubMed – as supplied by publisher]

May 17, 2020

Topographic Computer Analysis for Acne Scar Treatment on Face accompanying Biopsy Study after Dermal Injection of Hydrotoxin Mixture

Abstract

Background
Acne during youth can leave permanent facial scarring. The depressed acne scars can be treated by injection of stabilized hyaluronic acid (S‐HA) into the dermis. Due to the large number of acne scars, manual injection methods are technically difficult, and bear high risk of lump formation in the dermis. Therefore, the author designed a specific injection method to solve the two abovementioned problems.

Materials/Methods
102 Patients who suffered from acne scars were treated with a mixture of S‐HA (Restylane Vital®) and abobotulinumtoxinA (Dysport®). Using an automatic injector, microdroplets of the mixture (0.001cc of S‐HA and 0.125 U abobotulinumtoxinA) were delivered into 1000 intradermal sites on whole face except eyelids. This instrument radically reduced injection amounts per site (0.001cc), lessened manual operator efforts, and ensured consistent injection depth (from 0.8mm to 1.2mm depending on individual dermal thickness) into the facial dermis. The changes in each depression site of acne scars were evaluated by topographical computer analysis (point‐roughness), based on the 40 magnification microscopic photos generated. Depth measurements of each small acne scar point were taken one by one at the exact same point before and after the treatments. Global Aesthetic Improvement Scale (GAIS) was measured for improvement of acne scars at 1 and 6 months post‐treatment. Additionally, serial histologic examinations of the biopsy specimens evaluated neocollagenesis, neoelastinogenesis, and longevity state of the S‐HA.

Results
78 patients showed improvements of depressed acne scars in physical examinations, medical photos, and dermascopic photos.
Using topographic computer analysis, the average point‐roughness decreased 27.48 % (at 1‐month) from 29.042±6.85 (baseline) to 21.05±6.30 µm (P

May 17, 2020

Long‐term results of the treatment of primary hyperhidrosis with oxybutynin: follow‐up of 1,658 cases

Abstract

Background
Hyperhidrosis (HH) is characterized by exaggerated sweating in a specific region due to hyperfunction of the sweat glands. In the late 2000s, we started treating patients with an anticholinergic, oxybutynin, that was not being used until then.

Objectives
To present, after 12 years of utilizing this medication in our service, the substantial experience obtained with the use of oxybutynin as an initial treatment of HH in a large series of 1,658 patients.

Methods
We analyzed 1,658 patients treated with oxybutynin for HH from May 2006 to June 2018. The patients were divided into four groups according to the main site of HH: the plantar group, the axillary group, the facial group, and the palmar group. To measure the degree of satisfaction, a quality of life (QoL) questionnaire was used.

Results
Pre‐treatment QoL was poor or very poor in more than 94% of the cases, and the palmar group had the worst quality of life. After treatment, we observed an improvement in the quality of life in 77% of patients. More than 70% of the patients in all groups present moderate or optimal subjective clinical improvement in sweating after treatment. The group with the best result was the facial group. Intense dry mouth was reported in 24.9% of all patients in all groups.

Conclusions
This study included a large number of patients followed for a long period and demonstrated the good effectiveness of treatment with oxybutynin for hyperhidrosis in the main sites of sweating.

April 19, 2020

Long-term results of the treatment of primary hyperhidrosis with oxybutynin: follow-up of 1,658 cases.

Long-term results of the treatment of primary hyperhidrosis with oxybutynin: follow-up of 1,658 cases.

Int J Dermatol. 2020 Apr 16;:

Authors: Wolosker N, Kauffman P, de Campos JRM, Faustino CB, da Silva MFA, Teivelis MP, Puech-Leão P

Abstract
BACKGROUND: Hyperhidrosis (HH) is characterized by exaggerated sweating in a specific region due to hyperfunction of the sweat glands. In the late 2000s, we started treating patients with an anticholinergic, oxybutynin, that was not being used until then.
OBJECTIVES: To present, after 12 years of utilizing this medication in our service, the substantial experience obtained with the use of oxybutynin as an initial treatment of HH in a large series of 1,658 patients.
METHODS: We analyzed 1,658 patients treated with oxybutynin for HH from May 2006 to June 2018. The patients were divided into four groups according to the main site of HH: the plantar group, the axillary group, the facial group, and the palmar group. To measure the degree of satisfaction, a quality of life (QoL) questionnaire was used.
RESULTS: Pre-treatment QoL was poor or very poor in more than 94% of the cases, and the palmar group had the worst quality of life. After treatment, we observed an improvement in the quality of life in 77% of patients. More than 70% of the patients in all groups present moderate or optimal subjective clinical improvement in sweating after treatment. The group with the best result was the facial group. Intense dry mouth was reported in 24.9% of all patients in all groups.
CONCLUSIONS: This study included a large number of patients followed for a long period and demonstrated the good effectiveness of treatment with oxybutynin for hyperhidrosis in the main sites of sweating.

PMID: 32301117 [PubMed – as supplied by publisher]