Category: Facial

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Hyperhidrosis – Sweating Sites Matter: Quality of Life in Primary Hyperhidrosis according to the Sweating Sites Measured by SF-36.

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Hyperhidrosis – Sweating Sites Matter: Quality of Life in Primary Hyperhidrosis according to the Sweating Sites Measured by SF-36.

Dermatology. 2017;233(6):441-445

Authors: Shayesteh A, Janlert U, Nylander E

Abstract
BACKGROUND: Primary hyperhidrosis has negative impacts on quality of life. The aim of this study was to investigate whether the impacts of primary hyperhidrosis on quality of life are different depending on the localisation of the sweating.
METHOD: We compiled background data, Hyperhidrosis Disease Severity Scale (HDSS), and Short-Form Health Survey (SF-36) post hoc results from 2 previous studies. Cases who described only 1 site as their most problematic area of sweating were included (n = 160/188) while individuals with multifocal primary sites of hyperhidrosis were excluded (n = 28/188).
RESULTS: Individuals included were 11-62 years old with a mean age of 30.2 ± 10.4 years, and axillary hyperhidrosis (65.6%) was the most common type of hyperhidrosis. Comorbidities were more common when hyperhidrosis was reported in other than the axillary, palmar, and plantar regions. Excluding comorbidities showed the lowest SF-36 mental component summary scores for axillary (41.6 ± 11.6), palmar (40.0 ± 9.4), and plantar hyperhidrosis (41.1 ± 13.7). The HDSS showed the highest proportion of severe cases in axillary (60.6%) and palmar (51.5%) hyperhidrosis (p < 0.01) while mild cases were more often observed in plantar (60%), facial (83.3%), and other sites (85.7%) in primary hyperhidrosis (p < 0.01).
CONCLUSION: Our results indicate that impairments in quality of life can be different depending on the manifestation of primary hyperhidrosis on the body. This can have an influence on how patients with hyperhidrosis could be prioritised in health care. Subgroup samples affected by facial hyperhidrosis and other sites of primary hyperhidrosis were however small, and more research is required to verify our findings.

PMID: 29502112 [PubMed – indexed for MEDLINE]

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Epidemiologic analysis of prevalence of the hyperhidrosis.

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Epidemiologic analysis of prevalence of the hyperhidrosis.

An Bras Dermatol. 2017 Sep-Oct;92(5):630-634

Authors: Estevan FA, Wolosker MB, Wolosker N, Puech-Leão P

Abstract
BACKGROUND: The present paper aims to study the prevalence of the various manifestations of hyperhidrosis in patients who sought treatment in a specialized ambulatory in the state of São Paulo.
OBJECTIVES: Opposite to previous studies, this paper studies the different combinations of sweating sites, not being restricted to the main complaint site of the patients, but taking into consideration secondary complaints patients may present.
METHODS: This was a retrospective approach of a database containing more than 1200 patients in which were mapped: combination of sweating sites, age of onset, age spectrum, mean age, body mass index and gender of patients. Patients were categorized into four groups based on their main sweating site – palmar, plantar, axillary and facial.
RESULTS: We concluded that hyperhidrosis appears frequently in more than one site, being the main complaint that affects the most patients palmar hyperhidrosis, which appears early in the patients during adolescence. When there are two sites of sweating, the most frequent combination is palmar + plantar, and when there are three sites of sweating the most frequent combinations are palmar + plantar + axillary and axillary + palmar + plantar.
STUDY LIMITATIONS: This research has casuistics limited to a single care service for patients with hyperhidrosis.
CONCLUSION: It is necessary to keep in mind that the disease manifests itself mainly in more than one location, with different intensities in each of the patients, generating a significant impairment of their quality of life.

PMID: 29166497 [PubMed – indexed for MEDLINE]

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Plantar Sweating as an Indicator of Lower Risk of Compensatory Sweating after Thoracic Sympathectomy.

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Plantar Sweating as an Indicator of Lower Risk of Compensatory Sweating after Thoracic Sympathectomy.

Thorac Cardiovasc Surg. 2017 Sep;65(6):479-483

Authors: Kargi AB

Abstract
Background Hyperhidrosis is a dysfunction of the autonomic nervous system that results in regional excessive sweating, mostly in the hands, armpits, and feet. A permanent and effective treatment of hyperhidrosis can be achieved by interruption of the thoracic sympathetic chain with endoscopic thoracic sympathectomy (ETS). However, some side effects, particularly compensatory sweating (CS), are the limitations of this procedure. The mechanism of CS and the associated risk factors are still controversial. The aim of this retrospective study was to determine the relationship with various parameters associated with CS in patients undergoing ETS. Materials and Methods ETS was performed on a total of 95 patients for palmar hyperhidrosis, axillary hyperhidrosis and facial blushing by the same surgeon. The mean age of the patients was 26.41 (± 7) years, and 54 (56.8%) were males. Palmar hyperhidrosis was present in 54 (56.8%) patients, axillary hyperhidrosis in 33 (34.7%) patients, and facial blushing in 8 (8.5%) patients. Moreover, 38 (40%) patients also had plantar sweating. The severity of CS was rated into three scales as less, moderate, and severe. Results Regarding the severity of CS, 55 (57.9%) patients had no or less CS, 28 (29.5%) had moderate CS, and 12 (12.6%) patients had severe CS. Higher age group had a significant increased risk of severe CS (p = 0.03) (r = 0.262). Patients with body mass index (BMI) > 25 kg/m2 had a statistically significantly increased risk of severe CS (p = 0.016). Facial blushing resulted in severe CS in a significantly higher proportion of patients than by palmar and axillary hyperhidrosis (p = 0.001). The level of surgery was another important risk factor for CS, with the T2 level showing an increased risk of severe CS compared with T3 level (p < 0.001). Furthermore, plantar sweating was inversely and significantly related to the development of CS. Patients with plantar sweating had a significantly decreased incidence of developing CS (p = 0.015). Conclusion CS after thoracic sympathectomy for primary hyperhidrosis is the most displeasing and restrictive side effect. This study demonstrates that older age, operation level, facial blushing, and high BMI are risk factors for CS, as have been shown in several similar studies. An interesting finding of the present study is that there was a decreased incidence of CS among patients with plantar sweating. This situation may help us to distinguish high risk for CS before ETS operation.

PMID: 27043786 [PubMed – indexed for MEDLINE]

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Gravimetry in sweating assessment in primary hyperhidrosis and healthy individuals.

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Gravimetry in sweating assessment in primary hyperhidrosis and healthy individuals.

Clin Auton Res. 2013 Aug;23(4):197-200

Authors: Stefaniak TJ, Proczko M

Abstract
OBJECTIVE: Though hyperhidrosis is generally considered a subjectively perceived disease, it seems more and more doubtful that merely subjective evaluation is sufficient to qualify the patient to surgery. The aim of this study was to develop further gravimetry as a method of evaluation of sweating intensity and determination of the applicability of it in post-operative follow-up of primary hyperhidrosis (PHH) patients.
METHODS: Total of 1,485 gravimetry assays has been performed in 343 patients treated for hyperhidrosis and in 220 healthy volunteers. In all of the subjects the measurements were taken from four localizations (face, hands, armpits and trunk) and normalized by body surface of the participant. The measurements were taken twice for every participant to obtain test-retest correlations. Mean values and standard deviations (SD) have been evaluated and on that basis reference values were quantified. Thresholds for diagnosis of hyperhidrosis were quantified on the basis of normal distribution theory as healthy population mean +2 SD.
RESULTS: In healthy volunteers, mean value of gravimetrically evaluated intensity of sweating were: facial: 19.15 ± 14.97 mg/min/m(2), palmar: 18.49 ± 14.06 mg/min/m(2), axillary: 42.39 ± 47.08 mg/min/m(2) and plantar: 15.77 ± 16.87 mg/min/m(2). Thresholds for diagnosis of hyperhidrosis were quantified, respectively as: 49, 46, 136 and 50 mg/min/m(2). The overall test-retest correlation was 0.71.
INTERPRETATION: Gravimetry is easy, reproducible and fast method of evaluation of sweating. The reference values are stable and can serve as a qualifying and follow-up tool for evaluation of the patients with PHH in any localization.

PMID: 23761115 [PubMed – indexed for MEDLINE]

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[Botulinum toxin type A for the treatment of primary hyperhidrosis: a prospective study of 52 patients].

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[Botulinum toxin type A for the treatment of primary hyperhidrosis: a prospective study of 52 patients].

Actas Dermosifiliogr. 2010 Sep;101(7):614-21

Authors: Martí N, Ramón D, Gámez L, Reig I, García-Pérez MA, Alonso V, Jordá E

Abstract
BACKGROUND AND OBJECTIVES: Primary hyperhidrosis is characterized by excessive sweating in a defined region of the body. It should not be considered a purely cosmetic problem as it has a significant impact on the social and professional relationships of affected individuals. The aim of this study was to determine the clinical profile of patients with primary hyperhidrosis and assess the results obtained with the use of botulinum toxin type A (BTX-A) in clinical practice.
MATERIAL AND METHODS: The study included 52 patients (39 women and 13 men) with a diagnosis of primary hyperhidrosis treated for the first time with BTX-A. All patients completed a questionnaire that included the following information: age; sex; profession; age at onset, family history, and site of hyperhidrosis; accompanying signs and symptoms, and previous treatment; time to effect of BTX-A; local or systemic side effects; and severity of hyperhidrosis before and after BTX-A treatment.
RESULTS AND CONCLUSIONS: Primary hyperhidrosis began during puberty in 61.5% of the patients included in the study, 75% were women, and the mean age was 29.9 years. In 36.5% of patients, first-degree relatives also had primary hyperhidrosis. Hyperhidrosis was classified as palmar in 61.5% of cases, plantar in 53.8%, and axillary in 59.6%. Other sites were affected less frequently. The most common accompanying symptoms were facial erythema (32.7%), palpitations (30.7%), muscle tension (28.8%), shivering (23%), and headache (17.3%). Treatment with BTX-A was well tolerated and there was a highly significant reduction in the severity of hyperhidrosis 2 months after performing the treatment (P<0.001).

PMID: 20858387 [PubMed – indexed for MEDLINE]

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Botulinum Toxin Type A for the Treatment of Primary Hyperhidrosis: A Prospective Study of 52 Patients.

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Botulinum Toxin Type A for the Treatment of Primary Hyperhidrosis: A Prospective Study of 52 Patients.

Actas Dermosifiliogr. 2010 Sep;101(7):614-621

Authors: Martí N, Ramón D, Gámez L, Reig I, García-Pérez MÁ, Alonso V, Jordá E

Abstract
BACKGROUND AND OBJECTIVES: Primary hyperhidrosis is characterized by excessive sweating in a defined region of the body. It should not be considered a purely cosmetic problem as it has a significant impact on the social and professional relationships of affected individuals. The aim of this study was to determine the clinical profile of patients with primary hyperhidrosis and assess the results obtained with the use of botulinum toxin type A (BTX-A) in clinical practice.
MATERIAL AND METHODS: The study included 52 patients (39 women and 13 men) with a diagnosis of primary hyperhidrosis treated for the first time with BTX-A. All patients completed a questionnaire that included the following information: age; sex; profession; age at onset, family history, and site of hyperhidrosis; accompanying signs and symptoms, and previous treatment; time to effect of BTX-A; local or systemic side effects; and severity of hyperhidrosis before and after BTX-A treatment.
RESULTS AND CONCLUSIONS: Primary hyperhidrosis began during puberty in 61.5% of the patients included in the study, 75% were women, and the mean age was 29.9 years. In 36.5% of patients, first-degree relatives also had primary hyperhidrosis. Hyperhidrosis was classified as palmar in 61.5% of cases, plantar in 53.8%, and axillary in 59.6%. Other sites were affected less frequently. The most common accompanying symptoms were facial erythema (32.7%), palpitations (30.7%), muscle tension (28.8%), shivering (23%), and headache (17.3%). Treatment with BTX-A was well tolerated and there was a highly significant reduction in the severity of hyperhidrosis 2 months after performing the treatment (P<0.001).

PMID: 28709543 [PubMed]