A collection of the latest publications on hyperhidrosis
J Drugs Dermatol. 2021 Dec 1;20(12):1359-1360. doi: 10.36849/jdd.5755.
ABSTRACT
Diabetic gustatory hyperhidrosis is a late sequela of diabetes and can have profound consequences. We report a case of diabetic gustatory hyperhidrosis controlled with topical aluminum chloride hexahydrate and support this as a first-line treatment. Aluminum chloride hexahydrate is a safe, effective, inexpensive and commercially available treatment.
PMID:34898156 | DOI:10.36849/jdd.5755
Expert Opin Investig Drugs. 2021 Dec 10. doi: 10.1080/13543784.2022.2017880. Online ahead of print.
ABSTRACT
INTRODUCTION: In the last years, increased knowledge about pathophysiology of primary hyperhidrosis has led to novel therapeutic advances. Topical and systemic anticholinergic agents have been proven beneficial in reducing sweat production in primary axillary hyperhidrosis (PAH), although their use is limited by the increased likelihood of systemic anticholinergic drug reactions, particularly regarding the systemic agents.
AREAS COVERED: This paper provides an overview of pharmaceutical characteristics, efficacy and safety data from phase II and III clinical trials on sofpironium bromide (SB), a topical anticholinergic agent which has been employed for the treatment of PAH and has already received its first approval in Japan for the treatment of PAH in the form of 5% gel formulation.
EXPERT OPINION: The retrometabolic drug design of topical SB presents distinct advantages, by limiting systemic absorption and therefore development of anticholinergic adverse events. This along with the popularity of the non-greasy gel formulation is expected to increase compliance. However, this therapy still offers a temporary control of PAH, compared to sympathectomy or device-based treatments, such as microwave thermolysis. Hence, physicians should balance the effectiveness against adverse events of each therapeutic modality and use a personalized approach based on patient’s needs.
PMID:34890517 | DOI:10.1080/13543784.2022.2017880
Kyobu Geka. 2021 Dec;74(13):1086-1090.
ABSTRACT
A 66-year-old man visited our department because of palmar hyperhidrosis. Computed tomography had revealed division of the right upper lobe by a fissure and the azygos vein, and the presence of an azygos lobe had been diagnosed. Endoscopic thoracic sympathectomy (resection of T3 ganglion) was performed. Adhesion between the azygos lobe and parietal pleura was dissected to pulling out the azygos lobe and the sympathectomy was safely performed.
PMID:34876538
Indian J Dermatol Venereol Leprol. 2021 Nov 20:1-2. doi: 10.25259/IJDVL_132_2021. Online ahead of print.
NO ABSTRACT
PMID:34877842 | DOI:10.25259/IJDVL_132_2021
Am J Cardiovasc Dis. 2021 Oct 25;11(5):635-641. eCollection 2021.
ABSTRACT
Profuse sweating is a symptom often reported by cardiological patients and could be also an early phenomenon of adaptation or rather cardiac maladaptation in the context of incipient heart failure (HF). By definition, in HF patients the low cardiac output causing reduced renal blood supply and reduced pressure in the arterial baroreceptors activate compensatory mechanisms such as the RAAS and the adrenergic autonomic nervous system. The retention of fluids caused by the decompensation of heart-kidney system could generate a reactive hyperhidrosis and even anticipate an incipient decompensation and might prevent manifest volume overload. Moreover, in HF patients the overactive sympathetic nervous system generates an increase in the reabsorption of fluids in the kidney, on the other hand it generates a signaling to the sweat glands to induce a dispersion of fluids, with loss of sodium and chlorine at the glandular ductal level. Finally sweat gland production physiology during physical activity is also altered in HF patients. This review is focused on sweating and its pathophysiological role in heart failure. Although all the mechanisms underlying this phenomenon are not fully understood, there are interesting connections that might explain this fluid elimination as a wise and sophisticated way to prevent incipient heart failure crisis. Future research could be focused on studying new drugs that selectively would be able to promote fluid elimination by this specific way in patients suffering from heart failure.
PMID:34849296 | PMC:PMC8611272
J Pediatr Surg. 2021 Oct 30:S0022-3468(21)00747-8. doi: 10.1016/j.jpedsurg.2021.10.036. Online ahead of print.
ABSTRACT
INTRODUCTION: Compensatory sweating (CS) is a common complication after thoracoscopic sympathectomy (TS) and is mainly associated with surgical technique. Our aim was to identify potential risk-factors for CS following TS for primary focal hyperhidrosis in children.
METHODS: A retrospective, single-center review of all bilateral TS was performed between 2017 and 2019. Hyperhidrosis disease severity scale was used for pre-operative severity assessment. Post-operative evaluations were performed after three and six months.
RESULTS: More than the 36-month period, 41 patients were submitted to T2-T4 TS, and 25 were females (60.9%). Median age at surgery was 15.5 years. CS was identified at the 3rd month in 17 (41%) children with most in the dorsolumbar region (56%). By the 6th month, there was a significant reduction in CS (41 to 32%, p = 0.02). The probability of resolution of CS by 6 months is about 50% in both the dorsolumbar and abdominal regions. Neither age, gender, body mass index, family history, or concomitant illnesses seemed to influence CS (p > 0.05). Axillary hyperhidrosis appears to be associated with the development of dorsolumbar CS (p = 0.037).
CONCLUSION: Thoracoscopic sympathectomy for PFH is a safe and effective procedure, but compensatory sweating can be a common and debilitating side effect. Age, gender, and body mass index do not appear to influence CS. Axillary hyperhidrosis may be related to the development of dorsolumbar CS.
LEVEL OF EVIDENCE: III.
PMID:34815104 | DOI:10.1016/j.jpedsurg.2021.10.036
Dermatol Surg. 2021 Dec 1;47(12):1572. doi: 10.1097/DSS.0000000000003258.
NO ABSTRACT
PMID:34818272 | DOI:10.1097/DSS.0000000000003258
Dermatol Surg. 2021 Dec 1;47(12):1666-1669. doi: 10.1097/DSS.0000000000003253.
NO ABSTRACT
PMID:34818280 | DOI:10.1097/DSS.0000000000003253
Dermatol Ther. 2021 Nov 19:e15210. doi: 10.1111/dth.15210. Online ahead of print.
ABSTRACT
BACKGROUND: Hyperhidrosis impairs quality of life (QOL) in hidradenitis suppurativa (HS) patients and may exacerbate HS. However, there is limited literature on whether hyperhidrosis treatments improve HS disease.
OBJECTIVE: To systematically review literature on efficacy and tolerability of hyperhidrosis treatments in HS patients.
METHODS: In May 2021, MEDLINE and EMBASE databases were systematically searched by two reviewers per PRISMA guidelines for articles on hyperhidrosis and HS.
RESULTS: Sixteen articles met inclusion criteria (2 randomized controlled trials (RCTs), 1 case-control study, 3 cross-sectional studies, 10 case-studies/series), encompassing 252 HS patients across studies. They examined botulinum toxin A (BTX-A) (n=6) and B (BTX-B) (n=1), suction-curettage (n=1), diode laser (n=1), and microwave-based energy device (MED) (n=3). Overall, BTX treatments improve HS severity, QOL, hyperhidrosis, and were well-tolerated. Suction-curettage did not improve disease. One HS patient tolerated diode laser well, with improvement in sweating and HS. One RCT studying MED was discontinued due to adverse events. Two studies reported MED-induced HS.
CONCLUSIONS: BTX was overall helpful in HS patients, including in patients without concomitant hyperhidrosis. However, more prospective studies are needed to examine its utility in HS. There is potential harm of MEDs in HS. Most studies examining hyperhidrosis treatments in HS patients are low level of evidence. Larger RCTs should examine the efficacy and tolerability of hyperhidrosis treatments in HS.
PMID:34796606 | DOI:10.1111/dth.15210
JAAD Case Rep. 2021 Oct 8;18:15-16. doi: 10.1016/j.jdcr.2021.09.039. eCollection 2021 Dec.
NO ABSTRACT
PMID:34778499 | PMC:PMC8577431 | DOI:10.1016/j.jdcr.2021.09.039