Category: Hyperhidrosis

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Postmenopausal craniofacial hyperhidrosis treated with botulinum toxin type B.

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Postmenopausal craniofacial hyperhidrosis treated with botulinum toxin type B.

J Dermatol. 2019 Aug 02;:

Authors: Cabreus P, Swartling C, Rystedt A

Abstract
Hyperhidrosis can seriously impair patients’ quality of life. Medical history, including heredity and hyperhidrosis during youth, as well as current age and time elapsed since menopause, is important to consider when distinguishing between postmenopausal hyperhidrosis and vasomotor symptoms to enable adequate treatment. This report concerns a subgroup of eight postmenopausal patients participating in a randomized controlled trial regarding botulinum toxin (Btx) type B treatment in craniofacial hyperhidrosis. Even though the sample size is small and the enrolment is not yet completed, the promising data collected hitherto are interesting to present in advance because this subtype of craniofacial hyperhidrosis is often underrecognized and challenging to treat. Patients were randomized to receive Btx type B or placebo. Measurements were performed before treatment and 3 ± 1 weeks after. The Dermatology Life Quality Index (DLQI) score was improved for all patients after Btx type B treatment (n = 3) with a median decrease of 9 points (90% median improvement). The placebo group (n = 5) had a median increase of 2 points (-18% median decline). When the same group (n = 5) received Btx type B (open) the DLQI score decreased with a median of 7 points compared with baseline (91% median improvement). Treatment-related adverse events were temporary and did not prevent improvement of life quality. Furthermore, background data evaluation uncovered interesting findings regarding vasomotor symptoms in relation to postmenopausal hyperhidrosis. In conclusion, the results indicated that Btx type B seems to be a safe and effective treatment in postmenopausal craniofacial hyperhidrosis. Further research is encouraged.

PMID: 31373068 [PubMed – as supplied by publisher]

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Erratum: Zur E. Topical Treatment of Primary Focal Hyperhidrosis, Part 2. IJPC 2019; 23(2):94-104.

Erratum: Zur E. Topical Treatment of Primary Focal Hyperhidrosis, Part 2. IJPC 2019; 23(2):94-104.

Int J Pharm Compd. 2019 Jul-Aug;23(4):351

Authors: IJPC Staff

Abstract
The METHOD OF PREPARATION in the formulation titled Compounded Oxybutynin Chloride 10% Topical Gel on page 102 in the article titled Topical Treatment of Primary Focal Hyperhidrosis, Part 2. IJPC. 2019; 23(2): 94-104 was published incorrectly. Please replace that information with the data provided herein.

PMID: 31315087 [PubMed – in process]

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Ipsilateral Hyperhidrosis: Atypical Symptom of Small Lung Adenocarcinoma Evaluated by 18F-FDG PET-CT.

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Ipsilateral Hyperhidrosis: Atypical Symptom of Small Lung Adenocarcinoma Evaluated by 18F-FDG PET-CT.

Nucl Med Mol Imaging. 2019 Jun;53(3):231-234

Authors: Yoo MY, Koong SS, Kim SW, Kim D

Abstract
A 45-year-old male visited our clinic due to right palmar anhidrosis and contralateral hyperhidrosis. Chest computed tomography (CT) showed a solitary pulmonary nodule with mediastinal lymph node enlargement, but a cause for atypical palmar anhidrosis was not identified. Subsequent fluorine-18-fluorodeoxyglucose (18F-FDG) positron emission tomography/computed (PET/CT) revealed a localized pleural metastasis at the right apex with direct invasion of the paravertebral sympathetic chain. The pleural metastasis, which was not seen on chest CT, evoked ipsilateral anhidrosis independent of a mass effect or direct invasion by the primary lung tumor. 18F-FDG PET/CT can be helpful in identifying the cause of atypical symptoms in patient with small sized lung cancer.

PMID: 31231444 [PubMed]

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Safety and efficacy of topical formulations containing 0.5, 1 and 2% glycopyrronium bromide in patients with primary axillary hyperhidrosis: a randomised, double-blind, placebo-controlled study.

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Safety and efficacy of topical formulations containing 0.5, 1 and 2% glycopyrronium bromide in patients with primary axillary hyperhidrosis: a randomised, double-blind, placebo-controlled study.

Br J Dermatol. 2019 Jun 19;:

Authors: Masur C, Soeberdt M, Kilic A, Knie U, Abels C

Abstract
primary hyperhidrosis (HH), a dysregulation of the parasympathetic nerve system, is characterized by focal symmetrical sweating of axillae, palms or the plantar region.1 Hyperhidrosis is a chronic condition with severe impact on patients’ quality of life, however, more than 50% of hyperhidrosis patients receive no treatment.1,2 Overall prevalence was reported to be 16% in German adults, with axillary hyperhidrosis being the most common form of HH.2 The objective of this study was to assess safety and tolerability, efficacy and pharmacokinetics, of escalating concentrations of glycopyrronium bromide (GPB), a competitive antagonist of muscarinic acetylcholine receptor mAChR, in subjects with axillary hyperhidrosis. This article is protected by copyright. All rights reserved.

PMID: 31218668 [PubMed – as supplied by publisher]

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A 44-Week Open-Label Study Evaluating Safety and Efficacy of Topical Glycopyrronium Tosylate in Patients with Primary Axillary Hyperhidrosis.

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A 44-Week Open-Label Study Evaluating Safety and Efficacy of Topical Glycopyrronium Tosylate in Patients with Primary Axillary Hyperhidrosis.

Am J Clin Dermatol. 2019 May 20;:

Authors: Glaser DA, Hebert AA, Nast A, Werschler WP, Green L, Mamelok RD, Quiring J, Drew J, Pariser DM

Abstract
BACKGROUND: Glycopyrronium tosylate is a topical anticholinergic approved in the USA for primary axillary hyperhidrosis in patients aged ≥ 9 years (Qbrexza™ [glycopyrronium] cloth, 2.4%).
OBJECTIVE: This 44-week open-label extension study assessed glycopyrronium tosylate safety and descriptive efficacy in patients completing one of two, phase III, double-blind, vehicle-controlled, 4-week trials (NCT02530281; NCT02530294).
METHODS: Patients aged ≥ 9 years with primary axillary hyperhidrosis were randomized 2:1 (glycopyrronium tosylate: vehicle, once daily) in the double-blind trials. Completers could receive open-label glycopyrronium tosylate for up to an additional 44 weeks. Treatment-emergent adverse events and local skin reactions were assessed. Descriptive efficacy assessments were gravimetrically measured sweat production, Hyperhidrosis Disease Severity Scale responder rate (≥ 2 grade improvement), and Dermatology Life Quality Index/children’s Dermatology Life Quality Index.
RESULTS: Of 651 patients completing the double-blind trials, 564 (86.6%) entered the open-label extension; 550 were analyzed. Most patients experiencing treatment-emergent adverse events had mild or moderate events (> 90%). Discontinuation because of treatment-emergent adverse events remained low and relatively stable, with a cumulative rate of 8.0% (44/550) over 44 weeks. Common treatment-emergent adverse events (> 5%) were dry mouth (16.9%), vision blurred (6.7%), application-site pain (6.4%), nasopharyngitis (5.8%), and mydriasis (5.3%). Most patients (67.5%) had no local skin reactions; those occurring were predominantly mild/moderate. Glycopyrronium tosylate efficacy was maintained throughout the trial; at week 44, the Hyperhidrosis Disease Severity Scale responder rate was 63.2%, and improvements from baseline (double blind) in sweat production were - 71.3% and 8.7 ± 6.2/6.2 ± 4.9 for Dermatology Life Quality Index/children’s Dermatology Life Quality Index.
CONCLUSIONS: Daily long-term application of glycopyrronium tosylate for up to 48 weeks (double blind plus open label) was generally well tolerated and efficacy was maintained. No new safety signals emerged.
TRIAL REGISTRY: Clinicaltrials.gov NCT02553798.

PMID: 31111409 [PubMed – as supplied by publisher]

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[A retrospective study on the quality of life of patients with primary focal hyperhidrosis that underwent a video-assisted thoracoscopic sympathectomy].

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[A retrospective study on the quality of life of patients with primary focal hyperhidrosis that underwent a video-assisted thoracoscopic sympathectomy].

Rev Port Cir Cardiotorac Vasc. 2019 Jan-Mar;26(1):31-35

Authors: Teixeira J, Moreira R, Vieira M, Miranda JA, Mota JC

Abstract
Backgroud: Primary focal hyperhidrosis affects between 1 to 4% of the general population, with a higher prevalence in teenagers and young adults. The condition is characterized by excessive sweating in 1 or more body part, most often the palms, face, armpits and soles. This condition causes a significant negative impact on patient’s quality of life. The pathophysiology of focal hyperhidrosis is believed to be due to excessive sympathetic stimulation, and videothoracoscopic sympathectomy is a recognized form of treatment. The aim of this study is to evaluate the post-operative quality of life of patients who underwent thoracoscopic sympathectomy.
MATERIALS AND METHODS: This is a retrospective study of fifty-four patients with primary focal hyperhidrosis submitted to bilateral thoracoscopic thoracic sympathectomy at the Center of Cardiothoracic Surgery of Casa de Saúde da Boavista, between January 2011 and December 2014. The Quality of Life questionnaire and the Hyperhidrosis Severity Scale questionnaire were used to evaluate the quality of life in the pre-operative period and 3 months after surgery. Further to this, data was collected regarding medium-term follow-up by telephone. All patients underwent general anesthesia and had bilateral video-assisted thoracoscopic resection of the sympathetic chain.
RESULTS: The majority of patients are females 59.3% (32). The mean age is 30.8 ± 7.70 (between 16 and 49 years). Prior to surgery, 85% of the patients had severe hyperhidrosis. 79.6% of respondents stated that general discomfort was promoted by the condition, with the Funcional-Social domain being the most affected aspect of their life (61.1%). The rates of peri-operative complications and major post-operative complications were null, and minor complications were 5.5%. After 3 months, improvement in patient’s quality of life and satisfaction level were of 100% and 96.3% respectively, however compensatory hyperhidrosis was observed in 53.7% of patients. 57.3% of the patients reported significant improvements in the Funcional-Social domain. Medium-term follow-up (mean=6 years) allowed for the evaluation of 31 patients (57.4% of the population), of whom 77.4% maintained compensatory hyperhidrosis. 93.5% reported to be highly satisfied with the surgical results and claimed to have improved their quality of life by 93.5%. 94% and 94.4% respectively of the patients evaluated in the medium term follow-up and after 3 months and in the medium term follow-up, recommend the surgery.
CONCLUSION: Sympathectomy by video-assisted thoracoscopic surgery (VATS) is an effective and viable therapeutic option for primary focal hyperhidrosis patients. Despite compensatory hyperhidrosis being observed at time, this procedure produces very satisfactory results particularly in regard to the patient’s post-operative quality of life.

PMID: 31104374 [PubMed – in process]

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Topical Treatment of Primary Focal Hyperhidrosis, Part 2.

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Topical Treatment of Primary Focal Hyperhidrosis, Part 2.

Int J Pharm Compd. 2019 Mar-Apr;23(2):94-104

Authors: Zur E

Abstract
This represents part 2 of a 2-part article on the topic of primary focal hyperhidrosis. Part 1, which was published in the International Journal of Pharmaceutical Compounding’s January/February 2019 issue, provided a comprehensive review of the active pharmaceutical ingredients aluminum salts and methenamine in the treatment of primary focal hyperhidrosis. Part 2 provides a comprehensive review of the active pharmaceutical ingredients glycopyrronium salts and oxybutynin chloride in the treatment of primary focal hyperhidrosis.

PMID: 31085774 [PubMed – in process]