Category: Hyperhidrosis

Posted on

Is There a Risk of Recurrence That Would Discourage Sympathicotomy for Hyperhidrosis in Minors?

J Clin Med. 2025 Nov 19;14(22):8194. doi: 10.3390/jcm14228194.

ABSTRACT

Background/Objectives: Primary palmar hyperhidrosis (PPH) is a socially debilitating condition that often begins in adolescence. Although sympathicotomy is a low-risk procedure, there are conflicting opinions about the optimal time for surgery: some recommend it at onset in adolescence, while others are cautious because of the risk of recurrence associated with juvenile neuroplasticity. The primary objective was to assess the recurrence rate; secondary objectives included the management of hyperhidrosis, compensatory sweating onset, and satisfaction. Methods: This retrospective cohort study included sympathicotomy procedures for palmar hyperhidrosis performed between 2004 and 2024 in patients younger than 18 years with a preoperative Hyperhidrosis Disease Severity Scale (HDSS) class of 4. Quantitative data are presented as medians and interquartile ranges, while categorical data are presented as numbers and percentages. Results: 28 patients were included, of whom 4 underwent single-stage surgery and 24 two-stage surgery. The median age was 17.30 years, with no gender predominance. At a median follow-up of 75 months, the recurrence rate was 10.71%. Twenty-two patients experienced compensatory sweating, with the majority (60.7%) reporting mild symptoms and the remainder reporting moderate. The median patient satisfaction score was 9.34 (range 9-10). Conclusions: Even though PPH typically begins during adolescence, there is no consensus on the appropriateness of sympathicotomy for younger patients, primarily due to concerns about recurrence. Our data, characterized by long-term follow-up and large numbers of minors, are consistent with those observed in adults’ cohorts in terms of hyperhidrosis management, compensatory sweating rates, and, particularly, recurrence rates, supporting the surgical approach even at a young age.

PMID:41303230 | DOI:10.3390/jcm14228194

Posted on

Can large language models respond health education questions for patients with palmar hyperhidrosis? A comparative study of ChatGPT and DeepSeek

Digit Health. 2025 Nov 13;11:20552076251396576. doi: 10.1177/20552076251396576. eCollection 2025 Jan-Dec.

ABSTRACT

OBJECTIVE: To compare the adaptability of two large language models: ChatGPT and DeepSeek in responding to health education questions related to patients with palmar hyperhidrosis.

METHODS: Based on clinical guidelines and expert experience, 17 health education questions relevant to palmar hyperhidrosis were developed and posed separately to ChatGPT and DeepSeek. Twelve experienced thoracic surgery experts independently evaluated the adaptability of the responses generated by both models. Each response was rated using a five-point Likert scale to quantitatively analyze the adaptability of the information provided.

RESULTS: Both language models demonstrated good adaptability in addressing health education questions related to palmar hyperhidrosis. In the English context, 10 responses of ChatGPT received a full score (5 points) from more than 50% of experts, while DeepSeek did so for 8. In the Chinese context, both ChatGPT and DeepSeek receive 10 responses a full score (5 points) from more than 50% of experts. ChatGPT outperformed DeepSeek in the English-language setting, whereas DeepSeek showed superior overall performance in the Chinese context.

CONCLUSION: This preliminary study demonstrates that both ChatGPT and DeepSeek are capable of effectively addressing health education questions for patients with palmar hyperhidrosis. ChatGPT performs better in English-language setting, while DeepSeek shows greater adaptability in Chinese-language context. However, human review remains essential to ensure the accuracy and reliability of the provided information in practical applications.

PMID:41246197 | PMC:PMC12615908 | DOI:10.1177/20552076251396576

Posted on

Scar-concealed 2 + 3 mm dual-port thoracoscopic sympathectomy for palmar hyperhidrosis: single-center outcomes

Front Surg. 2025 Oct 24;12:1664901. doi: 10.3389/fsurg.2025.1664901. eCollection 2025.

ABSTRACT

OBJECTIVE: To minimize the trauma and incision of the operation for primary palmar hyperhidrosis (PPH), we have designed a inconspicuous scar thoracoscopic bilateral thoracic sympathetic chain transection via “2 + 3 mm” two-pinhole incisions (ISTTST). This study mainly retrospectively compares and analyzes the pros and cons of this surgical method vs. the conventional single-port thoracoscopic sympathetic nerve transection (CSTTST).

METHODS: Data of patients with moderate or severe PPH and underwent thoracic sympathetic chain transection were collected. Patients undergoing ISTTST and those receiving CSTTST were included in the two-pinhole group and the single-port group respectively. The baseline characteristics, intraoperative and postoperative conditions of the two groups were compared.

RESULTS: A total of 265 patients were enrolled, including 162 in the single-port group and 103 in the two-pinhole group. There were no statistically significant differences in baseline conditions such as gender, age, BMI, age of onset of PPH, hyperhidrosis sites, hyperhidrosis degree, and transection level of thoracic sympathetic chain between the two groups (P > 0.05). The two-pinhole group had shorter operation time (19.809 ± 3.356 min vs. 22.534 ± 4.541 min), lower postoperative incision pain score (1.563 ± 0.518 vs. 2.012 ± 0.788), and better incision satisfaction (9.437 ± 0.498 vs. 8.068 ± 1.424) (all P < 0.001). There were no statistically significant differences in postoperative conditions such as surgical effect, 24-h postoperative discharge rate, postoperative complication rate, postoperative compensatory hyperhidrosis, postoperative recurrence rate of PPH, and postoperative follow-up time between the two groups (P > 0.05).

CONCLUSION: The ISTTST is a more concealed-scar, minimally invasive, and convenient procedure, meeting the aesthetic needs. Compared with the CSTTST, it has certain advantages and deserves more attention and attempts.

PMID:41209064 | PMC:PMC12592174 | DOI:10.3389/fsurg.2025.1664901

Posted on

Altered Th17/Treg balance and therapeutic targeting of RORgamma in primary focal hyperhidrosis

Front Immunol. 2025 Oct 17;16:1656632. doi: 10.3389/fimmu.2025.1656632. eCollection 2025.

ABSTRACT

BACKGROUND: Primary focal hyperhidrosis (PFH) significantly impacts patients’ physical and mental health, yet its underlying mechanisms remain unclear.

METHODS: This study involved 80 healthy controls and 60 patients each with primary palmar (PPH), craniofacial (PCH), or axillary hyperhidrosis (PAH). Peripheral blood mononuclear cells (PBMCs) were analyzed via flow cytometry to assess Th17 and Treg cell populations. Cytokine levels were measured in patient serum using ELISA, while sweat gland tissue from PAH patients underwent gene expression analysis. A pilocarpine-induced mouse model of hyperhidrosis was used to test SR2211, a RORγ inverse agonist.

RESULTS: PFH patients exhibited a disrupted Th17/Treg balance, with increased Th17 and decreased Treg cells across all subtypes compared to controls. Elevated IL-17 and IL-6 and reduced IL-10 and TGF-β1 levels were observed in PFH serum. Sweat glands showed increased RORγt and decreased FOXP3 expression. In mice, SR2211 treatment reduced sweat secretion, secretory granules, and serum acetylcholine. It also lowered Th17 infiltration, serum IL-17/IL-6, and IL-17A expression in sweat glands.

DISCUSSION: PFH is associated with a Th17/Treg immune imbalance. SR2211 alleviated hyperhidrosis and Th17-related inflammation in mice, highlighting the potential of targeting the RORγ-Th17 axis as a therapeutic strategy for PFH.

PMID:41181099 | PMC:PMC12575253 | DOI:10.3389/fimmu.2025.1656632

Posted on

Food and Beverage Habits Among Individuals with Primary Hyperhidrosis: A Case-Control Survey in Sweden

Clin Cosmet Investig Dermatol. 2025 Oct 24;18:2769-2776. doi: 10.2147/CCID.S547497. eCollection 2025.

ABSTRACT

AIM: Excessive sweat production in primary hyperhidrosis (PH) can lead to water and mineral loss, yet data on patients’ dietary habits are limited.

PURPOSE: To explore associations between food and beverage consumption and severe PH.

PATIENTS AND METHODS: Participants with primary palmar and axillary hyperhidrosis (n=171) and without hyperhidrosis (n=165) completed a validated questionnaire on food and beverage habits at two hospitals in northern Sweden. Frequency and quantity of specific foods and beverages were compared between groups.

RESULTS: A total of 336 individuals participated in this study (men, n=109; women, n=218; unspecified sex, n=9). Individuals with PH were younger (18-29 years, n=104 vs n=66; p<0.001) and more frequently female compared to controls (n=75 vs 58; p<0.001). Total caffeine consumption was higher in PH (median score: 186.6 vs.151.0; p<0.001), and 57% of individuals with PH consumed energy drinks weekly compared with 39.5% of controls (p<0.001). Spicy foods, fatty foods, fast foods, and sweets were reported to trigger sweating. Women with PH more often reported difficulties replenishing water loss, and increased thirst was the most reported symptom in both men and women.

CONCLUSION: PH was associated with higher caffeine intake, distinct beverage consumption patterns, and self-reported fluid loss symptoms. These findings indicate potential associations between diet and PH and may inform patient education and future research, although causality cannot be inferred from this study.

PMID:41164747 | PMC:PMC12560645 | DOI:10.2147/CCID.S547497

Posted on

Development and validation of a model for predicting depression risk in primary palmar hyperhidrosis: a cross-sectional retrospective observational study

BMJ Open. 2025 Oct 10;15(10):e101212. doi: 10.1136/bmjopen-2025-101212.

ABSTRACT

OBJECTIVE: Primary palmar hyperhidrosis (PPH), characterised by excessive palm sweating, significantly impacts patients’ physiology, psychology, self-esteem, work, life and social interactions. The incidence of depression is higher among PPH patients. Timely detection of key predictive factors and the development of risk prediction models are crucial for effective intervention and treatment in this patient group.

DESIGN: We conducted an in-depth analysis of clinical data from 926 PPH patients treated at the Thoracic Surgery Department of Beijing Haidian Hospital between 2016 and 2021. We used the Boruta algorithm alongside the Backward Elimination strategy to select predictive factors and constructed five machine-learning models. By evaluating these models’ performance, we determined the optimal one. Additionally, we introduced the Shapley Additive exPlanations method to enhance the interpretability of this optimal model.

RESULTS: The Personality Diagnostic Questionnaire-4 score, Self-Rating Anxiety Scale score, family history, quality of life excluding PPH, onset age and the age when PPH begins to impact life (Impact age) are six predictive factors for depression in PPH patients. The support vector machine (SVM) model performs more comprehensively through model validation. In the validation set, the area under the curve is 0.798 (95% CI: 0.737 to 0.859), with a Brier score of 0.1451 (95% CI: 0.1233 to 0.1716), accuracy of 0.7184, sensitivity of 0.775, specificity of 0.699 and F1 score of 0.585.

CONCLUSIONS: These findings can enhance our understanding of depression in PPH patients, and the SVM model is a valuable screening tool for assessing the risk of depression in PPH patients.

PMID:41073115 | DOI:10.1136/bmjopen-2025-101212

Posted on

Hyperhidrosis increases the risk of postoperative infections after shoulder arthroplasty and rotator cuff repair

JSES Int. 2025 May 26;9(5):1623-1629. doi: 10.1016/j.jseint.2025.04.034. eCollection 2025 Sep.

ABSTRACT

BACKGROUND: Hyperhidrosis (HH), or excessive sweating, has been associated with higher rates of infections. Despite being a relatively common condition, its impact on postoperative outcomes following orthopedic procedures in proximity to the axilla, such as rotator cuff repair (RCR) and shoulder arthroplasty (SA), remains unknown.

METHODS: A retrospective cohort study was conducted using the TriNetX globally federated database. Patients with and without HH who underwent either RCR or SA were matched based on patient demographics and comorbidities. A standard difference of <0.1 was used to assess success of propensity score matching. Primary outcomes were 90-day postoperative superficial soft tissue infections (SSTIs), deep infections, and wound complications. Tests of significance and risk ratios (RR) with 95% confidence intervals were calculated.

RESULTS: After matching, 2,941 patients who underwent RCR and 2,066 patients who underwent SA were identified in each cohort. HH patients undergoing RCR demonstrated a higher risk of SSTIs (RR = 1.81; P = .007), urinary tract infection (UTI; RR = 2.09; P < .001), and emergency services usage (RR = 1.69; P < .001). Similarly, HH patients undergoing SA were also at higher risk of SSTIs (RR = 1.87; P = .004), UTI (RR = 1.65; P = .003), and emergency services usage (RR = 1.54; P < .001). There was no significant difference in the rates of deep soft tissue infections between the HH and non-HH groups for both RCR and SA.

DISCUSSION: HH is associated with an increased risk for 90-day complications including SSTIs, UTIs, and emergency services usage following both RCR and SA. Additional strategies for optimizing surgical care of these patients should be investigated.

PMID:41049663 | PMC:PMC12490586 | DOI:10.1016/j.jseint.2025.04.034