Treatment – Page 32 – Hyperhidrosis Research . org

September 23, 2019

Is there any relationship between quality of life and the level of sympathectomy in primary palmar hyperhidrosis? Single-center experience.

Is there any relationship between quality of life and the level of sympathectomy in primary palmar hyperhidrosis? Single-center experience.

Gen Thorac Cardiovasc Surg. 2019 Sep 21;:

Authors: Dogru MV, Sezen CB, Girgin O, Cansever L, Kocaturk CI, Metin M, Dincer SI

Abstract
BACKGROUND: The discussions at the surgical levels (sympathectomy levels) about endoscopic thoracic sympathectomy (ETS) method, which is applied in hyperhidrosis treatment in the present day and acknowledged as the golden treatment method, continue. Mainly, most of the studies evaluates postoperative early period results. Our aim in this study is to compare the long-term quality of life depending on the different surgical levels (sympathectomy levels) and evaluate the postoperative complications.
METHODS: 165 patients operated due to palmar hyperhidrosis between January 2012 and July 2017 were evaluated. Sympathectomy was performed either by clipping or cauterization and sympathetic nerves included were T2-4, T3-4, or T3 levels. Data were retrospectively reviewed for complications, factors affecting the postoperative quality of life.
RESULTS: Ninety of the patients were male (54.5%) and 75 (45.5%) were female. The level of ganglion block was T2-T4 in 62 patients (37.6%), T3-T4 in 46 patients (27.9%), and T3 in 57 patients (34.5%). Early complications were observed in 27 patients (16.4%). Compensatory hyperhidrosis (CH) was observed in 62 patients (37.6%). There was a significant difference in the postoperative quality of life according to ETS level (p < 0.001). Patients who underwent T2-T4 sympathectomy had a lower quality of life than patients who underwent isolated T3 or T3-T4 sympathectomy.
CONCLUSION: Based on our results, we recommend performing lower level resections to increase the long-term quality of life in palmar hyperhidrosis patients. The lower risk of CH and comparable quality of life suggest that T3 sympathectomy is more effective.

PMID: 31542862 [PubMed – as supplied by publisher]

September 9, 2019

Analysis of the results of videotoracoscopic sympathectomy in the treatment of hyperhidrosis in patients 40 years or older.

Analysis of the results of videotoracoscopic sympathectomy in the treatment of hyperhidrosis in patients 40 years or older.

Ann Vasc Surg. 2019 Sep 05;:

Authors: Faustino CB, Milanez de Campos JR, Kauffman P, Leiderman D, Tedde M, Cucato G, Fernandes PP, Leão PP, Wolosker N

Abstract
OBJECTIVE: Several factors that could influence the efficacy and satisfaction of patients after bilateral thoracic sympathectomy (VATS) in the treatment of hyperhidrosis (HH) have been studied, but no studies in the literature have specifically analyzed the effectiveness of treatment and variations in the quality of life of patients aged 40 years or older compared to those of young adult patients (19-40 years).
METHODS: We retrospectively analyzed 2431 hyperhidrosis patients who underwent bilateral VATS and divided the patients into the following groups: a group <40 years old (1760 patients) and a group ≥40 years (142 patients). Variables included quality of life prior to surgery, improvement in quality of life after surgery, clinical improvement in sweating, presence of severe compensatory hyperhidrosis and general satisfaction at one month after surgery.
RESULTS: We observed that all surgical patients presented with poor or very poor quality of life before surgery, with similar proportions in both groups. In the postoperative period, we observed improvement in quality of life in more than 90% of the patients, with no significant difference noted between the two groups of patients. More than 90% of the patients in this series had great clinical improvement in the main hyperhidrosis site, with no significant difference between the two groups. Severe compensatory hyperhidrosis occurred in 23.8% of the patients in this series, with no significant difference between the two groups.
CONCLUSIONS: Patients 40 years of age or older benefit just as much as younger patients from VATS performed to treat primary hyperhidrosis, presenting excellent, significant surgical results.

PMID: 31494263 [PubMed – as supplied by publisher]

September 6, 2019

[Video-assisted thoracoscopic treatment for two ports for idiopathic palmar and axillary hyperhidrosis in children].

[Video-assisted thoracoscopic treatment for two ports for idiopathic palmar and axillary hyperhidrosis in children].

Cir Pediatr. 2019 Jul 29;32(3):115-120

Authors: González López SL, Díaz Juárez M, Cabrera Machado CA, García González M, Cortiza Orbe GM, Quintero Delgado Z

Abstract
JUSTIFICATION: Primary hyperhidrosis is a benign disease that consists in the excessive production of sweat, mainly in the hands, axillas and feet. It may to interfere with the social and work life of the sufferer. It affects up to 3% of the population. In Cuba there are no epidemiological studies on its prevalence. One of the treatment modalities is videothoracoscopic sympathicotomy.
OBJECTIVES: To describe the results of the videothoracoscopic sympathicotomy technique for two ports using apneic oxygenation to achieve lung collapse.
METHOD: Descriptive, retrospective study of 27 cases operated by primary hyperhidrosis in the period from May 2015 to June 2018. Demographic and clinical characteristics of operated patients, results of the endoscopic surgical technique, postoperative complications and satisfaction were described.
RESULTS: The 27 patients were adolescents with ages ranging from 11 to 19 years old, it was more frequent in the female sex. All patients had total solution of the symptoms in the intraoperative period, demonstrated by the cessation of sweat in the palms or axillas and by the verification of the increase of the palmar temperature in the monitor. No patient had intraoperative complications. Compensatory sweating occurred in four patients and one had intercostal neuritis. 100% of the patients were satisfied with the result at 30 days of treatment.
CONCLUSIONS: It is a safe technique, with few complications, high satisfaction with the results and feasible to perform in pediatric hospitals with basic resources of minimal access surgery.

PMID: 31486302 [PubMed – in process]

August 3, 2019

Postmenopausal craniofacial hyperhidrosis treated with botulinum toxin type B.

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]

July 18, 2019

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]

June 21, 2019

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.

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]

May 22, 2019

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

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]

May 20, 2019

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

[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]

May 16, 2019

Topical Treatment of Primary Focal Hyperhidrosis, Part 2.

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]

April 16, 2019

Hyperhidrosis and Dysautonomia in a Patient with a History of Tetraplegia following Cervical Facet Radiofrequency Ablation: A Case Report.

Hyperhidrosis and Dysautonomia in a Patient with a History of Tetraplegia following Cervical Facet Radiofrequency Ablation: A Case Report.

PM R. 2019 Apr 15;:

Authors: Reddy R, Zardouz S, Rejai S, Chen J

Abstract
Chronic pain in those with spinal cord injury (SCI) can significantly impact quality of life, with prevalence ranging from 26%-96%1 . Treatment of chronic pain is notoriously challenging and unsatisfactory for providers and patients1,2 . Patients with traumatic SCI and fusion can develop adjacent-level degeneration3 . Facet-mediated pain can be treated with radiofrequency ablation (RFA) of the medial branch nerves that innervate the zygapophyseal joints4 .

PMID: 30985080 [PubMed – as supplied by publisher]