Clin Exp Dermatol. 2022 Mar 9. doi: 10.1111/ced.15164. Online ahead of print.
NO ABSTRACT
PMID:35262223 | DOI:10.1111/ced.15164
Hyperhidrosis and human leucocyte antigens in the Danish Blood Donor Study
Scand J Immunol. 2022 Feb 25:e13150. doi: 10.1111/sji.13150. Online ahead of print.
ABSTRACT
Familial clustering of the skin disease primary hyperhidrosis suggests a genetic component to the disease. The human leucocyte antigen (HLA) is implicated in a range of diseases, including many comorbidities to hyperhidrosis. No study has investigated whether the HLA genes are involved in the pathogenesis of hyperhidrosis. We, therefore, compared HLA alleles in individuals with and without hyperhidrosis in this study of 65,000 blood donors. In this retrospective cohort study, we retrieved information on individuals with and without hyperhidrosis using self-reported questionnaires, the Danish National Patient Registry and the Danish National Prescription Registry on participants recruited to the Danish Blood Donor Study between 2010 and 2019. Association tests using logistic regression were conducted for each HLA allele corrected for sex, age, body mass index, smoking and principal components. Overall, 145 of 65,795 (0.2%) participants had hospital diagnosed hyperhidrosis. Similarly, 1,379 of 15,530 (8.9%) participants had moderate-severe self-reported hyperhidrosis, of whom 447 (2.9%) had severe self-reported hyperhidrosis. Altogether 28 participants had both hospital diagnosed and moderate-severe self-reported hyperhidrosis. Severe self-reported hyperhidrosis was associated with HLA-A*80:01 (adjusted odds ratio 26.97; 95% confidence interval 5.32-136.70; n=7; p<0.001). Moderate-severe self-reported hyperhidrosis and hospital diagnosed hyperhidrosis were not associated with any HLA. The association between hyperhidrosis and HLA-A*80:01 was based on a very small number of cases and not replicated in other patient subsets, and therefore likely a chance finding. Thus, this study suggests that genes other than the HLA are involved in the pathogenesis of hyperhidrosis.
PMID:35212011 | DOI:10.1111/sji.13150
Thoracoscopic resympathectomy for persistent or recurrent palmar hyperhidrosis: single-center experience
Gen Thorac Cardiovasc Surg. 2022 Feb 23. doi: 10.1007/s11748-022-01788-5. Online ahead of print.
ABSTRACT
BACKGROUND: In case of recurrence or persistent palmar hyperhidrosis, a sympathetic chain resection is suggested, however, many surgeons are still reluctant to offer further intervention because of the inability to predict the efficacy of such a procedure. We analyzed our large series of resympathectomy.
METHODS: Substantive retrospective analysis of 39 patients underwent a resympathectomy (minimally invasive bilaterally sympathetic chain Th2-3 resection). Patients referred from other hospitals or primarily operated at our institution for recurrence or persistence palmar hyperhidrosis were included in the study group.
RESULTS: No intraoperative complications were detected. Reoperation or chest tube positioning was necessary in 2 patients. Twenty-eight patients had a positive response (excellent or good results). Seven patients described a substantial, but not sufficient, reduction of the symptomatology. Four patients were very unsatisfied and regretted the operation.
CONCLUSIONS: Resympathectomy is highly effective procedure for patients who have persistent or recurrent symptoms. However, the indication of the operations should be more dissuasive as possible to avoid the risk of any undesirable psychologically side effects.
PMID:35195859 | DOI:10.1007/s11748-022-01788-5
Cohort study on 20 years’ experience of bilateral video-assisted thoracic sympathectomy (VATS) for treatment of hyperhidrosis in 2431 patients
Sao Paulo Med J. 2022 Feb 21:S1516-31802022005004202. doi: 10.1590/1516-3180.2021.0078.R1.23072021. Online ahead of print.
ABSTRACT
BACKGROUND: Primary hyperhidrosis is a condition characterized by excessive sweating, inconsistent with the needs for thermoregulation.
OBJECTIVE: To assess the effectiveness and the change in the quality of life of patients undergoing bilateral VATS (video-assisted thoracoscopic sympathectomy) for treatment of hyperhidrosis, in a large case series.
DESIGN AND SETTING: Cohort study conducted in a tertiary hospital specializing in hyperhidrosis located in São Paulo, Brazil.
METHODS: A total of 2,431 patients who underwent surgery consisting of bilateral video-assisted thoracoscopic sympathectomy between January 2000 and February 2017 were retrospectively assessed in an outpatient clinic specializing in hyperhidrosis. The patients underwent clinical and quality of life assessments on two occasions: firstly, prior to surgery, and subsequently, one month after the operation. The presence or absence of compensatory hyperhidrosis (CH) and general satisfaction after the first postoperative month were also evaluated.
RESULTS: All the patients operated had poor or very poor quality of life before surgery. In the postoperative period, an improvement in the quality of life was observed in more than 90% of the patients. Only 10.7% of the patients did not present CH, and severe CH occurred in 22.1% of the patients in this sample.
CONCLUSION: Bilateral VATS is a therapeutic method that decreases the degree of sweating more than 90% of patients with palmar and axillary hyperhidrosis. It improves the quality of life for more than 90% of the patients, at the expense of development of CH in approximately 90% of the patients, but not intensely.
PMID:35195234 | DOI:10.1590/1516-3180.2021.0078.R1.23072021
The health-related quality of life in hyperhidrosis and co-morbidities
Qual Life Res. 2022 Feb 22. doi: 10.1007/s11136-022-03108-z. Online ahead of print.
ABSTRACT
PURPOSE: Hyperhidrosis has been associated with a reduced health-related quality of life (HRQoL). The role of common confounding factors of this association such as stress and socioeconomic status, however, remain largely unexplored, and may affect the management strategy for hyperhidrosis. Therefore, the study objective was to compare the HRQoL in individuals with and without hyperhidrosis while adjusting for confounders.
METHODS: In this retrospective cohort study, data on the HRQoL measured by the short-form-12 questionnaire and self-reported hyperhidrosis were collected from the Danish Blood Donor Study-cohort. Data on international classification of disease-10 codes and redeemed prescriptions were collected from nationwide registries. Linear regression investigated the association between hyperhidrosis and HRQoL.
RESULTS: Total 2794 (9.1%) of 30,808 blood donors had self-reported hyperhidrosis and 284 (0.2%) of 122,225 had hospital diagnosed hyperhidrosis. Self-reported hyperhidrosis was associated with a reduced mental HRQoL (adjusted beta coefficient – 1.10; 95% confidence interval – 1.37, – 0.82; p < 0.001) and physical HRQoL (adjusted beta coefficient – 0.90; 95% confidence interval – 1.09, – 0.70; p < 0.001). Hospital diagnosed hyperhidrosis was associated with a reduced mental HRQoL (adjusted beta coefficient – 0.91; 95% confidence interval – 1.82, – 0.04; p = 0.049).
CONCLUSION: Hyperhidrosis is associated with a reduced HRQoL, independently of confounders or mode of diagnosis. This supports an approach primarily targeting hyperhidrosis.
PMID:35192149 | DOI:10.1007/s11136-022-03108-z
Unexpected improvement of hyperhidrosis with cannabidiol
Einstein (Sao Paulo). 2022 Feb 14;20:eRC5795. doi: 10.31744/einstein_journal/2022RC5795. eCollection 2022.
ABSTRACT
Hyperhidrosis is characterized by excessive sweating and it affects almost 5% of the population. The affected age group is wide, and it can affect from children to elderlies. There are two types of hyperhidrosis: generalized and focal. Treatment depends on the symptoms presented. In more severe cases, radiofrequency sympatholysis and bilateral thoracic sympathectomy are the options. However, recurrence is possible or the postoperative appearance of conditions called compensatory hyperhidrosis or reflex hyperhidrosis. We describe two cases of patients treated with Cannabidiol who had significant and unexpected improvement of hyperhidrosis. The first patient received Cannabidiol specific for public presentations at work, and the second patient had a diagnosis of autism spectrum disorder. The hyperhidrosis improved in both patients immediately after using Cannabidiol.
PMID:35170710 | DOI:10.31744/einstein_journal/2022RC5795
Minimally Invasive Sympathicotomy for Palmar Hyperhidrosis and Facial Blushing: Current Status and the Hyperhidrosis Expert Center Approach
J Clin Med. 2022 Jan 31;11(3):786. doi: 10.3390/jcm11030786.
ABSTRACT
Hyperhidrosis, the medical term for excessive sweating beyond physiological need, is a condition with serious emotional and social consequences for affected patients. Symptoms usually appear in focal areas such as the feet, hands, axillae and face. Non-surgical treatment options such as topical antiperspirants or systemic medications are usually offered as a first step of treatment, although these therapies are often ineffective, especially in severe and intolerable cases of hyperhidrosis. In the treatment algorithm for patients suffering from hyperhidrosis, surgical thoracoscopic sympathicotomy offers a permanent solution, which is particularly effective in the treatment of palmar hyperhidrosis and facial blushing. In this review, we describe the current status of thoracoscopic sympathicotomy for palmar hyperhidrosis and facial blushing. In addition, we share the specific treatment approach, technique and results of our Hyperhidrosis Expert Center. Last, we share recommendations to ensure an effective, reproducible and safe application of single-port thoracoscopic sympathicotomy for palmar hyperhidrosis and facial blushing, based on our extensive experience.
PMID:35160238 | DOI:10.3390/jcm11030786
Efficacy and outcome prediction of unilateral video-assisted thoracoscopic sympathectomy in primary palmar hyperhidrosis: A comparative study with bilateral sympathectomy
World Neurosurg. 2022 Feb 5:S1878-8750(22)00142-5. doi: 10.1016/j.wneu.2022.02.005. Online ahead of print.
NO ABSTRACT
PMID:35134577 | DOI:10.1016/j.wneu.2022.02.005
A Phase 3, Randomized, Multi-center Clinical Trial to Evaluate the Efficacy and Safety of Neu-BoNT/A in Treatment of Primary Axillary Hyperhidrosis
Aesthetic Plast Surg. 2022 Feb 7. doi: 10.1007/s00266-021-02715-4. Online ahead of print.
ABSTRACT
BACKGROUND: Botulinum toxin type A is widely used to treat primary axillary hyperhidrosis and has proven to be an effective and safe approach. Onabotulinumtoxin A was approved by the FDA as a treatment for primary axillary hyperhidrosis. This study aimed to evaluate the efficacy and safety of Neu-BoNT/A in subjects diagnosed with primary axillary hyperhidrosis.
METHODS: The Hyperhidrosis Disease Severity Scale, gravimetric measurement of sweat, and Global Assessment Scale were analyzed at weeks 4, 8, 12, and 16 to determine the effect of treatment. Adverse events, physical examination, and vital signs were monitored.
RESULTS: Subjects treated with Neu-BoNT/A showed statistically significant improvement by all 3 methods at weeks 4, 8, 12, and 16 (P value = 0.00). There were no severe adverse events or significant changes in vital signs, physical examination, or laboratory tests.
CONCLUSION: Neu-BoNT/A can be effectively and safely used for primary axillary hyperhidrosis.
LEVEL OF EVIDENCE II: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
PMID:35132458 | DOI:10.1007/s00266-021-02715-4
Setting research priorities for management and treatment of hyperhidrosis: the results of the James Lind Alliance Priority Setting Partnership
Clin Exp Dermatol. 2022 Feb 5. doi: 10.1111/ced.15122. Online ahead of print.
ABSTRACT
BACKGROUND: Hyperhidrosis is a common skin condition characterised by excessive sweating, which can negatively impact on quality of life. It is under-researched compared with other conditions of similar prevalence.
OBJECTIVE: To generate a top ten list of research priorities for the treatment and management of hyperhidrosis, with equal input from people with hyperhidrosis and healthcare professionals.
METHODS: A priority setting partnership was established and processes from the James Lind Alliance Handbook were followed. An online survey asked participants what questions they would like research to answer. These questions were grouped into ‘indicative questions’ which were ranked in a second survey of 45 indicative questions. The top 23 questions were taken to a final workshop event attended by key stakeholders, and ranked to generate the top ten list of research priorities.
RESULTS: There were 592 questions submitted by 268 respondents for the first survey. For the second survey, 286 participants ranked the indicative questions in order of priority. At the final workshop, the top ten list was generated. The top three priorities were; Are there any safe and effective permanent solutions for hyperhidrosis?, what is the most effective and safe oral treatment (drugs taken by mouth) for hyperhidrosis? and what are the most effective and safe ways to reduce sweating in particular areas of the body?
CONCLUSIONS: There are many unanswered research questions that people with hyperhidrosis and healthcare professionals would like to see answered. The results from this PSP will help to ensure future research funding can be directed to these areas of priority.
PMID:35124833 | DOI:10.1111/ced.15122