Posts

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

Posted on

Pleural effusion following thoracoscopic sympathectomy in a patient with palmar hyperhidrosis

BMC Pulm Med. 2025 Oct 2;25(1):446. doi: 10.1186/s12890-025-03933-1.

ABSTRACT

Thoracoscopic sympathectomy can be used to treat primary hyperhidrosis (PH). Nonetheless, there is a paucity of literature addressing the postoperative complications associated with this procedure. We report a case of a 21-year-old male patient who developed prolonged bilateral pleural effusion after undergoing thoracoscopic sympathectomy for PH. This case aims to raise awareness of this rare complication and discuss effective management strategies for it.

PMID:41039538 | DOI:10.1186/s12890-025-03933-1

Posted on

Hyperhidrosis: Diagnosis and management strategies

Nurse Pract. 2025 Oct 1;50(10):31-36. doi: 10.1097/01.NPR.0000000000000354. Epub 2025 Sep 25.

ABSTRACT

Hyperhidrosis, a condition characterized by an overactive cooling system that produces four to five times the normal amount of sweat, can profoundly impact a person’s physical, psychological, and social well-being. It can be classified as primary or secondary, and the location and severity determine treatment options. These options include topical agents, systemic agents, and nonsurgical and surgical procedures. Nurse practitioners play a crucial role in managing this condition, and their awareness and understanding are vital in designing effective treatment options for their patients. This article aims to enhance knowledge by discussing hyperhidrosis, its impact on a patient’s physical and psychological well-being, and recommended treatment modalities.

PMID:40996843 | DOI:10.1097/01.NPR.0000000000000354

Posted on

Development of a Nomogram Model for Predicting Anxiety Risk in Patients With Hyperhidrosis: A Study Involving 234 Patients

J Dermatol. 2025 Sep 18. doi: 10.1111/1346-8138.17965. Online ahead of print.

ABSTRACT

Primary focal hyperhidrosis (HH) carries a substantial psychosocial burden, and anxiety is a common but underrecognized comorbidity. We developed and internally validated a nomogram to estimate individualized anxiety risk in primary HH and examined robustness in prespecified sensitivity analyses. We retrospectively analyzed 234 consecutive patients with primary HH at a single center (June 2020-August 2023). Eligibility followed Hornberger criteria; secondary causes were excluded by history/physical examination, medication review, and targeted laboratory tests when indicated. Anxiety was diagnosed clinically according to CCMD-3. After LASSO prescreening with a priori clinical inclusion, the final multivariable logistic model retained 10 readily available predictors: diabetes, intolerance to cold, intolerance to heat, male sex, fatigue, and sweating at the head, hand, foot, chest, and neck. Internal validation used 1000-bootstrap optimism correction to assess discrimination and calibration; clinical utility was quantified with decision-curve analysis (DCA) across threshold probabilities of 0.02-0.36. The nomogram showed good discrimination (optimism-corrected C-index 0.826) and good calibration (bootstrap-corrected MAE 0.033, Brier 0.219). Three prespecified sensitivity analyses yielded consistent conclusions: SA1 (no diabetes) C-index 0.827, Brier 0.221, MAE 0.043; SA2 (craniofacial involvement + number of involved sites) C-index 0.839, Brier 0.220, MAE 0.028; and SA3 (stricter exclusion) C-index 0.811, Brier 0.211, MAE 0.045. Across thresholds of 0.02-0.36, all models demonstrated positive net benefit versus treat-none with largely overlapping curves. This transparent, internally validated tool may help identify HH patients at high risk of anxiety and support timely psychological intervention; external multicenter validation is warranted.

PMID:40964789 | DOI:10.1111/1346-8138.17965

Posted on

Atypical Presentations of Levator Ani Syndrome With Perianal Hyperhidrosis: A Case Series

ACG Case Rep J. 2025 Sep 11;12(9):e01826. doi: 10.14309/crj.0000000000001826. eCollection 2025 Sep.

ABSTRACT

Levator ani syndrome (LAS) explains up to 7.4% of anorectal pain cases. Classic symptoms include rectal pain or pressure with sitting. We present 2 patients, ages 32 and 25 years, presenting initially with “diarrhea” and perianal hyperhidrosis. History revealed rectal discomfort, tenesmus, urgency, and sensation of incomplete evacuation. Puborectalis tenderness was present on digital rectal examination. Therapies were tailored to each patient, including pelvic floor physical therapy with biofeedback, bowel regulation, rectal diazepam, and ileostomy. These presentations offer insights into potential pathophysiological mechanisms in LAS and highlight the importance of considering LAS in non-pain presentations.

PMID:40948587 | PMC:PMC12431760 | DOI:10.14309/crj.0000000000001826

Posted on

Unilateral versus Bilateral T3 Ganglionectomy in Primary Palmar Hyperhidrosis Patients

Thorac Cardiovasc Surg. 2025 Sep 11. doi: 10.1055/a-2699-8163. Online ahead of print.

ABSTRACT

BACKGROUND: Primary palmar hyperhidrosis (PPH) is a distressing condition that significantly impairs quality of life. Endoscopic thoracic sympathectomy (ETS) is an effective treatment, but compensatory hyperhidrosis (CH) remains a common and problematic complication. The optimal extent of surgical interruption, particularly the choice between unilateral and bilateral ganglionectomy, remains uncertain.

METHODS: We conducted a retrospective analysis of 118 patients who underwent unilateral (n=41) or bilateral (n=77) T3 ganglionectomy via video-assisted thoracoscopic surgery (VATS) between November 2023 and January 2025. Patient-reported outcomes, including CH and postoperative satisfaction, were assessed three months postoperatively using standardized questionnaires. Comparisons between the two groups were performed using t-tests and chi-square tests.

RESULTS: Baseline demographics were comparable between groups. The unilateral group reported significantly higher satisfaction, with 93% “very satisfied” compared to 61% in the bilateral group (p<0.001). CH was less prevalent in the unilateral group (20% vs. 48%, p=0.007), and when present, was generally mild and limited to a single body region. In contrast, bilateral ganglionectomy was associated with more frequent and multi-regional CH. Among unilateral ETS patients, only 22% later underwent contralateral surgery, indicating that unilateral intervention was sufficient in most cases.

CONCLUSIONS: Unilateral T3 ganglionectomy offers a favorable balance of efficacy and safety, yielding higher satisfaction and significantly reduced CH compared to bilateral procedures. These findings support the use of unilateral ETS as a first-line surgical strategy for PPH, particularly in patients sensitive to CH. A tailored, staged approach may enhance long-term outcomes and patient satisfaction.

PMID:40935159 | DOI:10.1055/a-2699-8163