Focal hyperhidrosis: diagnosis and management

Haider, Aamir

doi:10.1503/cmaj.1040708

Cited by 225 publications

(274 citation statements)

References 38 publications

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“…Side effects include pain related to injections and slight hand muscle weakness after palmar injections (40). Counter indications of botulinum toxin therapy include neuromuscular disorders such as myasthenia gravis, pregnancy, lactation, organic causes of excessive sweating and the treatments that may affect motor end plate (41).…”

Section: Botulinum Toxin Therapymentioning

confidence: 99%

Diagnosis and Treatment of Primary Hyperhidrosis

Stefaniak¹,

Dobosz²,

Kaczor³

et al. 2013

Polish Journal of Surgery

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Section: Botulinum Toxin Therapymentioning

confidence: 99%

Diagnosis and Treatment of Primary Hyperhidrosis

Stefaniak¹,

Dobosz²,

Kaczor³

et al. 2013

Polish Journal of Surgery

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“…Primer Hiperhidroz Primer hiperhidroz; nedeni iyi bilinmeyen, en sık palmoplantar ve/veya aksiller bölgede görülen, genellikle bilateral ve simetrik olarak ortaya çıkan aşırı terleme ile karakterizedir (2,(7)(8)(9). Palmoplantar hiperhidroz sıklıkla çocukluk veya adolesan çağda başlarken, aksiller hiperhidroz tipik olarak puberte ve sonrasında görülür (6)(7)(8).…”

Section: Hiperhidroz Ve Başlıca Tedavi Seçenekleri Etiyolojiunclassified

“…Palmoplantar hiperhidroz sıklıkla çocukluk veya adolesan çağda başlarken, aksiller hiperhidroz tipik olarak puberte ve sonrasında görülür (6)(7)(8). Palmoplantar bölgedeki terleme serebral korteks tarafından kontrol edilir (10).…”

Section: Hiperhidroz Ve Başlıca Tedavi Seçenekleri Etiyolojiunclassified

“…Öykü ve fizik muayene bulguları-nın yönlendirdiği durumlarda tam kan sayımı, açlık kan şekeri, tiroid fonksiyon testleri, serumda büyüme hormonu seviyesi, elektrokardiyografi, ekokardiyografi ile 24 saatlik idrarda vanil mandelik asit, metanefrin ve 5-hidroksiindolasetik asit gibi tetkikler etiyolojiyi belirlemede yardımcı olacaktır (1). Yapılan tüm bu incelemeler sonucunda altta yatan bir neden bulunamayan ve en az 6 aydır devam eden lokalize terlemesi olan hastalarda aşağıdaki kriterlerden en az 2 tanesinin bulunmasının primer hiperhidroz için tanısal olduğu bildirilmiştir (8,9). -Terlemenin bilateral ve simetrik olması -Haftada en az bir terleme epizotu olması -Semptomların günlük hayatı olumsuz yönde etkilemesi -Hastalığın 25 yaşından önce başlaması -Aile öyküsünün olması -Uyku sırasında terleme olmaması Hiperhidrozlu hastalarda terlemenin şeklini ve miktarını saptamak için kalorimetrik ve gravimetrik ölçümler yapılır.…”

Section: Klinik Değerlendirme Ve Tanıunclassified

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Hyperhidrosis and Its Treatment: A Safe and Effective Alternative in the Treatment of Palmoplantar Hyperhidrosis, Iontophoresis

Özcan¹,

Güleç²

2011

Turk J Dermatol

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ÖzetPrimer hiperhidroz sebebi bilinmeyen, en sık palmar, plantar ve aksiller bölgede ortaya çıkan, çoğunlukla bilateral ve simetrik olan aşırı terleme ile karakterizedir. Etkilenen bireylerde fiziksel rahatsızlıklar ve psikososyal güçlüklere yol açtığı için etkin bir şekilde tedavi edilmelidir. Ancak, patofizyolojisinin tam olarak anlaşılmaması nedeniyle tedavisi zordur. Topikal ve sistemik ajanlar ile cerrahi ve cerrahi olmayan invaziv teknikler gibi çeşitli seçenekler bulunmaktadır. İyontoforez, iyonize maddelerin elektrik akımı aracılığıyla yüzey dokulara uygulanması işlemidir. Primer hiperhidrozda invaziv olmayan, güvenli, iyi tolere edilen, etkili ve uzun dönem yan etkiler ile kompansatuvar hiperhidroza neden olmayan bir tedavi yöntemidir. Şiddetli palmar ve/veya plantar hiperhidrozda ve topikal tedaviye yanıt vermeyen orta şiddetteki olgularda ilk tedavi seçeneği olarak önerilmektedir. Aksiller hiperhidrozda ise etkinliği düşüktür ve kullanımı pratik değildir. Zaman alıcı olması ve idame tedavisinin gerekliliği ise en önemli dezavantajlarıdır. Bu makalede, hiperhidroz ve başlıca tedavi seçenekleri, iyontoforezin primer hiperhidroz tedavisindeki endikasyonları, etki mekanizması, tedavi protokolü ile yöntemi, yan etkileri ve kontrendikasyonları derlenmiştir. AbstractPrimary hyperhidrosis is characterized by excessive sweating of unknown cause which most commonly involves the palms, soles, and axillae in a bilateral and symmetrical fashion. Since it leads to physical discomfort and psychosocial difficulties in the affected individuals, it should be treated effectively. However, treatment can be challenging as its pathophysiology is poorly understood. There are several treatment options, including topical or systemic medications and surgical or non-surgical invasive techniques. Iontophoresis is the introduction of ionized substances into the surface tissues by means of an electric current. It is a non-invasive, safe, well tolerated, and effective treatment method for primary hyperhidrosis without long-term adverse effects and compensatory hyperhidrosis. Iontophoresis is suggested as a first-line therapy in severe palmoplantar hyperhidrosis and second-line therapy in milder cases that are unresponsive to topical treatments. In axillary hyperhidrosis it is less effective and not practical to use. Being time consuming and requiring maintenance therapy are its most important disadvantages. In this article, hyperhidrosis and the principal treatment options, the indications of iontophoresis for the treatment of primary hyperhidrosis, its mechanism of action, treatment protocol and procedure, adverse effects, and contraindications are reviewed. (Turk J Dermatol 2011; 5: 5-12)

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“…[1,2,5] There are local (ionopheresis, botulinium toxin A), systemic (tricyclic antidepressants, anticholinergics) and surgical (thoracotomy or endoscopic sympathectomy, axillary curettage, and liposuction) treatment alternatives. [1,2,[5][6][7][8][9][10] Despite the various treatment options, uncontrollable hyperhidrosis has a higher cure rate with surgical procedures. [5] The most recommended technique is videoscopic thoracoscopic sympathectomy.…”

Section: Introductionmentioning

confidence: 99%

A New Target of Percutaneus Sympathic Radiofrequency Thermocoagulation for Treatment of Palmar Hyperhidrosis: T4

Purtuloglu¹,

Deniz²,

Atım³

et al. 2013

Agri

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SummaryObjectives: Hyperhidrosis is thought to result from a functional impairment of the sympathic nervous system. In this study, percutaneous T4 sympathic radiofrequency (RF) thermocoagulation was used to treat palmar hyperhidrosis which does not respond to conservative treatment. The results were evaluated in terms of safety, efficiency and patient satisfaction. Methods:In this study, 15 patients aged 16-48 years were retrospectively evaluated from prior records. Patient satisfaction scores (very satisfied, satisfied, not satisfied), after treatment of the hand condition (dry, mild dry, no improvement), and whether the most common complication and most patients expressed by the compensatory hyperhidrosis (CH) degree (none, mild, moderate, severe) were analyzed. Results:No complications were observed except a coughing crisis that lasted for 2 hours in one patient, transient bradycardia in 1 patient and transient injection site pain in all cases. Two patients 1 per week and three patients 1, 2 and 6 months developed recurrence.Conclusion: Sympathic T4 ablation with RF thermocoagulation was found to have long term (6 months) patient satisfaction (80%). It was also effective in reducing the hand sweating (80% dry or mild dry). The CH rate was 27%. According to our results, sympathic T4 ablation with RF thermocoagulation is a safe and effective treatment with a high degree of patient satisfaction.

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Focal hyperhidrosis: diagnosis and management

Cited by 225 publications

References 38 publications

Diagnosis and Treatment of Primary Hyperhidrosis

Diagnosis and Treatment of Primary Hyperhidrosis

Hyperhidrosis and Its Treatment: A Safe and Effective Alternative in the Treatment of Palmoplantar Hyperhidrosis, Iontophoresis

A New Target of Percutaneus Sympathic Radiofrequency Thermocoagulation for Treatment of Palmar Hyperhidrosis: T4

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