Multiple Eccrine Hidrocystomas

Blugerman, Guillermo; Schavelzon, Diego; DʼANGELO, SILVANA

doi:10.1097/00042728-200305000-00021

Cited by 4 publications

(3 citation statements)

References 3 publications

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“…Some articles suggested that the use of topical atropine offered an effective treatment option and the few adverse effects were either asymptomatic or well tolerated 5,8 . A case of successful treatment with injection of botulinum toxin type A in the superficial epidermis was reported 9 . Two cases were reported to be effectively treated with the 585‐nm PDL using a 7‐mm spot size at a fluence of 7 J/cm 2 and the 595‐nm PDL using a 7‐mm spot size at a fluence of 7 J/cm 2 and a 6‐ms pulse duration, respectively 10,11 .…”

Section: Discussionmentioning

confidence: 99%

Lack of Effect of the Pulsed-Dye Laser in the Treatment of Multiple Eccrine Hidrocystomas: A Report of Two Cases

Choi

Son

2007

Dermatol Surg

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Section: Discussionmentioning

confidence: 99%

Lack of Effect of the Pulsed-Dye Laser in the Treatment of Multiple Eccrine Hidrocystomas: A Report of Two Cases

Choi

Son

2007

Dermatol Surg

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“…However, side effects such as nausea and blurred vision limit the clinical use of anticholinergics in multiple eccrine hidrocystomas. One case of multiple eccrine hidrocystomas was treated with botulinum toxin type A injection, which might work via the blockage of cholinergic terminals of the parasympathetic system governing sweat gland secretion 4 . Surgical excision or aggressive destructive procedures may be effective, but the risk of scarring, ectropion and postinflammatory hyperpigmentation were considered as limiting factors in the choice of treatment 1 …”

Section: Discussionmentioning

confidence: 99%

Multiple Eccrine Hidrocystomas: Successful Treatment with a 595-nm Long-Pulsed Dye Laser

Lee

Chang

et al. 2006

Dermatologic Surgery

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“…Incision and drainage or surgical excision of such numerous lesions on the face is cumbersome, and cosmetic results may be unacceptable. Topical and oral anticholinergics and Botulinum toxin type A injections may reduce sweat gland secretion, resulting in an improvement, but toxicity is a limiting factor, especially with anticholinergics 4–6 . Two reports of success and one describing failure of pulsed dye laser (PDL) in the treatment of MEHs have been published in this journal in recent years 7–9 .…”

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confidence: 99%

Letter

Madan

August

Ferguson

2009

Dermatologic Surgery

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The title of the article, however, is misleading because the authors did not provide evidence of an allergic reaction to the neurotoxin. Instead, according to their skin test results with Prosigne (containing gelatin and dextran) and Botox (Allergan, Irvine, CA), immunologic intolerance to gelatin or dextran or both but not to the neurotoxin itself or albumin carrier protein is seen (negative skin test results with Botox). Anaphylactoid reactions to dextran and gelatin are well known, the latter being associated with mast cell degranulation phenomena (pseudo-allergic reactions).However, one may doubt that the skin test results suggest unequivocally a type I hypersensitivity reaction pattern for several reasons. First, there was a 24-hour delay in the onset of skin reaction after intradermal testing. It would have been interesting if the onset of skin reaction started after a few hours, which is typical for a late-phase type I reaction pattern. Second, histology might suggest a type IV hypersensitivity reaction with lymphocytic rather than polymorphonuclear perivascular inflammatory infiltrates. Thus, a delayed-type hypersensitivity reaction might be discussed.In a study by Carruthers and colleagues, frequency of antibody formation after repeated botulinum toxin injections was found to be 1% to 1.4%. 2 In the context of this article, however, necessity of extensive discussion of antibody formation to botulinum neurotoxin is somewhat misleading because the patient reported did not produce antibodies, or the authors did not mention laboratory results. Although antibody formation is more common when higher doses are repeatedly used (e.g., for neurologic indications), this problem has not emerged in a higher percentage in aesthetic medicine. 3 Instead, focusing on hypersensitivity reactions against carrier molecules as additional risk factors of various preparations might have been valuable, in addition to the possibility of neurotoxin antibody formation leading to clinical nonresponse. References1. Tamura BM, Cucé LC, Rodrigues CJ. Allergic reaction to botulinum toxin: positive intradermal test. Dermatol Surg 2008;34:1117-9. 2. Carruthers A, Carruthers J, Lowe NJ, et al. One-year, randomised, multicenter, two-period study of the safety and efficacy of repeated treatments with botulinum toxin type A in patients with glabellar lines.

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Multiple Eccrine Hidrocystomas

Cited by 4 publications

References 3 publications

Lack of Effect of the Pulsed-Dye Laser in the Treatment of Multiple Eccrine Hidrocystomas: A Report of Two Cases

Lack of Effect of the Pulsed-Dye Laser in the Treatment of Multiple Eccrine Hidrocystomas: A Report of Two Cases

Multiple Eccrine Hidrocystomas: Successful Treatment with a 595-nm Long-Pulsed Dye Laser

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