Primary Focal Hyperhidrosis: Disease Characteristics and Functional Impairment

Hamm, Henning; Naumann, Markus; Kowalski, Jonathan W.; Kütt, Sandra; Kozma, Chris M; Teale, Chris

doi:10.1159/000092285

Cited by 139 publications

(129 citation statements)

References 54 publications

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“…More than a third (35.18%) of all evaluated patients in this study reported positive family history, which was in agreement with other studies, where it ranged from 30% to 65% (4,7,13).…”

Section: Resultssupporting

confidence: 93%

“…Various methods for reducing excessive sweating include: special diets (without coffee, tea, coca-cola, chocolate), diverse antiperspirants, such as over-the counter ointments/tinctures, topical aluminium chloride, medicines, drugs (oral anticholinergics), tap water ionophoresis (9), intradermal injections of botulinum toxin type A (botox) (10,11), but only surgical treatment has shown the best long-term results (12)(13)(14).…”

Section: Surgical Techniquementioning

confidence: 99%

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Videothoracoscopic sympathectomy - a standard treatment for primary hyperhidrosis at the Clinic of Thoracic Surgery in Sremska Kamenica / Videotorakoskopska simpatektomija – standarna hirurška metoda za lečenje primarne hiperhidroze na Klinici za grudnu hirurgiju u Sremskoj Kamenici

Kuhajda¹,

Milos²,

Đurić³

et al. 2010

Serbian Journal of Dermatology and Venerology

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Primary hyperhidrosis affects approximately 3% of the world's population, particularly young female adults. It is defined as excessive, profuse sweating of the palms, soles, armpits and face. Conservative treament includes diverse modalities, however, surgical treatment has shown the best long-term results. The objective of this study was to assess some disease-specific epidemiological characteristics in a pre-selected group of patients seeking surgical therapy, as well as outcomes of thoracoscopic sympathectomy. The severity and impact of hypehidrosis was assessed, using Hyperhidrosis Disease Severity Scale (HDSS: patients rate the serverity of symptoms on a scale from 1 to 4). Thoracoscopic sympathectomy was performed using a double lumen endotracheal tube, via bilateral 5 mm dual port videothoracoscopic camera 0°, and an endoscopic ultrasound activated harmonic scalpel. The sympathetic chain was resected on both sides at the level of the second and the third thoracic ganglion (T2 and T3), using an ultrasound knife. The extirpated chain was also at the level T3-T4 and sent for ex tempore analysis. There were 162 patients undergoing thoracoscopic sympathectomy: 39.51% were males and 60.49% females; at presentation their mean age (± SD) was 30.5 (±8.3), range 16 -58 years. Axillary hyperhidrosis occurs later than palmar-axillary-plantar (p<0.05). A total of 35.18% of the evaluated patients were able to name at least one member of their families who also suffered from hyperhidrosis. The most commonly affected area was palmar-axillary-plantar (30.25%). Fifty patients (30.86%) received conservative therapy before surgery. The most commonly used conservative therapy modalities included different kinds of ointments/tinctures (11.73%), botox (8.02%) and iontophoresis (2.47%). Prior to surgery, 91.36% of patients reported severe sweating (HDSS score 3 or 4). The highest mean score was given for a combination of facial-palmar-axillaryplantar hyperhidrosis (3.80±0.24). All surgeries were successfully performed, with no complications, or perioperative morbidity. The mean hospital stay was 1.28±0.68 days long. After surgery, 93.21% of patients reported mild or moderate hyperhidrosis (HDSS score 1 or 2). Compensatory sweating (lower part of the back, and abdomen) was reported by 34.57% of patients after the surgery. All patients had a 6-months long follow-up: a significant improvement in quality of life was reported by 84.56% of patients (Yates corrected c 2 (1) = 228.42; p=0.0000)); due to compensatory sweating, only 4.94% and 1.85% of patients reported bad and very bad quality of life, respectively. In conclusion, nowadays videothoracoscopic sympathectomy is a standard treatment for primary hyperhidrosis with a high success rate. T5, and to lower limbs at T2 and T7. Videothoracoscopic sympathectomy -a standard treatment for primary hyperhidrosis at the Clinic of Thoracic Surgery in Sremska KamenicaExcessive sweating or hyperhidrosis affects approximately 3% of the world population (1, 2), predominantly young femal...

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“…More than a third (35.18%) of all evaluated patients in this study reported positive family history, which was in agreement with other studies, where it ranged from 30% to 65% (4,7,13).…”

Section: Resultssupporting

confidence: 93%

Section: Surgical Techniquementioning

confidence: 99%

Videothoracoscopic sympathectomy - a standard treatment for primary hyperhidrosis at the Clinic of Thoracic Surgery in Sremska Kamenica / Videotorakoskopska simpatektomija – standarna hirurška metoda za lečenje primarne hiperhidroze na Klinici za grudnu hirurgiju u Sremskoj Kamenici

Kuhajda¹,

Milos²,

Đurić³

et al. 2010

Serbian Journal of Dermatology and Venerology

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“…It is likely that many of these patients meet criteria for SAD as well, because a convenience sample of 354 patients reported moderate to extreme limitations resulting from Hyperhydrosis in meeting people for the first time, being in public places, shaking hands, developing personal relationships, participation in family events, and sexual activities compared to controls. [54] Second is essential tremor, a condition that also can lead to social impairment and fear of being noticed for trembling.…”

Section: Fear Of Showing Anxiety Symptomsmentioning

confidence: 99%

Social anxiety disorder: questions and answers for the DSM-V

et al. 2010

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Background: This review evaluates the DSM-IV criteria of social anxiety disorder (SAD), with a focus on the generalized specifier and alternative specifiers, the considerable overlap between the DSM-IV diagnostic criteria for SAD and avoidant personality disorder, and developmental issues. Method: A literature review was conducted, using the validators provided by the DSM-V Spectrum Study Group. This review presents a number of options and preliminary recommendations to be considered for DSM-V. Results/Conclusions: Little supporting evidence was found for the current specifier, generalized SAD. Rather, the symptoms of individuals with SAD appear to fall along a continuum of severity based on the number of fears. Available evidence suggested the utility of a specifier indicating a ''predominantly performance'' variety of SAD. A specifier based on ''fear of showing anxiety symptoms'' (e.g., blushing) was considered. However, a tendency to show anxiety symptoms is a core fear in SAD, similar to acting or appearing in a certain way. More research is needed before considering subtyping SAD based on core fears. SAD was found to be a valid diagnosis in children and adolescents. Selective mutism could be considered in part as a young child's avoidance response to social fears. Pervasive test anxiety may belong not only to SAD, but also to generalized anxiety disorder. The data are equivocal regarding whether to consider avoidant personality disorder simply a severe form of SAD. Secondary data analyses, field trials, and validity tests are needed to investigate the recommendations and options. Depression and Anxiety 27:168-189, 2010. Key words: DSM-V; social anxiety disorder; social phobia; subtypes; classification; interpersonal; performance; test anxiety; selective mutism; avoidant personality disorder INTRODUCTIONThis review evaluates several issues pertaining to the diagnostic criteria for social phobia or social anxiety disorder (SAD) (Table 1), in light of empirical evidence gathered since DSM-IV. The review was guided by questions posed in the DSM-IV Sourcebook (Vol. 2), chapters titled ''Social phobia'' [1] and ''Social phobia subtypes,''[2] a review conducted as part of the DSM-V Stress Induced and Fear Circuitry Disorders Workgroup Conference, titled ''Social Phobia: Towards DSM V, '' [3] by questions posed by the DSM-V Anxiety, OC Spectrum, Posttraumatic, and Dissociative Disorder Work Group and by issues raised by consulted experts and advisors. The main issues to be addressed are the generalized specifier and its alternatives, the overlap with avoidant personality disorder, and developmental issues including the relationship that SAD shows in childhood with selective mutism (SM) and test anxiety. STATEMENT OF THE ISSUESThis review addresses the following questions, using the validators provided by the DSM-V Task Force: (1) What is the evidence/utility of the DSM-IV generalized specifier? If there is insufficient evidence/utility for a generalized specifier, what is the utility/evidence for alternative sub...

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“…In dermatology, health-related quality of life instruments are dominated by the Dermatology Life Quality Index [18], which is used widely [19,20,21]. Other disease-specific quality of life instruments exist and are described elsewhere [22, 23].…”

Section: Outcome Measures In Dermatologymentioning

confidence: 99%

Need and Greed in Dermatology: Disease and Outcome Measures in Dermatological Healthcare Planning

Dalgard

Finlay

2006

Dermatology

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Assessing dermatological needs in the population and our ability to meet them is a challenge. The choice of outcome measures is central in dermatological healthcare planning. The concept of ill health and its relationship to dermatological outcome measures is described. Outcome measures used should provide information on these issues in order to gain insight into genuine needs and illness behavior in the population and to ensure quality of healthcare. Nevertheless, the dilemma of assigning priorities in healthcare planning remains; outcome measures in dermatology should be perceived as appropriate by patients as well as by caregivers and policy makers. It is important to stimulate research to develop and refine person-focused outcome measures. Their use is essential to assess dermatological health needs and to understand illness behavior. The information they can provide can enable provision and evaluation of healthcare quality and contribute to the challenge of making appropriate priority decisions in healthcare.

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Primary Focal Hyperhidrosis: Disease Characteristics and Functional Impairment

Cited by 139 publications

References 54 publications

Videothoracoscopic sympathectomy - a standard treatment for primary hyperhidrosis at the Clinic of Thoracic Surgery in Sremska Kamenica / Videotorakoskopska simpatektomija – standarna hirurška metoda za lečenje primarne hiperhidroze na Klinici za grudnu hirurgiju u Sremskoj Kamenici

Videothoracoscopic sympathectomy - a standard treatment for primary hyperhidrosis at the Clinic of Thoracic Surgery in Sremska Kamenica / Videotorakoskopska simpatektomija – standarna hirurška metoda za lečenje primarne hiperhidroze na Klinici za grudnu hirurgiju u Sremskoj Kamenici

Social anxiety disorder: questions and answers for the DSM-V

Need and Greed in Dermatology: Disease and Outcome Measures in Dermatological Healthcare Planning

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