Prospective study of percutaneous radiofrequency sympathicolysis in severe hyperhidrosis and facial blushing: efficacy and safety findings

Franco, Carlos Enrique García; Pérez-Cajaraville, J.; Guillén-Grima, Francisco; España, A.

doi:10.1016/j.ejcts.2011.05.010

Cited by 11 publications

(14 citation statements)

References 20 publications

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“…262 Developed by Finlay and Khan 262 to provide a patient-centred method for comparison between different types of skin disease, the questionnaire records the impact each disease has on a patient's quality of life and the relative effectiveness of treatment. ), surgical studies (n = 5 176,208,210,214,217 ), studies of quality of life only (n = 2 225,227 ) and also economic assessments (n = 1 230 ).…”

Section: Hyperhidrosis Quality Of Life Indexmentioning

confidence: 99%

“…The DLQI was identified in studies conducted globally, including in the UK (n = 9 103,232,261,262,267,268,275 ), the USA and Canada (n = 8 77,107,139,173,176,208,222,263 ), Italy (n = 7 101,102,106,214,223,266,272 ), Germany (n = 5 69,158,227,270,271 ), Sweden (n = 4 114,116,117,128 ), Greece (n = 3 [119][120][121] ), Ireland (n = 2 265,274 ), Iran (n = 2 170,264 ), Spain (n = 2 210,230 ), Australia (n = 1 ) or surgical reviews or reviews of surgery compared with dermatology (n = 3 147,267,273 ). The DLQI was used in studies to measure quality of life on various areas of the body; studies of axillary sweating combined with other parts of the body, such as palms or feet, were most common (n = 26 54,56,69,77,101,103,106,107,…”

Section: Review Of Quality-of-life Measures/toolsmentioning

confidence: 99%

“…51,59,210,216,217,220,226,227,232 The HDSS is a disease-specific tool considered important for diagnostic use in clinical practice and for research to identify and quantify the severity of disease in patients with hyperhidrosis and also to assess treatment effects over time. 12,205 The HDSS allows researchers to measure the impact of hyperhidrosis on those suffering from excessive sweating by using a four-point scale:…”

Section: Hyperhidrosis Disease Severity Scalementioning

confidence: 99%

“…The DLQI was used in studies to measure quality of life on various areas of the body; studies of axillary sweating combined with other parts of the body, such as palms or feet, were most common (n = 26 54,56,69,77,101,103,106,107,114,[119][120][121]139,147,158,170,173,176,214,221,223,263,266,273,274 ). Studies were identified of the palm or palm and foot combined (n = 11 61,128,208,222,230,264,265,[269][270][271][272] ) and of other combinations including the face, palm and/or foot or generalised hyperhidrosis (n = 11 116,117,210,217,227,232,261,262,267,268,275 ).…”

Section: Review Of Quality-of-life Measures/toolsmentioning

confidence: 99%

“…Studies that were found to use the HDSS tool were conducted globally, including the USA and Canada (n = 21 21,27,29,52,77,107,108,139,159,160,164,175,176,179,180,208,209,218,225,226,229 ), Spain (n = 6 167,207,210,224,230,231 ), the UK (n = 5 91,97,125,222,232 ), Germany (n = 5 2,131,145,161,227 ), Italy (n = 5 102,106, 136,214,223 ), France (n = 3 59,61,211 ), South Korea (n = 3 51,171,174 ), Australia (n = 2 53,221 ), Egypt (n = 2 213,219 ), Iran (n = 2 28,220 ), the Netherlands (n = 2 ...…”

Section: Hyperhidrosis Disease Severity Scalementioning

confidence: 99%

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Interventions for hyperhidrosis in secondary care: a systematic review and value-of-information analysis

Wade

Rice

Llewellyn

et al. 2017

Health Technol Assess

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BackgroundHyperhidrosis is uncontrollable excessive sweating that occurs at rest, regardless of temperature. The symptoms of hyperhidrosis can significantly affect quality of life. The management of hyperhidrosis is uncertain and variable.ObjectiveTo establish the expected value of undertaking additional research to determine the most effective interventions for the management of refractory primary hyperhidrosis in secondary care.MethodsA systematic review and economic model, including a value-of-information (VOI) analysis. Treatments to be prescribed by dermatologists and minor surgical treatments for hyperhidrosis of the hands, feet and axillae were reviewed; as endoscopic thoracic sympathectomy (ETS) is incontestably an end-of-line treatment, it was not reviewed further. Fifteen databases (e.g. CENTRAL, PubMed and PsycINFO), conference proceedings and trial registers were searched from inception to July 2016. Systematic review methods were followed. Pairwise meta-analyses were conducted for comparisons between botulinum toxin (BTX) injections and placebo for axillary hyperhidrosis, but otherwise, owing to evidence limitations, data were synthesised narratively. A decision-analytic model assessed the cost-effectiveness and VOI of five treatments (iontophoresis, medication, BTX, curettage, ETS) in 64 different sequences for axillary hyperhidrosis only.Results and conclusionsFifty studies were included in the effectiveness review: 32 randomised controlled trials (RCTs), 17 non-RCTs and one large prospective case series. Most studies were small, rated as having a high risk of bias and poorly reported. The interventions assessed in the review were iontophoresis, BTX, anticholinergic medications, curettage and newer energy-based technologies that damage the sweat gland (e.g. laser, microwave). There is moderate-quality evidence of a large statistically significant effect of BTX on axillary hyperhidrosis symptoms, compared with placebo. There was weak but consistent evidence for iontophoresis for palmar hyperhidrosis. Evidence for other interventions was of low or very low quality. For axillary hyperhidrosis cost-effectiveness results indicated that iontophoresis, BTX, medication, curettage and ETS was the most cost-effective sequence (probability 0.8), with an incremental cost-effectiveness ratio of £9304 per quality-adjusted life-year. Uncertainty associated with study bias was not reflected in the economic results. Patients and clinicians attending an end-of-project workshop were satisfied with the sequence of treatments for axillary hyperhidrosis identified as being cost-effective. All patient advisors considered that the Hyperhidrosis Quality of Life Index was superior to other tools commonly used in hyperhidrosis research for assessing quality of life.LimitationsThe evidence for the clinical effectiveness and safety of second-line treatments for primary hyperhidrosis is limited. This meant that there was insufficient evidence to draw conclusions for most interventions assessed and the cost-effectiveness analysis was restricted to hyperhidrosis of the axilla.Future workBased on anecdotal evidence and inference from evidence for the axillae, participants agreed that a trial of BTX (with anaesthesia) compared with iontophoresis for palmar hyperhidrosis would be most useful. The VOI analysis indicates that further research into the effectiveness of existing medications might be worthwhile, but it is unclear that such trials are of clinical importance. Research that established a robust estimate of the annual incidence of axillary hyperhidrosis in the UK population would reduce the uncertainty in future VOI analyses.Study registrationThis study is registered as PROSPERO CRD42015027803.FundingThe National Institute for Health Research Health Technology Assessment programme.

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Section: Hyperhidrosis Quality Of Life Indexmentioning

confidence: 99%

Section: Review Of Quality-of-life Measures/toolsmentioning

confidence: 99%

Section: Hyperhidrosis Disease Severity Scalementioning

confidence: 99%

Section: Review Of Quality-of-life Measures/toolsmentioning

confidence: 99%

Section: Hyperhidrosis Disease Severity Scalementioning

confidence: 99%

See 3 more Smart Citations

Interventions for hyperhidrosis in secondary care: a systematic review and value-of-information analysis

Wade

Rice

Llewellyn

et al. 2017

Health Technol Assess

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Effectiveness of Bilateral Clipping of the Thoracic Sympathetic Chain for the Treatment of Severe Palmar and/or Axillary Hyperhidrosis and Facial Flushing

Alfara

López-Rodó

Ferrández

et al. 2019

Cirugía Española (English Edition)

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Efficacy and safety of radiofrequency ablation versus surgical sympathectomy in palmar hyperhidrosis

Zhong,

Zhu,

et al. 2024

Sci Rep

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Radiofrequency ablation (RFA) comparative efficacy of treatments using video-assisted thoracoscopic sympathectomy (VATS) in the long term remains uncertain in patients with palmar hyperhidrosis (PHH). This study aimed to compare the efficacy and safety of RFA and VATS in patients with PHH. We recruited patients aged ≥ 14 years with diagnosed PHH from 14 centres in China. The treatment options of RFA or VATS were assigned to two cohort in patients with PHH. The primary outcome was the efficacy at 1-year. A total of 807 patients were enrolled. After propensity score matching, the rate of complete remission was lower in RFA group than VATS group (95% CI 0.21–0.57; p < 0.001). However, the rates of palmar dryness (95% CI 0.38–0.92; p = 0.020), postoperative pain (95% CI 0.13–0.33; p < 0.001), and surgery-related complications (95% CI 0.19–0.85; p = 0.020) were lower in RFA group than in VATS group, but skin temperature rise was more common in RFA group (95% CI 1.84–3.58; p < 0.001). RFA had a lower success rate than VATS for the complete remission of PHH. However, the symptom burden and cost are lower in patients undergoing RFA compared to those undergoing VATS.Trial Registration: ChiCTR2000039576, URL: http://www.chictr.org.cn/index.aspx.

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Prospective study of percutaneous radiofrequency sympathicolysis in severe hyperhidrosis and facial blushing: efficacy and safety findings

Abstract: Our results support the view of surgical sympathectomy as the gold-standard treatment in severe cases of Hh and Fb. Radiofrequency sympathicolysis is useful as a second-treatment choice for Hh patients. Fb patients do not benefit from radiofrequency sympathicolysis.

Cited by 11 publications

References 20 publications

Interventions for hyperhidrosis in secondary care: a systematic review and value-of-information analysis

Interventions for hyperhidrosis in secondary care: a systematic review and value-of-information analysis

Effectiveness of Bilateral Clipping of the Thoracic Sympathetic Chain for the Treatment of Severe Palmar and/or Axillary Hyperhidrosis and Facial Flushing

Efficacy and safety of radiofrequency ablation versus surgical sympathectomy in palmar hyperhidrosis

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