Psychosocial aspects of patients with focal hyperhidrosis. Marked reduction of social phobia, anxiety and depression and increased quality of life after treatment with botulinum toxin A

Weber, Amber; Heger, Steffen; Sinkgraven, Ronald; Heckmann, Marc; Elsner, Peter; Rzany, Berthold

doi:10.1111/j.1365-2133.2004.06334.x

Cited by 116 publications

(116 citation statements)

References 13 publications

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“…1 Local treatment and psychotherapy have low effectiveness. 2 Video-assisted thoracic sympathectomy (VATS) provides excellent resolution of facial hyperhidrosis, but is associated with certain complications, especially with compensatory hyperhidrosis, which is the most frequent and important complication.…”

Section: Introductionmentioning

confidence: 99%

The use of oxybutynin for treating facial hyperhidrosis

Wolosker

Campos

Kauffman

et al. 2011

An. Bras. Dermatol.

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BACKGROUND: Facial hyperhidrosis is a disease that may lead patients to serious emotional disturbances. Video-assisted thoracic sympathectomy provides excellent resolution of facial hyperhidrosis, but is associated with certain complications. The most frequent and important complication is compensatory hyperhidrosis. Especially in patients who have undergone resection of the second thoracic ganglion, the risk of severe compensatory hyperhidrosis is higher, which may cause dissatisfaction with the procedure. OBJECTIVE: The aim of this study was to evaluate the efficacy of the use of low doses of oxybutynin in treating facial hyperhidrosis as well as the level of patient satisfaction with its use. METHODS: 25 patients with facial hyperhidrosis were treated with oxybutynin. The patients underwent 2 evaluations: before and after treatment. These evaluations were used to assess the patients' clinical improvement and quality of life. RESULTS: We observed that more than 75% of the patients evolved with an improvement in facial hyperhidrosis, and 52% of them presented a great improvement. CONCLUSION: Treatment of facial hyperhidrosis with oxybutynin is a good alternative to sympathectomy, since it presents good results and improves quality of life, in addition to not exposing patients to the risk of experiencing the side effects of sympathectomy. Keywords: Advanced treatment; Clinical protocols; Hyperhidrosis; Indicators of quality of life; Sympathectomy; Sweating Resumo: FUNDAMENTOS: Hiperidrose facial é uma doença que pode levar os pacientes a sérios distúrbios emocionais. A simpatectomia torácica vídeo-assistida proporciona excelente resolução da hiperidrose facial, mas está associada a algumas complicações, sendo a mais freqüente e mais importante a hiperidrose compensatória. Especialmente em pacientes submetidos à ressecção do segundo gânglio torácico, o risco de hiperidrose compensatória grave é maior, o que pode causar insatisfação com o procedimento. OBJETIVO: O objetivo deste estudo foi avaliar a eficácia e a satisfação dos pacientes com o uso da oxibutinina em doses baixas para tratar a hiperidrose facial em uma série grande de pacientes. MÉTODOS: 25 pacientes com hiperidrose facial foram tratados com oxibutinina. Os pacientes foram submetidos a duas avaliações: antes e depois do tratamento. Estas foram usadas para avaliar a melhoria clínica e a qualidade de vida. RESULTADOS: Observou-se que mais de 75% dos pacientes evoluíram com melhora na hiperidrose facial, sendo que 52% deles apresentaram uma grande melhora. CONCLUSÃO: O tratamento da hiperidrose facial com oxibutinina é uma boa alternativa à simpatectomia, visto que apresenta bons resultados e melhora a qualidade de vida, e os pacientes não correm o risco dos efeitos colaterais da simpatectomia.

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Section: Introductionmentioning

confidence: 99%

The use of oxybutynin for treating facial hyperhidrosis

Wolosker

Campos

Kauffman

et al. 2011

An. Bras. Dermatol.

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“…Fokal hiperhidrozun yaşam kalitesini olumsuz yönde etkilediği, anksiyete, depresyon ve sosyal fobiye yol açabildiği bildirilmiştir. [5][6][7] Hastamızda frontal hiperhidrozun yaşam kalitesine olan olumsuz etkisi tedavi sonrası belirgin olarak azalmıştır. Aksiller ve palmar bölgede botulinum toksin uygulaması daha yaygın olarak kullanılmaktadır.…”

Section: Discussionunclassified

Frontal Hiperhidrozda Botulinum Toksin Uygulaması

Aksu¹,

Saraçoğlu²,

Sabuncu³

2011

TURKDERM

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ÖzetFokal hiperhidroz sıklıkla aksiller ve palmoplantar bölgeye lokalizedir. Fakat daha az sıklıkla hiperhidroz alın bölgesinde de görü- Sum maryFocal hyperhidrosis is usually localized to the axillae, palms and soles. Less frequently, hyperhidrosis may be confined to the forehead and may have negative impact on patient's quality of life.A 34-year-old man presented to our clinic with the complaint of frontal hyperhidrosis. He was treated with botulinum toxin A. Thirty points were marked over the forehead and at each injection point, 0.15 ml (3U) botulinum toxin A were injected intracutaneously.Hyperhidrosis was significantly reduced and the effect lasted for 12 months. Skindex-29, a quality-of-life measure for skin disease, was administered to the patient at the beginning and at the end of second week of botulinum toxin A injection. There was a significant improvement on the Skindex-29 scale at the end of the treatment.There was no any side effect detected during and after the treatment. Botulinum toxin A treatment is considered to be effective and Gi riflFokal hiperhidroz sıklıkla aksiller ve palmoplantar bölgeye lokalizedir. Bazı erişkinlerde, özellikle erkeklerde, alında terleme görülebilir ve buna bağlı olarak hastanın yaşam kalitesi olumsuz yönde etkilenebilir. Olgu sunumuOtuz dört yaşında erkek hasta alında terleme şikayetiyle dermatoloji polikliniğine başvurdu. Hasta şikayetinin 10-12 yıldır mevcut olduğunu belirtti. Hastanın terlemesi stres, heyecan, fiziksel aktivite ve sıcakla birlikte artmaktaydı. Hasta terin gözüne damladı- Olgu SunumuCase Report

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“…143,227,[281][282][283] The Lessa et al 284 study used . The studies included two quality-of-life reviews, a RCT, a single case series, a case report and a surgical observational 285 The tool's design was based on findings from a review of the literature and focus group interviews with patients and clinicians to construct the initial framework for the ways in which patients are affected by skin disease.…”

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

confidence: 99%

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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Psychosocial aspects of patients with focal hyperhidrosis. Marked reduction of social phobia, anxiety and depression and increased quality of life after treatment with botulinum toxin A

Cited by 116 publications

References 13 publications

The use of oxybutynin for treating facial hyperhidrosis

The use of oxybutynin for treating facial hyperhidrosis

Frontal Hiperhidrozda Botulinum Toksin Uygulaması

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

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