Drysol for treatment of hyperhidrosis.
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47 patients with axillary palmar hyperhydrosis underwent this surgery. There were 36 women (76.6%) and 11 men (23.4%) among them. The sympathetic trunk has been coagulated on the level between 2d and 4th ribs on both sides. There were no surgical mortality in this group. Nine patients (9.1%) had a pneumothorax, one patient (2.1%) had a subcutaneous emphysema, the other one had pneumonia and one had wound pyosis. In 43 cases the result of the surgery was very good. In 2 cases bilateral relapse and in 2 cases marked compensatory hyperhydrosis were resistered.
Unilateral hyperhydrosis due to a cerebral infarct is a clinical sign rarely described in the literature, the significance of which is unknown and may be due to a lesion of the crossed sympathetic inhibitory tract. We describe the case of a patient with contralateral hyperhydrosis due to a hemipontine infarct.
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60 patients suffering from excessive sweating in the hands underwent cervical sympathectomy. At follow-up 1-7 years after operation the hands were dry in 55. No differences in electrolyte concentrations were found in the sweat from palms, arms, or body prior to and after the surgical intervention. Similarly no differences were found in electrolyte concentrations between healthy subjects and hyperhidrotics. Palmar sweat was hypertonic in comparison to arm or body sweat. The Na and K sweat concentrations were: palmar 50 +/- 20 and 16 +/- 7 mEq/1; arm 30 +/- 11 and 8 +/- 2 mEq/1; and body 21 +/- 20 and 4 +/- 3 mEq/1, respectively. Na/K ratio was: palmar 3.2; arms 3.6 and body 5.8. Total sweat loss prior to the operation was 5.7 +/- 4.2 g/kg BW/h; afterwards it was 5.9 +/- 4 g/kg BW/h. These equal sweat rates were associated with compensatory sweating in areas of the body not affected prior to the operation.
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Although there had not been complaints of excessive sweating pre-operatively, it was noticed incidentally that a large proportion of patients who had undergone axillary lymph node sampling or clearance for breast carcinoma seemed to report ipsilateral sweat loss as a pleasing 'complication'. We interviewed 65 consecutive patients who had all had axillary dissections performed by the same surgeon's technique; the interviews were held 2-102 months after their operations. In 36 cases, patients reported no change in axillary sweating (mean 35 months), whereas 29 patients reported a decrease (mean 50 months). This result was statistically significant at the 95% confidence interval (p=0.022).
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