Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Hyperhidrosis”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 1,081 records · Page 60Linked to original sources
PubMed1993

Surgical treatment of axillary osmidrosis.

Various types of surgical procedures have been developed for treatment of axillary hyperhidrosis and osmidrosis. However, Asian people tend to seek treatment for osmidrosis rather than hyperhidrosis. In this article, we report a new modified surgical method concerning axillary osmidrosis. At first we make four transverse parallel incisions; two incisions in the center are large (approximately 4 cm in length) and the lateral ones are small (approximately 1.5 cm in length). Then, we do enough undermining from the four wound edges to make a wide subcutaneous tunnel, and the adipose tissue beneath the skin is removed with scissors through each incision. Finally, two pieces of Penrose drain are inserted through the small lateral incisions. With this method we have operated on 21 patients in the past 3 years; 19 patients were female, and only 2 were male. Patients were followed for a minimum of 3 months and a maximum of 22 months, with an average follow-up of 7 months. In terms of results, 14 were good, 5 fair, and 2 poor. Minor complications such as partial epidermal necrosis occurred in only 2 patients, but healed with conservative treatment, and other complications such as hematoma formation or infection did not occur. In this article, we emphasize two merits of our procedure. One is that adding small incisions at both lateral margins makes it possible to perform the further excision of the apocrine glands. The other merit is that drainage from the small incisions is very effective. We believe this procedure is a viable option for treatment of axillary hyperhidrosis and osmidrosis.

Adolescent↗
PubMed2001

A new mode of percutaneous upper thoracic phenol sympathicolysis: report of 50 cases.

OBJECTIVE: Our previous study demonstrated that a high concentration of phenol (75-90%) with minimal volume (0.02 ml) can elicit serious degeneration of ganglion cells of the stellate ganglia in cats. Another previous study in our clinical patients demonstrated that approximately 84 to 90% of the upper thoracic (T2-T3) sympathetic trunks can be found under an endoscope on the ventral side of the T2-T3 rib heads. In this report, we present a new mode of dorsal percutaneous thoracic phenol sympathicolysis (PTPS) for the treatment of palmar hyperhidrosis or axillary bromidrosis. METHODS: Fifty patients with palmar hyperhidrosis or axillary bromidrosis were injected with 75% phenol into a total of 98 sides of the T2-T3 or T3-T4 sympathetic trunks and ganglia. The injected volume was 0.6 to 1.2 ml (average, 0.8 ml) for each side. The technique of dorsal percutaneous injection was performed under local anesthesia or local with intravenous general anesthesia and under the guidance of a C-arm fluoroscope. RESULTS: Forty patients (80%) showed satisfactory results, including cessation of sweating. The success rates of PTPS were 83.7% (41 of 49 patients) on the left side and 91.8% (45 of 49 patients) on the right side. The skin temperature of the thumb increased by 5.3 to 5.4 degrees C approximately 1 hour after the phenol injection in patients with satisfactory results, whereas it increased by only 1.3 to 2.7 degrees C in patients who had unsatisfactory results. CONCLUSION: PTPS may be a good alternative to endoscopic sympathectomy to treat palmar hyperhidrosis and axillary bromidrosis. The skin temperature of the thumb is still a useful index to evaluate preliminarily whether PTPS has been successful.

Adolescent↗
PubMed1978

Symmetrical lividity of the palms and soles.

Symmetrical lividity (SL) was the term coined by Pernet in 1925 for symmetrical, bluish-red plaques on the soles of the feet, accompanied by hyperhidrosis and not corresponding to areas of pressure or patterns of innervation. We report two patients with a persistent eruption of the palms analogous to that described by Pernet on the feet. Unlike most reported cases of SL, our patients did not respond to topical drying treatments, but one patient partially responded to tretinoin. There appear to be two forms of SL: transient, which responds to drying; and persistent which does not respond to drying. The hyperhidrosis studied in one of our two patients was significantly greater within the plaques of SL than the normal palm. While we could suppress the hyperhidrosis with topical therapy, this failed to clear his hyperkeratosis or eliminate the livid color.

Adult↗
PubMed2005

Treatments for excessive armpit sweating.

Many people who complain of excessive sweating have primary hyperhidrosis. This idiopathic disorder is characterised by excessive, bilateral and roughly symmetrical sweating, most commonly affecting the axillae, palms, feet and face. For some patients, excessive sweating is intolerable as it stains and damages clothes, reduces confidence and limits social contact. Treatment options have been limited but now include botulinum toxin for severe axillary hyperhidrosis. Here we review treatments for primary focal hyperhidrosis, focusing on axillary sweating.

Administration, Topical↗
PubMed2005

A comparison of peripheral skin blood flow and temperature during endoscopic thoracic sympathotomy.

The assessment of sympathetic denervation to the upper extremities during surgery for hyperhidrosis is essential in predicting postoperative outcome, particularly for endoscopic thoracic chain sympathotomy, a recently described, minimally destructive technique that minimizes postoperative compensatory hyperhidrosis. To test the hypothesis that skin blood flow (SkBF; laser Doppler flowmetry) provides a faster and more reliable indication of denervation than temperature (temp), we prospectively compared palmar SkBF and fingertip temp in 10 patients undergoing endoscopic thoracic chain sympathotomy for essential hyperhidrosis. From baseline to peak values, palmar SkBF (mean +/- SEM) increased 273.3 +/- 24.7 arbitrary units and 252.4 +/- 30.1 arbitrary units, whereas temp increased 0.9 degrees C +/- 0.3 degrees C and 1.5 degrees C +/- 0.6 degrees C on the right and left, respectively. Upon effective sympathotomy of the right thoracic chain, the time to peak SkBF was 43 +/- 13 s, whereas the time to peak temp was 277 +/- 53 s (P <0.001). On the left, the time to peak SkBF was 81 +/- 14 s, and time to peak temp was 305 +/- 34 s (P <0.001). All patients considered the sympathotomy successful. We conclude that laser Doppler SkBF is superior to temp in temporal resolution for assessment of denervation during sympathotomy and that it provides a superior qualitative and quantitative adjunct to monitoring denervation.

Adolescent↗
PubMed1993

Video-assisted endoscopic thoracic ganglionectomy.

Sympathetic nerve disorders of the upper extremities can be treated by neurosurgeons using upper thoracic sympathectomy via a posterior approach. Descriptions have been published of alternative endoscopic procedures involving thermocoagulation, laser coagulation, or nonvideo-assisted ganglionectomy using equipment not widely available, with low morbidity and excellent results. The authors describe the use of an endoscopic approach to the thoracic sympathetic ganglia with systems designed for laparoscopic cholecystectomy. Thoracic ganglionectomy is reported in 22 patients with primary palmar hyperhidrosis and eight patients with reflex sympathetic dystrophy. The patients underwent double-lumen endotracheal intubation, after which 11- and 5.5-mm trocars were introduced into the chest cavity. Pneumothorax was produced with CO2 insufflation. Fiberoptic closed-circuit television was used to visualize the structures to be dissected. The parietal pleura over the heads of the first and second ribs was excised using 5-mm blunt and sharp insulated coagulating microscissors. The stellate and upper thoracic ganglia were clearly identified and dissected. The T-2 and T-3 ganglia were grasped with forceps and excised. A No. 16 French chest tube was introduced through a trocar, placed under water seal after the lungs were reinflated, and removed in the recovery room. The average hospital stay was 15.4 hours. There were no intraoperative complications. The average operating time was 30 minutes per side. Five patients had mild pleuritic pain which resolved within 2 weeks after surgery. Six (75%) of the eight patients with reflex sympathetic dystrophy had complete or partial relief of their symptoms (average follow-up period 5 months), and all patients had complete relief of hyperhidrosis (average follow-up period 8 months). Endoscopic ganglionectomy requires readily available and easily used instrumentation and provides a well-tolerated, cost-effective alternative to posterior thoracic sympathectomy for primary palmar hyperhidrosis and reflex sympathetic dystrophy.

Ganglionectomy↗
PubMed1999

Endoscopic thoracic sympathectomy.

OBJECT: Thoracic sympathectomy has evolved as a treatment option for patients with hyperhidrosis and pain disorders. In the past, surgical procedures were highly invasive and caused significant morbidity, but the minimally invasive thoracoscopic procedure provides detailed visualization of the sympathetic ganglia and is associated with minimal postoperative morbidity. METHODS: The authors performed 112 thoracoscopic sympathectomy procedures in 65 patients, and the outcomes were equivalent to those previously established for open surgical techniques; however, the rate of surgery-related morbidity, length of hospital stay, and time until return to normal activity were substantially reduced. Complications and recurrence of symptoms were comparable with those demonstrated in previous reports. Overall patient satisfaction and willingness to undergo a repeated operative procedure ranged from 66 to 99%. Postoperatively, higher satisfaction rates were observed in patients with hyperhidrosis whereas in those with pain syndromes, satisfaction rates were lower. CONCLUSIONS: Minimally invasive thoracoscopic sympathectomy procedures are useful in treating sympathetically mediated disorders, and the results indicate that the procedure is associated with reduced morbidity and similar outcome when compared with results obtained after open surgery. Hyperhidrosis is well treated, but patients with pain syndromes have significantly poorer outcomes.

Causalgia↗
PubMed1999

[Intraoperative assessment by laser-Doppler skin blood flowmetry of the efficacy of endoscopic thoracic sympathectomy].

We have investigated whether laser-Doppler (L-D) skin blood flowmetry on the finger could be useful for an intraoperative assessment of the efficacy of endoscopic thoracic sympathectomy (ETS) under general anesthesia. Subjects were 5 young adults receiving ETS for palmar hyperhidrosis. ETS was performed with the patients in the semi-sitting position under one lung ventilation. A pair of LDF probes were placed on the palmar side of the both second fingers. Palmar hyperhidrosis disappeared after ETS in all cases, but compensatory hyperhidrosis developed in the back of the body and the thigh. After completion of ETS on one side, the L-D skin blood flow increased to 267.6 +/- 211.1% on the side of ETS, and it increased in 2 other cases and decreased on the contrary in 3 cases on the other side. After ETS on both sides the L-D skin blood flow increased to 265.0 +/- 185.9% on the side of initial ETS and to 211.4 +/- 172.8% on the side of subsequent ETS. The initial EST induced reflex vasoconstriction on the finger of both sides and also on the toe. Spontaneous fluctuation and reflex vasoconstriction of the skin blood flow were still observed, although the periodicity of spontaneous fluctuation between the right and the left finger was lost in some of the cases. An increase in L-D skin blood flow on the side of ongoing ETS is useful for intraoperative assessment of ETS.

Adult↗
PubMed1999

Extensor pollicis longus paralysis following thoracoscopic sympathectomy.

Thoracoscopic sympathectomy is an acceptable form of treatment for palmar hyperhidrosis. Many authors have reported favourable results. Complications range from pneumo-haemothorax, Horner's syndrome, compensatory hyperhidrosis and bleeding. Plas et al reported 2.7% of the procedures had complications requiring intervention and 9.7% had non-interventive complications. There have been isolated reports of other rare complications including false aneurysm of intercostal artery, inferior brachial plexus injury and abnormal suntanning. We report an unusual case of isolated extensor pollicis longus paralysis after a thoracoscopic sympathectomy for palmar hyperhidrosis, in a fit young male. Such complications have not been previously reported. We recognise that such isolated nerve injury is uncommon.

Adult↗
PubMed2002

Thoracoscopic sympathectomy for primary palmar hyperhydrosis: the Penang Hospital experience.

BACKGROUND: Primary palmar hyperhidrosis is a functionally and socially disabling condition. The choice of treatment is controversial. OBJECTIVE: To examine the clinical presentation of primary palmar hyperhidrosis and the results of treatment with thoracoscopic sympathectomy in a local setting. MATERIALS AND METHODS: A retrospective study of 7 patients involving 10 sympathectomies between October 1997 and October 2000 was undertaken. RESULTS: The duration of anaesthesia ranged from 55 to 130 minutes with the majority being 1 hour. The immediate results were good, with all operated limbs dry soon after operation. There was no mortality or serious morbidity in this study. All were satisfied with the results of surgery. CONCLUSIONS: Primary palmar hyperhidrosis is not uncommon but rather underdiagnosed. Thoracoscopic sympathectomy is an effective treatment with minimal complications.

Adolescent↗
PubMed1990

[Thoracic sympathectomy by thoracoscopy. Apropos of 15 cases].

UNLABELLED: Thoracic sympathectomy is achieved using the trans-axillary route during the course of a thoracotomy. The indications are Raynaud's phenomenon, digital arteriopathy, and hyperhidrosis. Alongside the surgical approach in theory it is possible to use a thoracoscopic approach for a thoracic sympathectomy, to achieve a physico-chemical destruction, we have studied this possibility using this technique. MATERIAL AND METHODS: Thoracoscopy is achieved under local anaesthetic after creating a pneumothorax. The approach is through the 2nd intercostal space in the mid-clavicular line. Anaesthesia of the 2nd sympathetic ganglion is achieved, the ganglion is destroyed by injection of 8 c.c's of Phenol. 15 patients were treated (15 to 7). The presented with palmar hyperhidrosis (7), digital arteriopathy (6) or Raynaud's syndrome (2). RESULTS: The first 5 patients were failures which led to a more precise technique. Overall we observed 8 favourable results. If we exclude the first 5 cases we achieved 8 favourable results and 2 failures. The approach to the 2nd sympathetic ganglion using the thoracoscope is not always possible: the vision may be obscured. When it is possible phenolization may yield excellent results comparable to those of surgical sympathectomy. CONCLUSION: Palmar hyperhidrosis for which we have obtained the best results seems to us to be an extra indication of this technique which enables a cure at the price of a relatively simple procedure and a brief period of hospital stay.

Adolescent↗
PubMed1979

'Rusters'. The corrosive action of palmar sweat: I. Sodium chloride in sweat.

Sweat from 8 'rusters' and 8 control persons was examined for its sodium concentration. Sweating was induced by iontophoresis of pilocarpine on the distal forearm. In no case did the concentrations exceed the normal upper limit for this procedure, and no difference was found between the two groups. In this way the study failed to confirm earlier reports of elevated sodium chloride concentrations in sweat from 'rusters'. Proposals of a relationship between 'rusters' and patients with pancreatic cystic fibrosis were not substantiated. Hyperhidrosis of the palms and volar surfaces of the fingers was present in all 'rusters'. This seemed to be the main cause of the corrosive tendency, and patients referred for palmar hyperhidrosis were found to produce corrosion similar to the 'rusters'. Topical application of aluminium chloride hexahydrate in a 25% solution in absolute ethyl alcohol proved effective against both hyperhidrosis and the corrosive tendency.

Administration, Topical↗
PubMed1996

[Granulosis rubra nasi and pheochromocytoma].

INTRODUCTION: Granulosis rubra nasi, a papular red lesion of the nose associated with hypersudation is an uncommon dermatosis usually seen in children. CASE REPORT: A noradrenalin secreting pheochromocytoma was found in 19-year-old girl with hyperhidrosis, granulosis rubra nasi and tachycardia. Surgical exeresis of the pheochromocytoma was followed by involution of the hyperhidrosis, regression of the nasal dermatosis and normalization of urinary catecholamines. DISCUSSION: The diagnosis of pheochromocytoma should be entertained in patients with hypersudation and tachycardia. Granulosis rubra nasi could be a complication of hyperhidrosis.

Adrenal Gland Neoplasms↗
PubMed1998

[Surgical technique of endoscopic transthoracic sympathicotomy: axillary approach].

A total of 181 endoscopic transthoracic sympathicotomy were performed at our hospital from December, 1992 to March, 1997. After single-lumen endotracheal intubation for general anesthesia, the patient was placed in half sitting position. A small (1 cm) incision was made in the anterior axillary line through the third intercostal space and an apical pneumothorax was created by insufflation of 1.8 L of CO2 in the pleural cavity through a Surgineedle. A 24 Fr. urological transurethral electroresectoscope was introduced through the same incision. The sympathetic chain could be observed through parietal pleura riding on the costovertebral junctions. In palmar hyperhidrosis the second and third thoracic sympathetic ganglia were electrocoagulated. In axillary hyperhidrosis the forth ganglion was included. The lung was expanded by limiting expiration and sucking CO2. The operation was repeated on the other side. Endoscopic transthoracic sympathicotomy was an efficient, safe and low invasive surgical procedure for the treatment of palmar, axillary hyperhidrosis, Raynaud's disease and Buerger disease.

Axilla↗
PubMed2003

Specific complications and mortality of endoscopic thoracic sympathectomy.

Endoscopic Thoracic Sympathectomy (ETS) has gained an increasing popularity due to its minimal invasive character. Despite the simplicity of the procedure, non-surgical options should always be considered as the first line of treatment. The complication risk of ETS is low but side effects, primarily compensatory sweating (CS) of mainly the trunk may be severe enough to cause regret of the procedure. The risk/benefit ratio should always be discussed with the patient. Severe palmar hyperhidrosis and facial blushing respond very well to ETS with a high patient satisfaction rate. Facial hyperhidrosis is effectively treated with ETS but is associated with a high risk for severe CS. Axillary hyperhidrosis is best treated by other means than ETS. The use of ETS for pain syndromes, vascular insufficiency and angina pectoris is not well supported by scientific evidence, making mandatory careful patient selection.

Humans↗
PubMed2005

Oximetry-derived perfusion index for intraoperative identification of successful thoracic sympathectomy.

BACKGROUND: Endoscopic thoracic sympathectomy treats patients with hyperhidrosis. Laser Doppler flow and changes in palmar temperature have been advocated for intraoperative monitoring. The pulse oximetry-derived perfusion index (PI) is used to quantify pulsatile blood flow at the pulse oximeter. Upper limb sympathectomy is associated with increased flow to the ipsilateral extremity; thus we postulate that it will increase PI. We evaluated changes in intraoperative PI as a monitor of successful thoracic sympathectomy. METHODS: After institutional review board approval and informed consent, 10 adult patients undergoing bilateral endoscopic thoracic sympathectomy under general anesthesia were studied. Finger pulse-oximetry probes were placed on each hand, and reference probes on each earlobe. Hemodynamic variables and PI were continuously monitored. Data were collected immediately before and every minute after sympathectomy for 5 minutes. Anesthetic management remained constant throughout. A successful sympathectomy was defined by a twofold increase in PI on the ipsilateral arm. Data were analyzed with analysis of variance and Student's t tests; a p < 0.05 was considered significant. RESULTS: Baseline oximetric waveforms were adequate in all subjects. Right sympathectomy was associated with a 372% increase in PI (p < 0.0001), and left sympathectomy with a 316% increase in PI (p < 0.029). This occurred as early as 1 minute after transection of the sympathetic chain. The PI in the reference probes as well as the hemodynamics remained constant. All patients had postoperative resolution of their hyperhidrosis symptoms. CONCLUSIONS: In patients with hyperhidrosis of the upper extremity, the intraoperative PI derived from pulse oximetry is an additional indicator of successful thoracic sympathectomy.

Adolescent↗
PubMed2003

Biofeedback, cognitive-behavioral methods, and hypnosis in dermatology: is it all in your mind?

Biofeedback can improve cutaneous problems that have an autonomic nervous system component. Examples include biofeedback of galvanic skin resistance (GSR) for hyperhidrosis and biofeedback of skin temperature for Raynaud's disease. Hypnosis may enhance the effects obtained by biofeedback. Cognitive-behavioral methods may resolve dysfunctional thought patterns (cognitive) or actions (behavioral) that damage the skin or interfere with dermatologic therapy. Responsive diseases include acne excoriée, atopic dermatitis, factitious cheilitis, hyperhidrosis, lichen simplex chronicus, needle phobia, neurodermatitis, onychotillomania, prurigo nodularis, trichotillomania, and urticaria. Hypnosis can facilitate aversive therapy and enhance desensitization and other cognitive-behavioral methods. Hypnosis may improve or resolve numerous dermatoses. Examples include acne excoriée, alopecia areata, atopic dermatitis, congenital ichthyosiform erythroderma, dyshidrotic dermatitis, erythromelalgia, furuncles, glossodynia, herpes simplex, hyperhidrosis, ichthyosis vulgaris, lichen planus, neurodermatitis, nummular dermatitis, postherpetic neuralgia, pruritus, psoriasis, rosacea, trichotillomania, urticaria, verruca vulgaris, and vitiligo. Hypnosis can also reduce the anxiety and pain associated with dermatologic procedures.

Biofeedback, Psychology↗
PubMed2002

Treatment of dyshidrotic hand dermatitis with intradermal botulinum toxin.

BACKGROUND: Botulinum toxin (Btx A) has recently been used in the treatment of focal hyperhidrosis. Hyperhidrosis is also an aggravating factor in nearly 40% of patients with dyshidrotic hand eczema. OBJECTIVE: The objective of this study was to evaluate the effect of intradermal injections of Btx A on dermatitis in patients with vesicular hand dermatitis. METHODS: Ten patients with vesicular dermatitis were treated on one hand with intradermal Btx A (mean, 162 U BOTOX, Allergan Pharmaceuticals, Irvine, Calif) with the untreated side as a control. RESULTS: Self-assessment at follow-up 5 to 6 weeks after injection on a 5-point scale (none, slight, moderate, good, or very good effect) showed that 7 of 10 patients experienced good or very good effect. A decrease in itching was shown with a visual linear analogue scale (VAS) for itching, with mean 39% on the treated side compared with an increase by 52% on the untreated side. These findings were supported by the evaluation of clinical signs. Six of 7 patients who experienced good or very good effect also had aggravating hand sweating or worsening during the summer. CONCLUSION: Btx A can be a valuable alternative for patients with treatment-refractory hand eczema of the vesicular type, especially with hyperhidrosis or worsening during the summer.

Adult↗