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PubMed2002

Uniportal and biportal endoscopic thoracic sympathectomy.

Sypathectomy for treatment of hyperhidrosis and pain syndromes of the upper extremities has recently evolved from invasive open procedures to endoscopic procedures. These minimally invasive techniques also have evolved, from complex staged procedures with multiple ports to more simplified biportal and uniportal procedures that require minimal tissue disruption and more limited yet effective sympathectomy procedures. We describe our techniques, experience, and results using endoscopic sympathectomy procedures with further reduced invasiveness, morbidity, and complications.

Humans↗

PubMed2003

Eccrine angiomatous hamartoma: a case report and review of the literature.

Eccrine angiomatous hamartoma (EAH) is a rare, benign condition recognized histologically by increased numbers of eccrine elements, as well as numerous vascular channels. Patients typically present with a solitary, sometimes enlarging, nodule of the extremities usually appearing at birth or arising during childhood. When symptomatic, EAH may be associated with hyperhidrosis or pain. We report a case of EAH on the calf of a young girl; review all other known documented cases in the literature; and summarize the clinical characteristics, histologic findings, and prognosis of this uncommon entity.

Child↗

PubMed1956

Symmetric lividity of the soles as seen in private practice.

As seen in private practice, symmetric lividity of the soles is a relatively common condition which occurs predominantly in males in the first three decades of life.Untreated, the syndrome may persist for many years or it may be self-limiting, lasting only a few days. Occupation does not seem to be a factor predisposing to symmetric lividity of the soles. There is a high incidence of family occurrence of this condition.Any form of treatment which controls the hyperhidrosis controls the other symptoms of symmetric lividity of the soles.

Foot↗

PubMed1992

[The diagnostic significance of evoked cutaneous sympathetic potentials].

A study was made of evoked cutaneous sympathetic potentials in healthy persons, in simulation of emotional stress, in physical and orthostatic loads as well as during administration of 40 mg anapriline, 120 mg gangleron, and 15 mg diazepam. The purpose of the study was to identify factors that influence evoked cutaneous sympathetic potentials (ECSP). The mechanisms are reviewed of cutaneogalvanic reaction underlying ECSP. The data obtained were compared to those in patients with diabetes mellitus, Charcot-Marie amyotrophy, Guillain-Barré syndrome, Raynaud's disease, essential hyperhidrosis, panic attacks, and spinal amyotrophy. Analysis of ECSP makes it possible to reveal both brain function and primarily the presence of pathological alterations in the peripheral (segmental) autonomic nervous system.

Adult↗

PubMed1977

[Clinical studies and pathogenesis of hairdresser's dermatitis].

Characteristically, hairdresser's dermatitis arises shortly after occupational exposure and tends to clear quickly following a change of professions. A large number of causative agents are usually found. There is a considerably higher incidence in females. The following factors play a major role in the pathogenesis of hairdresser's dermatitis alkalinity of the substances used, carelessness in handling the chemicals, mechanical trauma and constant wetting of the skin, and constitutional factors such as hyperhidrosis and dyshidrosis.

Adolescent↗

PubMed1992

Transaxillary endoscopic laser sympathectomy.

The authors describe a technique of achieving sympathetic denervation of the upper limbs in a 20-year-old woman with hyperhidrosis. A thoracoscope was inserted through a short incision in the axilla. A fibreoptic wave guide was passed through the thoracoscope to allow photocoagulation of the second thoracic sympathetic ganglion by Nd:YAG laser irradiation. The procedure was well tolerated and subsequent scar formation was unobtrusive.

Adult↗

PubMed2004

Paroxysmal autonomic alterations mimicking epilepsy: a case report.

A 22-year-old male patient presented with paroxysmal hyperhidrosis, mydriasis, hypertension, and tachycardia. Cranial and cervical MRI revealed focal atrophy in the high order zone of the central autonomic network and syringomyelia. His physical and neurological examinations were unremarkable. Physiological testing included EEG, SPECT, serum/urine tests and autonomic testing. A poor response was achieved with the medical and interventional procedures employed. As the central autonomic network is an integral component of the internal regulation system of the brain, any lesion, no matter where in the network, may lead to paroxysmal autonomic alterations mimicking epilepsy (Published with videosequences).

Adult↗

PubMed1992

Clonidine therapy for Shapiro's syndrome.

Shapiro's syndrome comprises agenesis of the corpus callosum in association with episodic hyperhidrosis and hypothermia. We describe a 25-year-old man who is the twentieth case to be reported. There was no evidence of epilepsy, sympathetic nervous system dysfunction or inappropriate vasopressin release. However, investigation demonstrated a central defect in temperature regulation with an abnormally low hypothalamic set-point and normal homeothermic reflexes. Therapy with clonidine, an alpha 2-adrenoceptor agonist, was associated with remission of symptoms: these recurred on four occasions when clonidine was withdrawn. Clonidine therapy was also associated with a return to normal central temperature regulation. We suggest that the efficacy of clonidine reflects an action on hypothalamic thermoregulation rather than on peripheral catecholamine release. These findings have implications for the use of clonidine in other patients with Shapiro's syndrome and in more common disorders of temperature control, including perimenopausal flushing.

Adult↗

PubMed2006

[Paroxysmal sympathetic storm after diffuse axonal head injury].

The term paroxysmal sympathetic storms is used to define episodic alterations in body temperature, blood pressure, heart and respiratory rate, size of pupil, and level of consciousness coinciding with hyperhidrosis, excessive salivation and extensor posturing. All the cases were presented after severe diffuse axonal head injury. We present two young patients with diffuse axonal head injury that develop in their evolution hypertension, tachycardia and fever without evidence during the episodes of epileptiform activity and without any infectious cause with excellent answer to the treatment with beta-blockers and morphine. We consider that the correct diagnosis of this entity minimizes the application of unnecessary studies allowing an appropriate treatment.

Adult↗

PubMed1990

Experimental frost-bite in Hanford Miniature Swine. III. Sweat gland changes.

Frost-bite was produced in five Hanford Miniature Swine by exposure to -75 degrees C air for 1, 3, 5, 10 or 20 min. Biopsies were taken at 0, 3, 6, 12, 24 and 48 h and 1, 2 and 15 weeks. Sweat glands were evaluated microscopically and graded: 0, no change to 5, severe change. Sweat gland changes were mild by 1 h and moderate by 24 h for all freeze groups, except the 1-min freeze group. Severe morphological changes were of two types: degeneration/necrosis and squamous metaplasia. These changes suggest that hyperhidrosis, as a sequel to frost-bite, may be more subjective than real and that squamous cell carcinoma, as a delayed sequel to frost-bite, could originate from sweat glands as well as from the epidermis.

Animals↗

PubMed1990

[Granulosis rubra nasi].

The Authors report a case of Granulosis Rubra Nasi, a rare early childhood dermatitis that was also defined as "Acne papulo-rosacea of the nose". The hyperhidrosis the most conspicuous features of the disease and small beads of sweat and erythema on the tip of the nose may often occur. Sometimes small red papules and comedo-like lesions may be present.

Child↗

PubMed1989

[Intravenous regional sympathetic block with guanethidine. Retrospective study of 251 blocks of the upper limb in 68 patients].

68 patients have been treated by regional intravenous blocks with guanethidine. 251 blocks have been realized. The majority of the patients received 3 blocks of one week. Some of them got a second series of 3 blocks after a minimum interval of one month. The study included 3 groups of patients. The first group showed 12 patients in the first stage of Sudeck; the second group 22 patients in the second stage. The third group included 34 patients for which the indication to blockade had been a chronic painful stage (19 cases), an ankylosis (8 cases), a Dupuytren post-traumatic contracture (3 cases) a stage before the operation predisposing to dystrophy reflex (3 cases) and one case of hyperhidrosis of the hand. Considering the three groups it can be stated that the first one responded the best to the treatment with a success in 80% of the cases. This success confirms the necessity of intervening as soon as possible in case of an algoneurodystrophy. The third group reveals that this therapeutical method can be useful in other situations than the dystrophy reflexes. The indication herewith is more founded on a possible sympathetic origin of the troubles as on the comportment psycho-affective of the patient.

Autonomic Nerve Block↗

PubMedDate not supplied

Percutaneous phenol block of the upper thoracic sympathetic chain with computed tomography guidance. A new technique.

Twenty-one percutaneous neurolyses of the upper thoracic sympathetic chain were performed in 12 patients with CT guidance by a single injection of 1 to 3 ml of phenol at the level of Th3. Results were assessed after a follow-up period varying from 4 to 33 months. Three patients with hyperhidrosis had immediate and complete disappearance of symptoms, but only one patient remained dry. In 7/14 procedures done for Raynaud's disease symptoms disappeared or diminished. These long term results are competitive with surgery. Three transitory Horner syndromes and one pneumothorax occurred.

Adult↗

PubMed1987

[Dermatoses caused by footwear made of synthetic material: the rubber-boot syndrome].

One hundred patients, workers from a meat packing plant that wear rubber boots while working, were studied. Besides the well known allergic manifestations to rubber or other plastic materials used in footwear other pathologic findings included mycotic and bacterial lesions formed by plantar hyperhidrosis with the development of bromhidrosis and plantar xanthokeratoderma. These occupational dermatoses are a medical problem, but also have social and economical implications.

Adolescent↗

PubMed1977

[Significance of iontophoresis in dermatology. With special reference to the management of lymphedemas].

The development of modern medicine has very often pushed older methods of treatment to the background. It will be tried to represent the importance of iontophoresis as a special form of electrotherapy for dermatology according to studies of literature and own observations. Iontophoresis is for most of the 40 to 50 dermatologic indications named in literature without any importance for the present. This is also to be said for their diagnostic and experimental application. Because of the synergistic effect of the galvanic current and the medicament sluiced in, iontophoresis is said to be recommended following literature, for the treatment of the rest of therapeutically only with difficulty to be influenced idiopathic hyperhidrosis manuum et pedum, constitutional hypertrichosis, the lymphedema and also the induratio penis plastica and of thrombophlebitis. It will be reported about own experiences in the treatment of lymphedema.

Follow-Up Studies↗

PubMedDate not supplied

N-isopropyl I-123 p-iodoamphetamine brain scans with single photon emission computed tomography: mental sweating and EEG abnormality.

We studied a patient with hyperhidrosis and electroencephalographic (EEG) abnormality using N-isopropyl I-123 p-iodoamphetamine (I-123 IMP) with single photon emission computed tomography (SPECT). EEG abnormality was found predominantly in the frontal area, and sharp wave bursts were induced by hyperventilation. Ictal and nonictal scans were obtained with simultaneous EEG recordings. Ictal scans revealed increased uptake of IMP in the frontal cortex, reflecting hyperperfusion to the frontal area. The ratio of IMP uptake of the frontal to the parietal cortex (F/P ratio) was calculated both in the ictal and nonictal phase. In the ictal phase, the F/P ratio was 1.23, compared with 0.91 in the nonictal phase. The data indicated altered regional cerebral blood flow with EEG abnormality and hyperventilation load. Although the relationship between sweating and cortical function is not fully understood, our study indicates that excessive mental sweating is related to frontal cortical dysfunction. I-123 IMP-SPECT seems valuable for topographical demonstration of epileptogenic lesions and understanding the pathophysiological process of mental sweating.

Adult↗

PubMed1987

Emotional eccrine sweating. A heritable disorder.

A family with hereditary emotional hyperhidrosis is described. The inheritance pattern is autosomal dominant. A simple quantitative palmar sweat test was used to objectively confirm historical data. Of two family members tested, both had a marked decrease in palmar sweat secretion during administration of diltiazem, a calcium-channel blocker. Additional studies in a large group of patients are needed to extend this observation.

Adolescent↗

PubMed1986

[A case of Isaac's syndrome--continuous muscle fiber activity syndrome].

A 34-year-old woman noted difficulty of gait initiation, then dilated finger opening and hyperhidrosis appeared. Her stature was a muscular habitus, and muscle stiffness and myokymia were found in all muscles of the extremities. Her stiffness persisted during sleep. Her calf muscles were large and a contracture was noticed in ankle joints. There was no evidence of wasting and weakness. A remarkable delay in voluntary relaxation of the contracted muscles without percussion myotonia was recognized. Tendon reflexes of lower extremities were absent. Laboratory examination revealed elevation of CPK, LDH, myoglobulin, aldolase and basal metabolic rate (BMR). An extraband of CPK isoenzyme between MB and MM fraction was observed. The thin layer gel filtration technique and immunofixation technique showed that this extraband was complexes of CPK and IgA, and light chain of the CPK linked IgA was lambda type. All other laboratory tests were normal for the following: urinalysis, ESR, a blood count, liver function, kidney function, glucose, rheumatoid factor, CRP, thyroid function, parathyroid function, serum electrolytes, ECG, EEG, cranial CT, without slight elevation of IgA, and CSF protein. In needle EMG and surface EMG spontaneous discharges were recorded at rest. These discharges consist of normal motor unit potentials, doublets, and triplets in needle EMG. The discharges were markedly reduced after the median nerve block with xylocaine. In needle EMG, myotonic discharge was not observed. Nerve conduction velocities were within normal ranges. According to these data, she was diagnosed as having Issacs' syndrome (continuous muscle fiber activity syndrome). Carbamazepine, 200 mg daily was administrated and showed a dramatic reversal of the symptoms.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗