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1.
Hyperhidrosis can seriously impair patients’ quality of life. Medical history, including heredity and hyperhidrosis during youth, as well as current age and time elapsed since menopause, is important to consider when distinguishing between postmenopausal hyperhidrosis and vasomotor symptoms to enable adequate treatment. This report concerns a subgroup of eight postmenopausal patients participating in a randomized controlled trial regarding botulinum toxin (Btx) type B treatment in craniofacial hyperhidrosis. Even though the sample size is small and the enrolment is not yet completed, the promising data collected hitherto are interesting to present in advance because this subtype of craniofacial hyperhidrosis is often underrecognized and challenging to treat. Patients were randomized to receive Btx type B or placebo. Measurements were performed before treatment and 3 ± 1 weeks after. The Dermatology Life Quality Index (DLQI) score was improved for all patients after Btx type B treatment (n = 3) with a median decrease of 9 points (90% median improvement). The placebo group (n = 5) had a median increase of 2 points (–18% median decline). When the same group (n = 5) received Btx type B (open) the DLQI score decreased with a median of 7 points compared with baseline (91% median improvement). Treatment‐related adverse events were temporary and did not prevent improvement of life quality. Furthermore, background data evaluation uncovered interesting findings regarding vasomotor symptoms in relation to postmenopausal hyperhidrosis. In conclusion, the results indicated that Btx type B seems to be a safe and effective treatment in postmenopausal craniofacial hyperhidrosis. Further research is encouraged. 相似文献
2.
Shah-Hwa Chou Eing-Long Kao Chien-Chih Lin Meei-Feng Huang 《Clinical autonomic research》2006,16(3):240-242
A total of 114 patients with various sympathetic disorders underwent endoscopic sympathetic block over different thoracic
ganglions by the clipping method. The advantages of this method include the recognition of the clipped level, changeability,
and reversibility. However, 4.4% of patients were unilaterally clipped at the wrong level. 相似文献
3.
Nelson Wolosker Guilherme Yazbek José Ribas Milanez de Campos Paulo Kauffman Augusto Ishy Pedro Puech-Leão 《Clinical autonomic research》2007,17(3):172-176
Background Sympathectomy is the treatment of choice for primary hyperhidrosis. One curious occurrence that is difficult to explain from
an anatomophysiological point of view in cases of video-assisted thoracoscopic sympathectomy (VATS) for the treatment of palmar
hyperhidrosis (PH) is the observed improvement in plantar hyperhidrosis (PLH). Nevertheless, current reports on VATS rarely
describe the effect on PLH or just give superficial data. The aim of this study was to prospectively investigate, how surgery
affects PLH in patients with PH and PLH over one-year period.
Methods From May 2003 to January 2004, 70 consecutive patients with combined PH and PLH underwent VATS at the T2, T3, or T4 ganglion
level (47 women and 23 men, with mean age of 23 years).
Results Immediately after the operation, all the patients said they were free from PH episodes, except for two patients (2.8%) who
suffered from continued PH. Compensatory hyperhidrosis (CH) of various degrees was observed in 58 (90.6%) patients after one
year. Only 13 (20.3%) suffered from severe CH. There was a great initial improvement in PLH in 50% of the cases, followed
by progressive regression, such that only 23.4% still presented that improvement after one year. The number of cases without
overall improvement increased progressively (from 17.1% to 37.5%) and the numbers with slight improvement remained stable
(32.9–39.1%). Of the 24 patients with no improvement after one year, 6 patients graded plantar sweating worse.
Conclusion Patients with PH and PLH who undergo VATS to treat their PH present a good initial improvement in PLH that reduces to a lower
level of improvement after the one-year period. 相似文献
4.
To assess and compare the long-term results of upper dorsal sympathetic ganglionectomy (UDS) and endoscopic thoracic sympathectomy
(ETS), we examined 84 patients who underwent UDS and 71 patients who underwent ETS for the treatment of palmar hyperhidrosis.
The period of follow-up ranged from 37 to 228 months. The immediate success rate was 100% in the UDS group and 98.6% in the
ETS group. Troublesome compensatory hyperhidrosis occurred in 67.8% of the UDS patients and 84.8% of the ETS patients; however,
55% of the UDS patients and 63% of the ETS patients felt satisfied with their operation. The main reasons for dissatisfaction
were recurrence and compensatory hyperhidrosis. Interestingly, simultaneous cure of plantar hyperhidrosis occurred in 28 (40%)
of the UDS patients and 28 (44%) of the ETS patients with concomitant plantar hyperhidrosis. ETS required both a shorter operation
time and hospital stay than UDS. Thus, we now perform ETS as the treatment of choice because of its excellent illumination
and adequate magnification via a minimally invasive approach. The use of ETS as the first choice of treatment for palmar hyperhidrosis
is supported not only by the immediate results, complications, and cure of plantar hyperhidrosis, but also by the long-term
results. Nevertheless, compensatory hyperhidrosis was also a major complication after ETS. 相似文献
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Torsten Ertongur‐Fauth Andreas Hochheimer Joerg Martin Buescher Stefan Rapprich Michael Krohn 《Experimental dermatology》2014,23(11):825-831
Sweating is an important physiological process to regulate body temperature in humans, and various disorders are associated with dysregulated sweat formation. Primary sweat secretion in human eccrine sweat glands involves Ca2+‐activated Cl? channels (CaCC). Recently, members of the TMEM16 family were identified as CaCCs in various secretory epithelia; however, their molecular identity in sweat glands remained elusive. Here, we investigated the function of TMEM16A in sweat glands. Gene expression analysis revealed that TMEM16A is expressed in human NCL‐SG3 sweat gland cells as well as in isolated human eccrine sweat gland biopsy samples. Sweat gland cells express several previously described TMEM16A splice variants, as well as one novel splice variant, TMEM16A(acΔe3) lacking the TMEM16A‐dimerization domain. Chloride flux assays using halide‐sensitive YFP revealed that TMEM16A is functionally involved in Ca2+‐dependent Cl? secretion in NCL‐SG3 cells. Recombinant expression in NCL‐SG3 cells showed that TMEM16A(acΔe3) is forming a functional CaCC, with basal and Ca2+‐activated Cl? permeability distinct from canonical TMEM16A(ac). Our results suggest that various TMEM16A isoforms contribute to sweat gland‐specific Cl? secretion providing opportunities to develop sweat gland‐specific therapeutics for treatment of sweating disorders. 相似文献