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Abstract
Background Hyperhidrosis (HH) is a condition characterized by excessive sweating caused by overstimulation of cholinergic receptors on eccrine glands. Primary hyperhidrosis (PH) is idiopathic, bilaterally symmetric, and affects various parts of the body. Botulinum neurotoxin-A (BTX-A) has a role in the nonsurgical management of HH. Dermapen was introduced for transdermal drug delivery. Objective To evaluate the clinical efficacy of Dermapen assisted delivery of BTX-A versus its intradermal injection in the treatment of primary palmar HH. Patients and methods A prospective intrapatient comparative study, conducted on 20 patients with bilateral palmar HH categorized into two groups, group A: left palm was treated by intradermal injection of BTX-A, group B: right palm was treated by Dermapen combined with topically applied BTX-A. Results Both groups had significant improvement after treatment. However, group A showed significantly better grades regarding hyperhidrosis disease severity scale, dermatology life quality index, and patient satisfaction. Conclusion Both methods were effective and tolerable. Intradermal injection intervention was better regarding hyperhidrosis disease severity scale, dermatology life quality index, patients satisfaction, and long-term follow-up.
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