Eficacia del tratamiento con toxina botulínica en la hiperhidrosis palmar en nuestro medio

Abstract

IntroductionPrimary hyperhidrosis (PH) is a disorder of unknown etiology characterized by uncontrolled and excessive secretion of sweat on the surface of the palms, armpits, groin and soles of the feet due to increased cholinergic activity of the sympathetic nerves. The aim of this study was to determine the effectiveness of botulinum toxin in this disease. Material and methodA prospective study was conducted in 16 patients with severe hyperhidrosis (grade IV). The Hyperhidrosis Disease Severity Scale was administered before treatment, and at 1, 3, and 6 months after treatment. ResultsOne patient was not the primary responder and therefore withdrew from the study. Of the 15 remaining patients, 93.8% improved, with a reduction in hyperhidrosis stage from 4 at baseline to 1 at 3 months. Only one patient showed a reduction in stage from 4 to 3. At 6 months, 3 patients showed a worsening, with an increase in stage from 1 to 3, while stage 1 was maintained in the remainder. The change was statistically significant between baseline and 1 month (P<.001) and between baseline and 6 months (P<.001). Worsening in some patients was not statistically significant (P=.083). Adverse effects included 1 case of self-limiting weakness of the thenar that resolved at 4 weeks. ConclusionsBotulinum toxin is safe and effective in treating severe palmar hyperhidrosis. Pain control was better through locoregional block. The dose used should be standardized.