Idiopathic Hyperhidrosis Research Articles

Participation of the sympathetic nervous system in the hunting reaction. Investigationsof idiopathic palmo-plantar hyperhidrosis

Participation of the sympathetic nervous system in the hunting reaction. Investigationsof idiopathic palmo-plantar hyperhidrosis

Endoscopic transthoracic sympathectomy for idiopathic upper limb hyperhidrosis.

A 5-year experience of 51 endoscopic transthoracic dorsal sympathectomies for idiopathic palmar hyperhidrosis in 26 patients is presented. Fifty-two percent complained of excessive sweating over their hands, 28% of axillary sweating and 20% over both areas, with a mean duration of 10 years. The second, third and fourth thoracic ganglia and their interconnecting fibres on the affected side were ablated using diathermy cautery. Over a mean follow up time of 26 months, this procedure was successful in curing or improving intractable sweating in 92%. However, axillary sweating was less well controlled than in the palms with 20% of patients describing residual wetness in the axilla. Compensatory sweating (75%) and gustatory sweating (48%) were the commonest side effects; despite this, most patients were satisfied with the functional and cosmetic outcome. Other complications included a temporary Horner's syndrome in one patient, a pneumothorax in the immediate post-operative period in another and a unilateral non-infective reactionary pleural effusion in a third. Two patients developed recurrence of palmar hyperhidrosis within 6 months of surgery. One has been successfully treated by re-operation on the affected side. All patients complained of mild to moderate interscapular chest pain which was easily controlled by non-steroidal anti-inflammatory agents, and resolved within 7-10 days post-operatively. The technique of endoscope transthoracic sympathectomy is effective, relatively simple to perform and usually requires only an overnight stay. It is recommended as the surgical treatment of choice for upper limb hyperhidrosis unresponsive to conservative measures.

Hyperhidrosis and its surgical treatment.

111 sections of high thoracic sympathectomies in 60 cases suffering from primary palmar hyperhidrosis are reported. Surgical results and postoperative complications are discussed in detail. Complications were few in number and were of a transitory nature. No mortality occurred in our series. Various surgical and nonsurgical procedures of treatment are reviewed. Surgical intervention remains the treatment of choice in essential idiopathic hyperhidrosis.

Surgical treatment of axillary hyperhidrosis.

The results of surgical treatment of idiopathic hyperhidrosis by axillary skin excision are reported. Symptomatic improvement occurred in 81 per cent of patients treated. In suitable patients this simple operation would appear beneficial.

TREATMENT OF HYPERHIDROSIS WITH TOPICAL METHENAMINE

Idiopathic palmar and plantar hyperhidrosis is a relatively common disorder of eccrine sweat gland function. Treatment with glutaraldehyde of formaldehyde, although successful, may cause undesirable side effects. Methenamine is a polycyclic organic compound which release ammonia and formaldehyde at acid pH. Five per cent methenamine in a firm stick gel, applied daily to one palmar or plantar surface of 109 patients with hyperhidrosis, resulted in significantly less sweating after one month. No patients were sensitized to formaldehyde.

The treatment of idiopathic hyperhidrosis by glycopyrronium bromide and tap water iontophoresis.

A method of treating idiopathic hyperhidrosis usitig direct current iontophoresis is described. Employing a solution of glycopyrronium bromide, such treatment produces prolonged periods of suppression of palmar and plantar hyperhidrosis but only occasionally do useful periods of dryness result from treatment of axillary hyperhidrosis. Tap water iontophoresis can also be used to produce sweat suppression but its effects are generally less satisfactory.

Localized unilateral hyperhidrosis--a clinical and laboratory study.

Summary.— Three case of unilateral idiopathic hyperhidrosis are described. Two of the lesions were congenital; the thrid occurred in later life. Quantitative sweat collections demonstrated that the sweat glands in the lesion were hyperresponsive to those stimuli, which normally evoked sweating in the skin sites where the lesions occurred. Hyper-responsiveness of the sweat glands to cholinergic stimuli was also demonstrated, and histology revealed greatly enalrged glands. These results suggest that the hyperhidrosis is due to Increased glandular mass, although sweat gland hypersensitivity could notberuled out as an additional contributing factor to the hyperhidrosis. Local anticholinergic therapy was found to besuccessful in the treatment of all 3 patients.

Treatment of idiopathic hyperhidrosis with iontophoresis of tap water and poldine methosulphate.

SUMMARY.— Iontophoresis of tap water or of an anticholincrgic compound (poldine methosulphate) was simple and useful in the treatment of idiopathic hyperhidrosis of the palms and soles. Axillary hyperhidrosis was not so easily controlled. Poldine was more effective than tap water; with increasing doses, systemic effects were produced. Treatment was arranged easily in the Physical Medicine Department, It was suggested that, before resorting to surgery, iontophoresis is worth a trial in idiopathic hyperhidrosis.