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Angela Hou, Brandon Cohen, Adele Haimovic, Nada Elbuluk
BACKGROUND: Microneedling is a minimally invasive procedure that uses fine needles to puncture the epidermis. The microwounds created stimulate the release of growth factors and induce collagen production. The epidermis remains relatively intact, therefore helping to limit adverse events. The indications for microneedling therapy have grown significantly, and it is becoming a more widely used treatment in dermatology. OBJECTIVE: A comprehensive review of microneedling in human subjects and its applications in dermatology...
October 13, 2016: Dermatologic Surgery: Official Publication for American Society for Dermatologic Surgery [et Al.]
James Doolittle, Patricia Walker, Thomas Mills, Jane Thurston
Current published estimates of the prevalence of hyperhidrosis in the United States are outdated and underestimate the true prevalence of the condition. The objectives of this study are to provide an updated estimate of the prevalence of hyperhidrosis in the US population and to further assess the severity and impact of sweating on those affected by the condition. For the purposes of obtaining prevalence, a nationally representative sample of 8160 individuals were selected using an online panel, and information as to whether or not they experience hyperhidrosis was obtained...
October 15, 2016: Archives of Dermatological Research
Peter B Licht
No abstract text is available yet for this article.
November 2016: Thoracic Surgery Clinics
Roman Rieger
Primary plantar hyperhidrosis is defined as excessive secretion of the sweat glands of the feet and may lead to significant limitations in private and professional lifestyle and reduction of health-related quality of life. Conservative therapy measures usually fail to provide sufficient relieve of symptoms and do not allow long-lasting elimination of hyperhidrosis. Endoscopic lumbar sympathectomy appears to be a safe and effective procedure for eliminating excessive sweating of the feet and improves quality of life of patients with severe plantar hyperhidrosis...
November 2016: Thoracic Surgery Clinics
Lyall A Gorenstein, Mark J Krasna
Because of video-assisted thoracic technology and increased patient awareness of treatment options for palmar hyperhidrosis, endoscopic thoracic sympathectomy (ETS) has become a well-accepted treatment for this disorder. Video assistance affords excellent visualization of thoracic anatomy, which allows the procedure to be done quickly with few complications. However, despite the ease of performing ETS, complications can occur unless thoracic anatomy and physiology are well-understood. Awareness of possible intraoperative and postoperative complications is essential if this procedure is gong to be performed safely...
November 2016: Thoracic Surgery Clinics
Nelson Wolosker, José Ribas Milanez de Campos, Juliana Maria Fukuda
Compensatory hyperhidrosis (HH) is the most common and feared side effect of thoracic sympathectomy, because patients with severe forms have their quality of life greatly impaired. The most well-known factors associated with compensatory HH are extension of manipulation of the sympathetic chain, level of sympathetic denervation, and body mass index. Technical developments as well as the proper selection of patients for surgery have been crucial in reducing the occurrence of severe forms of compensatory HH. Therapeutic options include topical agents, botulinum toxin, systemic anticholinergics, clip removal, and sympathetic chain reconstruction, although the efficacy is not well-established for all the methods...
November 2016: Thoracic Surgery Clinics
José Ribas Milanez de Campos, Hugo Veiga Sampaio da Fonseca, Nelson Wolosker
The best way to evaluate the impact of primary hyperhidrosis on quality of life (QL) is through specific questionnaires, avoiding generic models that do not appropriately evaluate individuals. QL improves significantly in the short term after sympathectomy. In the longer term, a sustained and stable improvement is seen, although there is a small decline in the numbers; after 5 and even at 10 years of follow-up it shows virtually the same numerical distribution. Compensatory hyperhidrosis is a major side effect and the main aggravating factor in postoperative QL, requiring attention to its management and prevention...
November 2016: Thoracic Surgery Clinics
Cliff P Connery
There is a small subset of patients who have undergone endoscopic thoracic sympathectomy for hyperhidrosis or facial blushing who are dissatisfied and would wish reversal. Compensatory sweating is the most common side effect that causes a person to regret surgery. Treatment options are limited and usually not effective in patients with severe side effects from sympathectomy. Nerve graft interposition has been proven to be effective in experimental models and small clinical series. Da Vinci robotic nerve graft reconstruction with interposition graft and direct suturing of nerve and high magnification dissection most closely mirrors standard nerve reconstruction principles when done as a minimally invasive procedure...
November 2016: Thoracic Surgery Clinics
Conor F Hynes, M Blair Marshall
Endoscopic thoracic sympathectomy (ETS) is an effective treatment of primary hyperhidrosis of the face, upper extremities, and axillae. The major limitation is the side effect of compensatory sweating severe enough that patients request reversal in up to 10% of cases. When ETS is performed by cutting the sympathetic chain, reversal requires nerve grafting. However, for ETS done with clips, reversal is a simple thoracoscopic outpatient procedure of removing the clips. Subsequent reversal of the sympathectomy, ie, nerve regeneration, is successful in many cases...
November 2016: Thoracic Surgery Clinics
Joel M Sternbach, Malcolm M DeCamp
Large case series and randomized trials over the past 25 years have consistently demonstrated thoracoscopic interruption of the sympathetic chain to be a safe and effective treatment of focal primary hyperhidrosis. The surgical technique has evolved toward less-invasive and less-extensive procedures in an effort to minimize perioperative morbidity and effectively balance postoperative compensatory sweating with symptomatic relief. This review summarizes available evidence regarding the surgical approach and the optimal level of interruption of the sympathetic chain based on a patient's presenting distribution of pathologic sweating...
November 2016: Thoracic Surgery Clinics
Alan Edmond Parsons Cameron
This article presents a personal view of the indications for surgical treatment of patients with hyperhidrosis based on long clinical experience. Endoscopic thoracic sympathectomy is the preferred opinion for palmar sweating. It is also useful when there is additional axillary sweating but is not the first choice for isolated armpit symptoms. Surgical treatment of craniofacial sweating is much more likely to be followed by undesirable side-effects.
November 2016: Thoracic Surgery Clinics
Anastasia O Kurta, Dee Anna Glaser
A variety of available treatment options are available for primary focal hyperhidrosis, and some can be combined to obtain maximum effective results. Most treatment options have only been studied in patients with axillary hyperhidrosis, and more studies are needed to develop therapies for other body regions. Several clinical trials are underway with promising preliminary results; however, there is still a large need for new therapies.
November 2016: Thoracic Surgery Clinics
Christoph H Schick
Studies and case reports on excessive sweating frequently state that hyperhidrosis is a disease whose origin and mechanism are unknown. However, the term excessive is rarely based on systematic diagnostic measurements, instead being a description of the symptoms from patient histories, which suggests that hyperhidrosis is purely a problem involving the quantity of sweat, whereas it is a change in the control mechanism of sweating in which the need for and production of sweat are strongly disproportionate. This lack of proportion is perceived by those affected to be a limitation of activities of daily living and is thus pathologic...
November 2016: Thoracic Surgery Clinics
Moshe Hashmonai
At present, primary hyperhidrosis is the main indication for sympathectomy. For upper thoracic sympathetic ablation, excision of the second thoracic ganglion alone or with the first and/or third ganglia was the standard during the open surgery era. With the advent of thoracoscopy, modifications related to the level, extent, and type of ablation were proposed to attenuate compensatory hyperhidrosis. The ideal operation for sympathetic denervation of the face and upper limbs remain to be defined. Controlled double-blind studies with quantitave measurements of sweat production are required...
November 2016: Thoracic Surgery Clinics
Charlotte Pineau, Brice Lavrard, François Boyer, Laëtitia Percebois-Macadré
OBJECTIVE: MRI has highly changed the assessment of post-traumatic syringomyelia (PTS), roughly estimated at 30% nowadays. Times to onset (TTO) symptoms are random. This case report describes how hyperhidrosis appeared and revealed PTS diagnosis. OBSERVATIONS: Mr M., 43-year-old, is rehabilitation inpatient after T10 AIS A spinal cord injury (SCI). Three months after this event, Mr M complains of acute hyperhidrosis crisis always located below the injury, which can occur at any time of the day, particularly when he moves...
September 2016: Annals of Physical and Rehabilitation Medicine
Charles R Cowan
No abstract text is available yet for this article.
September 2016: PM & R: the Journal of Injury, Function, and Rehabilitation
Rungsima Wanitphakdeedecha, Chanida Ungaksornpairote, Arisa Kaewkes, Viboon Rojanavanich, Weeranut Phothong, Woraphong Manuskiatti
BACKGROUND: Botulinum toxin type A (BTA) has been approved for the treatment of strabismus, blepharospasm, muscle spasm, cervical dystonia, pain syndrome, glabella wrinkles, and severe primary axillary hyperhidrosis. Intradermal injection of BTA has been used off-label by many clinicians for the purpose of face-lifting effect. Few studies on onabotulinumtoxinA (ONA) demonstrated no clinical efficacy on face-lifting effect when comparing to normal saline solution (NSS). So far, there is no split-face comparison study on face-lifting effect of abobotulinumtoxinA (ABO)...
September 19, 2016: Journal of Cosmetic Dermatology
Seok Won Yun, Yun Seok Kim, Yongjik Lee, Han Jung Lim, Soon Ik Park, Jong Pil Jung, Chang Ryul Park
BACKGROUND: There are many ways to treat focal hyperhidrosis, including surgeries for palmar and axillary hyperhidrosis. However, doctors and patients tend to be reluctant to perform surgery for plantar hyperhidrosis due to misconceptions and prejudices about surgical treatment. In addition, few studies have reported the outcome of surgeries for plantar hyperhidrosis. Therefore, the objective of this study was to determine the outcome (early and late postoperative satisfaction, complication, compensatory hyperhidrosis, recurrence rate, and efficiency) of surgical treatment for plantar hyperhidrosis...
September 13, 2016: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
Alfred Gugerell, Johanna Kober, Melanie Schmid, Elisabeth Buchberger, Lars-Peter Kamolz, Maike Keck
BACKGROUND: Botulinum (neuro)toxin A (BoNT) is widely used in the field of plastic and reconstructive surgery. Among treatment of pain, hyperhidrosis, or aesthetic purposes, it is also used to enhance wound healing and prevent excessive scar formation. Some clinical data already exist, but only little is known on a cellular level. The aim of this study was to evaluate the effect of BoNT on cells essential for wound healing in vitro. Therefore, primary human keratinocytes and endothelial cells were treated with different concentrations of BoNT and tested on proliferation, migration, and angiogenic behavior...
August 2016: Plastic and Reconstructive Surgery. Global Open
Lucy L Shi, Michael R Sargen, Suephy C Chen, Jack L Arbiser, Brian P Pollack
BACKGROUND: Botulinum toxin type A (BTX-A) injections are an effective treatment for controlling hyperhidrosis at sites of amputation. Hyperesthesia associated with amputated limbs is a major barrier to performing this procedure under local anesthesia. OBJECTIVE: To present a novel method for improving local anesthesia with BTX-A injections. Methods & RESULTS: A 29-year-old military veteran with a below-the-knee amputation of his right leg was suffering from amputation site hyperhidrosis, which was impeding his ability to comfortably wear a prosthesis...
June 15, 2016: Dermatology Online Journal
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