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    Botulinum toxin in the management of head and neck disorders.
    Oral Surg Oral Med Oral Pathol Oral Radiol 2016 Dec 7. Epub 2016 Dec 7.
    Department of Oral Medicine and Radiology, New Horizon Dental College and Research Institute, Sakri, Bilaspur, India.
    Botulinum toxin is a polypeptide protoxin synthesized by Clostridium botulinum that results in localized reduction of muscle activity by inhibiting acetylcholine release at the neuromuscular junction. In 2004, the US Food and Drug Administration approved its application in the treatment of various medical conditions, such as facial wrinkles, strabismus, cervical dystonia, blepharospasm, and hyperhidrosis. Later, its application extended to improving dental esthetics and gummy smile. Read More

    Drug safety and adverse drug reaction reporting behavior related to outpatient opioid replacement therapy: Results from a survey among physicians.
    J Subst Abuse Treat 2017 Mar 14;74:7-15. Epub 2016 Dec 14.
    University of Ulm, Department of Psychiatry and Psychotherapy III, Leimgrubenweg 12-14, 89075 Ulm, Germany.
    To study drug safety and the reporting behavior of adverse drug reactions (ADR) related to agents used for opioid replacement therapy (ORT) we conducted a cross-sectional questionnaire-based telephone survey among physicians who provide outpatient ORT in Germany (n=176; response rate=55.7%). Most respondents (n=97/55. Read More

    Initial study of transdermal oxybutynin for treating hyperhidrosis.
    J Dermatol 2017 Jan 20. Epub 2017 Jan 20.
    Dermatology Department, Hospital Costa del Sol, Marbella, Málaga, Spain.
    Oral oxybutynin for treating hyperhidrosis is effective and safe. Its side-effects are mild but frequent so we consider whether transdermal oxybutynin (considered to have a better side-effect profile) could be an alternative for treating hyperhidrosis. During 2015, a prospective study was conducted. Read More

    [Fabry disease].
    Ann Dermatol Venereol 2017 Feb 16;144(2):137-146. Epub 2017 Jan 16.
    Département de dermatologie, Hôpital Hôtel-Dieu de France, Faculté de médecine, Université Saint-Joseph, Beyrouth, Liban.
    Fabry disease, also known as Anderson-Fabry disease or angiokeratoma corporis diffusum universale, is an X-linked recessive form of sphingolipidosis caused by total or partial deficiency of the lysosomal hydrolase, alpha-galactosidase A. From the youngest age, it results in a gradual ubiquitous build-up of glycosphingolipids that are not degraded by the missing enzyme. Cutaneous, neurological, nephrologic, cardiac, gastrointestinal, ophthalmological, respiratory, cochleovestibular and haematological involvement are responsible for increased mortality and significant impairment of quality of life in subjects affected by the disease. Read More

    Palmar hyperhidrosis: clinical, pathophysiological, diagnostic and therapeutic aspects.
    An Bras Dermatol 2016 Nov-Dec;91(6):716-725
    Universidade Estadual Paulista "Júlio de Mesquita Filho" (Unesp) - Botucatu (SP), Brazil.
    Palmar hyperhidrosis affects up to 3% of the population and inflict significant impact on quality of life. It is characterized by chronic excessive sweating, not related to the necessity of heat loss. It evolves from a localized hyperactivity of the sympathetic autonomic system and can be triggered by stressful events. Read More

    Clonidine is effective for the treatment of primary idiopathic hyperhidrosis and hot flushes: a case report.
    J Med Case Rep 2017 Jan 17;11(1):16. Epub 2017 Jan 17.
    Internal Medicine Department, College of Medicine, Prince Sattam bin Abdulaziz University, P.O. Box 173, Al-Kharj, 11942, Saudi Arabia.
    Background: While primary hyperhidrosis can be seen in men, accompanying hot flushes is rarely seen in men. Primary hyperhidrosis is thought to be related to overactivity of the sympathetic nervous system while hot flushes are believed to be related to altered peripheral vascular reactivity and a narrowed thermoregulatory zone.

    Case Presentation: I report the case of a 29-year-old man of Arab origin who presented to a dermatology clinic with a complaint of generalized sweating, with heavier involvement of his inguinal region, axilla, and lower back. Read More

    The impact of skin diseases on quality of life: A multicenter study.
    Actas Dermosifiliogr 2017 Jan 4. Epub 2017 Jan 4.
    Grupo de Investigación Dermatológica (GRID), Universidad de Antioquia, Medellín, Colombia.
    Introduction: To date, no formal study has been published regarding how Colombian patients with skin disorders could be affected according to their perception of disease.

    Objective: To determine the impact in quality of life of skin diseases in a Colombian population.

    Methods: This multicenter study included patients with skin disease from almost the whole country. Read More

    Spinal fusion and antibiotic treatment illustrating lumbar osteomyelitis and spinal instability as a previously unrecognized and surgically treatable cause of autonomic dysreflexia.
    Spinal Cord Ser Cases 2016 21;2:16013. Epub 2016 Jul 21.
    Department of Neurosurgery, Penn State Hershey Medical Center , Hershey, PA, USA.
    Autonomic dysreflexia (AD) following spinal cord injury can lead to a physiologic state where there is unopposed sympathetic tone and subsequent hypertension, bradycardia, hyperhidrosis and anxiety. It is known to be triggered by nociceptive stimuli below the level of injury-most commonly constipation and bladder retention. We present a case of a C6-7 tetraplegic who developed AD 20 years after his injury with the unusual trigger of positional spinal instability due to osteomyelitis and discitis. Read More

    BoNT/AB hybrid maintains similar duration of paresis as BoNT/A wild-type in murine running wheel assay.
    Neurotoxicology 2016 Dec 30;59:1-8. Epub 2016 Dec 30.
    Institut für Toxikologie, Medizinische Hochschule Hannover, Hannover, Germany. Electronic address:
    The highly potent Botulinum neurotoxins (BoNT) are successful drugs to treat neuromuscular disorders. Efforts are being made to further reduce the injected BoNT dose and to lengthen the interval between treatments. Detailed knowledge of the BoNT structure-activity relationship (SAR) allows combining the best features of the different BoNT serotypes. Read More

    A case of anti aquapolin-4 antibody positive myelitis with hyperhidrosis, following herpes zoster.
    Rinsho Shinkeigaku 2017 Jan 23;57(1):26-28. Epub 2016 Dec 23.
    Department of Neurology, Toranomon Hospital.
    We report an acute myelitis in a 53-year-old woman that occurred in 7 days after the diagnosis of Th5-6 herpes zoster. Clinical examination revealed hyperhidrosis of left side of her face, neck, arm and upper chest. She also had muscle weakness of her left leg and sensory impairment for light touch and temperature in her chest and legs. Read More

    Translation and validation of Hyperhidrosis Disease Severity Scale.
    Rev Assoc Med Bras (1992) 2016 Dec;62(9):843-847
    Vascular Surgery Department, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
    Introduction: The evaluation of patients with hyperhidrosis (HH) can be accomplished, among other ways, through questionnaires and scales. The Hyperhidrosis Disease Severity Scale (HDSS) has been used as a simple and quick tool to perform this evaluation. Although HDSS has been well established in several languages, it has not been translated into Portuguese, restricting its specific use for Brazilian patients. Read More

    [Anesthetic effect and safety of ultrasound-guided thoracic paravertebral blockade in sympathectomy for palmar hyperhidrosis: a randomized controlled trial].
    Nan Fang Yi Ke Da Xue Xue Bao 2016 Dec;36(12):1655-1659
    Department of Anesthesiology, Guangdong General Hospital and Guangdong Academy of Medical Science, Guangzhou 510080, China. E-mail:
    Objective: To explore the anesthetic effect and safety of ultrasound-guided thoracic paravertebral blockade in video-assisted thoracoscopic sympathectomy for treatment of palmar hyperhidrosis.

    Methods: A total of 120 patients undergoing video-assisted thoracoscopic sympathectomy for moderate or severe hyperhidrosis were randomized to receive ultrasound-guided thoracic paravertebral blockade (group A, n=60) or general anesthesia with tracheal intubation (group B, n=60). In both groups routine monitoring and radial artery catheterization were used. Read More

    Great saphenous vein dilatation with reflux at the saphenofemoral junction: A rare underlying association of eccrine angiomatous hamartoma.
    Indian Dermatol Online J 2016 Nov-Dec;7(6):533-535
    Department of Dermatology, Venereology and Leprosy, Jawaharlal Nehru Medical College (DMIMSU-DU), Sawangi, Wardha, Maharashtra, India.
    Eccrine angiomatous hamartoma (EAH) is an exceedingly rare benign tumor-like lesion prevalent in childhood, which can produce pain and marked sweating. Histological features include proliferation of eccrine sweat glands and angiomatous capillary channels. It may be rarely associated with underlying pathological conditions. Read More

    Relationship between anxiety, depression and quality of life with the intensity of reflex sweating after thoracoscopic sympathectomy for treatment of primary hyperhidrosis.
    Rev Col Bras Cir 2016 Sep-Oct;43(5):354-359
    Post-graduate Program in Surgery Sciences, Faculty of Medical Sciences, Campinas State University (Unicamp), Campinas, SP, Brazil.
    Objective:: to compare the intensity of reflex sweating with the degree of anxiety and its interference in the quality of life of patients undergoing Thoracoscopic (VATS) sympathectomy in the pre- and postoperative period.

    Methods:: we evaluated 54 patients with a mean age of 26 years (16-49 years) undergoing sympathectomy in the R3-R4 level. We applied two questionnaires at three different times: "Quality of life in patients with primary hyperhidrosis" and "Scale for anxiety and depression". Read More

    Treatment of primary hyperhidrosis with oral anticholinergic medications: a systematic review.
    J Eur Acad Dermatol Venereol 2016 Dec 15. Epub 2016 Dec 15.
    Department of Surgery, Royal Free Hospital, London, UK.
    Primary hyperhidrosis is a condition characterized by excessive sweating. Patients are treated off-license with oral anticholinergic medications and report adverse events associated with systemic anticholinergic interactions. This review assesses clinical evidence of efficacy, impact on quality of life and adverse events associated with oral anticholinergic therapy for primary hyperhidrosis. Read More

    [Use of intracutaneous or subcutaneous botulinum toxin for postherpetic neuralgia].
    Nervenarzt 2016 Dec 6. Epub 2016 Dec 6.
    Universitätsklinik für Anästhesiologie und Intensivmedizin, Klinische Abteilung für Spezielle Anästhesiologie, Schmerz- und Intensivmedizin, Medizinische Universität Graz, Auenbruggerplatz 29, 8036, Graz, Österreich.
    Background: Botulinum neurotoxin (BoNT), a toxin of the anaerobic spore-forming bacterium Clostridium botulinum is used as a drug for alleviating muscle spasticity. Other indications include the cosmetic application in facial muscles, hyperhidrosis and neurogenic bladder disorders. It has been approved since 2010 as the first prophylactic treatment for chronic migraine. Read More

    Tap water iontophoresis in the treatment of pediatric hyperhidrosis.
    J Pediatr Surg 2017 Feb 14;52(2):309-312. Epub 2016 Nov 14.
    Department of Dermatology, University Hospitals of Leicester, Leicester, UK.
    Aim Of The Study: The treatment options for localized hyperhidrosis include antiperspirants, anticholinergics, iontophoresis, botulinum toxin and surgery. Tap water iontophoresis (TWI) involves immersing the affected area in tap water and passing a small electrical current through the area. Our aim was to assess the success of this therapy in a pediatric cohort. Read More

    Thoracoscopic bilateral T3 sympathectomy for primary focal hyperhidrosis in children.
    J Pediatr Surg 2017 Feb 14;52(2):313-316. Epub 2016 Nov 14.
    Division of General, Thoracic and Fetal Surgery, Children's Hospital of Philadelphia, Philadelphia, PA, USA.
    Aim Of The Study: Present our experience in the surgical treatment of primary focal hyperhidrosis of the hands by thoracoscopic bilateral T3 sympathectomy in pediatric patients.

    Methods: Retrospective chart review of all patients operated between 2013 and 2015.

    Results: We operated and included in the study 28 patients, 22 females and 6 males. Read More

    Treatment of Palmar Hyperhidrosis With Needle Injection Versus Low-Pressure Needle-Free Jet Injection of OnabotulinumtoxinA: An Open-Label Prospective Study.
    Dermatol Surg 2017 Feb;43(2):264-269
    *All authors are affiliated with the Department of Medicine, Dermatology Division, Hôpital Saint-Luc du Centre Hospitalier de l'Université de Montréal, Montreal, Quebec.
    Background: OnabotulinumtoxinA (OnabotA) injections are effective to treat palmar hyperhidrosis (HH) but are quite painful.

    Objective: To evaluate efficacy and pain of OnabotA injection using a needle-free jet apparatus compared with the traditional needle injection to treat palmar HH.

    Methods: Twenty patients were recruited for a prospective open-label study. Read More

    Cardiac Autonomic Changes After Thoracic Sympathectomy: A Prospective, Randomized Study.
    Ann Thorac Surg 2017 Jan 23;103(1):216-224. Epub 2016 Nov 23.
    Department of Cardio-Thoracic Science, Thoracic Surgery Unit, Second University of Naples, Naples, Italy.
    Background: We evaluated whether cardiac autonomic changes could be associated with different extent of sympathetic nerve resection in the management of essential palmar hyperhidrosis.

    Methods: Sixty patients with essential palmar hyperhidrosis were randomly allocated to undergo excision of T3 ganglia (sympathicectomy group; n = 30) or to interruption of sympathetic chain at the T2 to T3 level with ganglion sparing (sympathicotomy group; n = 30). Time and frequency domains were measured with a 24-Holter monitor during daytime, nighttime, and 24-hour periods at different interval points (7 days before operation; 24 hours; and 1, 3, and 6 months later), and the differences were statistically compared. Read More

    Abnormal primary and permanent dentitions with ectodermal symptoms predict WNT10A deficiency.
    BMC Med Genet 2016 Nov 24;17(1):88. Epub 2016 Nov 24.
    Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden.
    Background: The WNT10A protein is critical for the development of ectodermal appendages. Variants in the WNT10A gene may be associated with a spectrum of ectodermal abnormalities including extensive tooth agenesis.

    Methods: In seven patients with severe tooth agenesis we identified anomalies in primary dentition and additional ectodermal symptoms, and assessed WNT10A mutations by genetic analysis. Read More

    Prevalence of Multifocal Primary Hyperhidrosis and Symptom Severity Over Time: Results of a Targeted Survey.
    Dermatol Surg 2016 Dec;42(12):1347-1353
    *Department of Dermatology, St. Louis University School of Medicine, St. Louis, Missouri; †International Hyperhidrosis Society, Charleston, South Carolina; ‡Candesant Biomedical, Palo Alto, California; §Department of Dermatology, Eastern Virginia Medical School, Norfolk, Virginia.
    Background: There is a paucity of data on the prevalence of multifocal primary hyperhidrosis and changes in hyperhidrosis severity over time.

    Objective: The goal of this study was to better understand multifocal primary hyperhidrosis, prevalence and distribution of hyperhidrosis by focal site, age of onset of symptoms by focal area, and change in hyperhidrosis severity over time and with seasons.

    Materials And Methods: The International Hyperhidrosis Society, through an unrestricted research grant from Revance Therapeutics, conducted an online survey of registered visitors to its Web site. Read More

    Botulinum toxin A for palmar hyperhidrosis: assessment with sympathetic skin responses evoked by train of stimuli.
    Auton Autacoid Pharmacol 2016 Jul 23;36(3-4):23-26. Epub 2016 Nov 23.
    Ibn Sina Hospital, Safat, Kuwait.
    Objective assessment of the effect of botulinum toxin A (BT) treatment in primary palmar hyperhidrosis (PH) is attempted by different methods. We decided to use for this purpose sympathetic skin responses evoked by train of stimuli (TSSR). Twenty patients with severe PH (five female, median age 24, range 18-36) were examined regularly over 3 months after receiving 50 UI BT in each palm. Read More

    [Multiple eccrine hidrocystomas on the lower forehead and nose of a 60-year-old man].
    Hautarzt 2016 Nov 21. Epub 2016 Nov 21.
    Universitäts-Hautklinik Heidelberg, Im Neuenheimer Feld 460, 69120, Heidelberg, Deutschland.
    Multiple eccrine hidrocystomas are benign cystic skin lesions which originate from the sweat gland ducts and typically affect women's midfacial area. Sweating may lead to an increase in size of the translucent papules. In some cases hidrocystomas are associated with other diseases such as Parkinson's disease. Read More

    The genesis and presentation of anxiety in disorders of autonomic overexcitation.
    Auton Neurosci 2017 Mar 19;203:81-87. Epub 2016 Oct 19.
    The Lindo Wing, Imperial College NHS Healthcare Trust, UK; Hospital of St John & St Elizabeth, London, UK.
    Introduction: We investigated the genesis and presentation of previously-reported anxiety in disorders of autonomic overexcitation in relation to interoception, body vigilance and trauma to test our hypothesis that patients with the postural tachycardia syndrome (PoTS), vasovagal syncope (VVS) and essential hyperhidrosis (EH) represent atypical anxiety phenotypes in whom affective symptoms are more related to apprehension and vigilance of physiological (interoceptive) feedback than neurotic or trauma-related factors.

    Methods: The Anxiety Sensitivity Index, Body Vigilance Scale, Self-consciousness Scale, Childhood Traumatic Events Scale and heartbeat tracking tasks were completed by 23 healthy controls, 21 PoTS, 20 EH and 20 VVS patients. Interoceptive accuracy (IA) was assessed during supine rest (9min), isometric exercise (3min), cold pressor (90s) and head up tilt (HUT) (9min). Read More

    A new method for evaluation of the autonomic nervous system in patients with idiopathic hyperhidrosis: systolic blood pressure and heart rate recovery after graded exercise.
    Clin Exp Dermatol 2016 Dec 19;41(8):847-851. Epub 2016 Oct 19.
    Department of Cardiology, Medical Faculty, Pamukkale University, Denizli, Turkey.
    Background: Idiopathic hyperhidrosis (IH) is characterized by excessive and uncontrolled production of sweat, mainly localized to the soles, palms, axillae and craniofacial area. Although IH is a disease concerning the autonomic nervous system, it is not clear yet whether this dysfunction is local or systemic.

    Objective: To evaluate the autonomic control of cardiovascular system by measuring values of heart rate recovery (HRR) and systolic blood pressure recovery (SBPR) obtained at various time intervals after maximal graded exercise treadmill testing in patients with IH compared with controls. Read More

    Thermoregulatory Instability in Childhood: Linking the Normal Brain to Hypothalamic Storm.
    Case Rep Neurol Med 2016 26;2016:3903854. Epub 2016 Oct 26.
    Service of Neurology, Faculty of Medicine, PUCRS, Porto Alegre, RS, Brazil; Internal Medicine, Division of Neurology, Faculty of Medicine, Hospital São Lucas, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, RS, Brazil.
    Central core temperature is tightly controlled by hypothalamic centers, a feature that makes sudden changes in body temperature very unusual. A dysfunction of these hypothalamic pathways leads to Shapiro's syndrome, comprising spontaneous hypothermia, hyperhidrosis, and corpus callosum dysgenesis. Although it may affect any age, usually it presents in childhood. Read More

    Hyperhidrosis in Iranian Traditional Medicine.
    Iran J Med Sci 2016 May;41(3 Suppl):S38
    Traditional Medicine Department, School of Traditional Medicine, Tehran University of Medical Sciences, Tehran, Iran.
    Background: Excessive sweating is a medical condition in which a person sweats much more than needed. The medical name of this disorder is hyperhidrosis known as a common dermal problem that affects people of all ages and leads to negative impact on the quality of life. During the last decades, several studies have shown that in many cases of hyperhidrosis there is no evidence of systemic disease. Read More

    The comparison between intradermal injection of abobotulinumtoxinA and normal saline for face-lifting: a split-face randomized controlled trial.
    J Cosmet Dermatol 2016 Dec 19;15(4):452-457. Epub 2016 Sep 19.
    Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
    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). Read More

    Current and Emerging Medical Therapies for Primary Hyperhidrosis.
    Dermatol Ther (Heidelb) 2016 Oct 27. Epub 2016 Oct 27.
    Department of Dermatology, UTHealth McGovern Medical School, Houston, TX, USA.
    Hyperhidrosis is defined as the production of sweat beyond what is physiologically necessary to maintain thermal homeostasis. This disease state may (and typically does) have a significant impact on the patient's quality of life. Medications including antiperspirants, anticholinergics, and botulinum toxin have been shown to be effective in the management of hyperhidrosis. Read More

    Comparison of microwave ablation, botulinum toxin injection, and liposuction-curettage in the treatment of axillary hyperhidrosis: A systematic review.
    J Cosmet Laser Ther 2017 Feb 23;19(1):36-42. Epub 2016 Dec 23.
    c Department of Obstetrics and Gynecology , Lebanese American University Medical Center , Beirut , Lebanon.
    Background: Primary focal axillary hyperhidrosis is a disorder of excessive sweating that can strongly impact quality of life.

    Objective: The objective if this study was to compare microwave ablation (MA), botulinum toxin (BT) injection, and liposuction-curettage (LC) in the treatment of primary axillary hyperhidrosis based on subjective and objective criteria.

    Methods: A systematic review of the literature published in French or English between 1 January 1991 and 1 February 2015 was completed using PubMed and Embase databases. Read More

    Current and future perspectives on the Major Depressive Disorder: Focus on the new multimodal antidepressant Vortioxetine.
    CNS Neurol Disord Drug Targets 2016 Oct 25. Epub 2016 Oct 25.
    NHS, Department of Mental Health, Psychiatric Service of Diagnosis and Treatment, Hospital "G. Mazzini", Asl 4 Teramo, Italy.
    Background: Vortioxetine (VRX) is a multimodal antidepressant that acts as serotonin (5¬HT) transporter inhibitor as well as 5¬HT3A and 5¬HT7 receptors antagonist, 5¬HT1A and 5¬HT1B receptors partial agonist. It was recently approved in the US and the EU for the treatment of adult patients with Major Depressive Disorder (MDD).

    Objective: The present article aims at systematically reviewing findings of the published and unpublished research on the pharmacological properties, efficacy, safety and tolerability of oral VRX in the treatment of major depressive disorder (MDD). Read More

    Residual Limb Hyperhidrosis Managed by Botulinum Toxin Injections, Enhanced by the Iodine-Starch Test: A Case Report.
    PM R 2016 Oct 22. Epub 2016 Oct 22.
    George E. Wahlen Department of Veterans Affairs Medical Center and Division of Physical Medicine and Rehabilitation, University of Utah School of Medicine, Salt Lake City, UT.
    Hyperhidrosis of the residual limb is a common condition affecting patients with amputations. The iodine-starch test is used by dermatologists to identify focal areas of hyperhidrosis before treatment with botulinum toxin. Here, we describe a case of a patient with a transtibial amputation with moderate-to-severe hyperhidrosis who received intradermal botulinum toxin injections to treat residual limb hyperhidrosis, with particular emphasis given to the utility of the iodine-starch test in managing this common condition. Read More

    Microneedling: A Comprehensive Review.
    Dermatol Surg 2016 Oct 13. Epub 2016 Oct 13.
    The Ronald O. Perelman Department of Dermatology, New York University School of Medicine, New York, New York.
    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. Read More

    Hyperhidrosis: an update on prevalence and severity in the United States.
    Arch Dermatol Res 2016 Dec 15;308(10):743-749. Epub 2016 Oct 15.
    Burke Inc., 500 West 7th Street, Cincinnati, OH, 45203, USA.
    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. Read More

    Management of Plantar Hyperhidrosis with Endoscopic Lumbar Sympathectomy.
    Thorac Surg Clin 2016 Nov 4;26(4):465-469. Epub 2016 Aug 4.
    Department of Surgery, Salzkammergut-Klinikum Gmunden, Miller von Aichholzstrasse 49, Gmunden 4810, Austria. Electronic address:
    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. Read More

    Less Common Side Effects of Sympathetic Surgery.
    Thorac Surg Clin 2016 Nov;26(4):453-458
    Meridian Cancer Care, Rutgers-Robert Wood Johnson Medical School, Jersey Shore University Medical Center, Ackerman South rm 553, 1945 rt 33, Neptune, NJ 07753, USA. Electronic address:
    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. Read More

    Management of Compensatory Sweating After Sympathetic Surgery.
    Thorac Surg Clin 2016 Nov 4;26(4):445-451. Epub 2016 Aug 4.
    Division of Vascular and Endovascular Surgery, Hospital Israelita Albert Einstein, Av. Albert Einstein, 627 - Bloco A1, 4° Andar, Sala 423 - Morumbi, São Paulo CEP 05652-000, Brazil. Electronic address:
    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. Read More

    Quality of Life Changes Following Surgery for Hyperhidrosis.
    Thorac Surg Clin 2016 Nov 31;26(4):435-443. Epub 2016 Aug 31.
    Vascular Surgery Division, Albert Einstein Israelite Hospital, 627/701 Albert Einstein Avenue, Block A1, Room 423, Morumbi, São Paulo 05652-900, São Paulo, Brazil; Vascular and Endovascular Division, Clinics Hospital from University of São Paulo Medical School, 225 Dr Ovídio Pires Campos St, Ambulatory Building, 6th floor, Unit 7B, São Paulo 05403-010, São Paulo, Brazil.
    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. Read More

    Reconstruction of the Sympathetic Chain.
    Thorac Surg Clin 2016 Nov 4;26(4):427-434. Epub 2016 Aug 4.
    Dyson Center, Thoracic Oncology, Vassar Brothers Medical Center, 3rd Floor, 45 Reade Place, Poughkeepsie, NY 12601, USA. Electronic address:
    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. Read More

    Reversibility of Sympathectomy for Primary Hyperhidrosis.
    Thorac Surg Clin 2016 Nov 4;26(4):421-426. Epub 2016 Aug 4.
    Division of Thoracic Surgery, Georgetown University Hospital, 3800 Reservoir Road Northwest, Washington, DC 20007, USA. Electronic address:
    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. Read More

    Targeting the Sympathetic Chain for Primary Hyperhidrosis: An Evidence-Based Review.
    Thorac Surg Clin 2016 Nov 4;26(4):407-420. Epub 2016 Aug 4.
    Division of Thoracic Surgery, Northwestern Memorial Hospital, Northwestern University Feinberg School of Medicine, 676 North Saint Clair Street, Suite 650, Chicago, IL 60611, USA. Electronic address:
    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. Read More

    Selecting the Right Patient for Surgical Treatment of Hyperhidrosis.
    Thorac Surg Clin 2016 Nov 31;26(4):403-406. Epub 2016 Aug 31.
    Department of Surgery, Ipswich Hospital, Heath Road, Ipswich IP4 5PD, United Kingdom. Electronic address:
    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. Read More

    Emerging Nonsurgical Treatments for Hyperhidrosis.
    Thorac Surg Clin 2016 Nov 31;26(4):395-402. Epub 2016 Aug 31.
    Department of Dermatology, Saint Louis University School of Medicine, 1755 South Grand Boulevard, St Louis, MO 63104, USA. Electronic address:
    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. Read More

    Pathophysiology of Hyperhidrosis.
    Thorac Surg Clin 2016 Nov 31;26(4):389-393. Epub 2016 Aug 31.
    Department of Surgery, University of Erlangen-Nuremberg, Erlangen, Germany. Electronic address:
    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. Read More

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