Unexpected improvement of hyperhidrosis with cannabidiol

ABSTRACT Hyperhidrosis is characterized by excessive sweating and it affects almost 5% of the population. The affected age group is wide, and it can affect from children to elderlies. There are two types of hyperhidrosis: generalized and focal. Treatment depends on the symptoms presented. In more severe cases, radiofrequency sympatholysis and bilateral thoracic sympathectomy are the options. However, recurrence is possible or the postoperative appearance of conditions called compensatory hyperhidrosis or reflex hyperhidrosis. We describe two cases of patients treated with Cannabidiol who had significant and unexpected improvement of hyperhidrosis. The first patient received Cannabidiol specific for public presentations at work, and the second patient had a diagnosis of autism spectrum disorder. The hyperhidrosis improved in both patients immediately after using Cannabidiol.

Calidad de vida luego de simpaticotomía toracoscópica por hiperhidrosis focal primaria / Quality of life after thoracoscopic sympathectomy for primary focal hyperhidrosis

RESUMEN Antecedentes: la simpaticotomía toracoscópica demostró ser una cirugía segura para el tratamiento de la hiperhidrosis focal primaria (HFP); sin embargo, la calidad de vida no es totalmente satisfactoria en algunos pacientes, teniendo en cuenta la sudoración compensatoria como principal efecto adverso. Objetivo: evaluar la calidad de vida de los pacientes operados por HFP mediante simpaticotomía toracoscópica utilizando una encuesta anónima posoperatoria. Material y métodos: se incluyó una serie consecutiva de pacientes operados de simpaticotomía toracoscópica entre agosto de 2016 y agosto de 2019. Se excluyeron pacientes que no respondieron a la encuesta de calidad de vida telefónica o cuyo tiempo de seguimiento fue menor de 6 meses. Se evaluaron variables clínicas, quirúrgicas y posoperatorias. Resultados: durante este período se operaron 61 pacientes; del total de la muestra se excluyeron 12 pacientes. El promedio de edad fue 28,9 años. Todos tenían hiperhidrosis primaria palmar y/o axilar moderada o grave, asociadas o no a rubor facial o hiperhidrosis plantar. La encuesta fue respondida por 49 pacientes; de esta observamos una resolución total de la HFP en 32 pacientes (65,3%) y parcial en 17 pacientes (34,6%), con un porcentaje de sudoración compensatoria del 61% (30 pacientes), de los cuales a 4 (8%) la sudoración compensatoria les alteró su calidad de vida, provocando malestar e insatisfacción, la mayoría transitorios. Con un tiempo promedio de 36 meses (6-72), el 97,9% (48 pacientes) sí recomendarían realizar el procedimiento. Conclusión: la simpaticotomía toracoscópica bilateral continúa siendo el tratamiento más eficaz para HFP. El nivel de satisfacción de los pacientes operados fue elevado. Si bien la sudoración compensatoria fue el efecto adverso más frecuente, generalmente se presentó de manera leve y transitoria.

ABSTRACT Background: Thoracoscopic sympathectomy demonstrated to be a safe surgical procedure for the management of primary focal hyperhidrosis (PFH); however, some patients are not completely satisfied with their quality of life as compensatory sweating is the main adverse event. Objective: The aim of this study was to evaluate the quality of life of patients with PFH undergoing thoracoscopic sympathectomy using an anonymous postoperative survey. Material and methods: Consecutive patients undergoing thoracoscopic sympathectomy between August 2016 and August 2019 were included. Patients who did not respond the telephone survey about their quality of life or who had been followed up for < 6 months. Clinical, intraoperative and postoperative variables were analyzed. Results: During this period 61 patients were operated on and 12 of them were excluded. Mean age was 28.9 years. All the patients presented moderate or severe primary palmar and/or axillary hyperhidrosis with or without facial flushing or plantar hyperhidrosis. Forty-nine patients responded the survey. Surgery completely solved PFH in 32 patients (65.3%) while 17 patients (34.6%) achieved a partial relief; 61% (30 patients) developed compensatory sweating affecting the quality of life in 4 (8%) causing transient discomfort and dissatisfaction in most cases. After a mean follow-up of 36 months (6-72), 97.9% (48 patients) recommended the procedure. Conclusion: Bilateral thoracoscopic sympathectomy is still the most efficient treatment for PFH with high level of satisfaction among the patients operated on. Compensatory sweating was the most common adverse effect and is mild and transient in most cases.

Symptoms of anxiety and depression in patients with primary hyperhidrosis and its association with the result of clinical treatment with oxybutynin

OBJECTIVES: Studies have identified correlations between the psychological characteristics of individuals with primary hyperhidrosis (HH), the degree of sweating, and the quality of life (QoL). This study aimed to evaluate the prevalence of anxiety and depression symptoms in patients with HH before and after oxybutynin treatment. METHODS: Data were collected from 81 patients. Palmar or axillary HH was the most frequent complaint (84.0%). All patients were evaluated before the medication was prescribed and after five weeks of treatment. The Beck Depression Inventory and Beck Anxiety Inventory were used to evaluate depression and anxiety. RESULTS: Improvement in HH occurred in 58 patients (71.6%), but there was no improvement in 23 patients (28.4%). The QoL before treatment in all patients was either "poor" or "very poor." Patients who experienced improvement in sweating rates also experienced a greater improvement in QoL than patients who did not experience improvement in sweating at the main site (87.9% vs. 34.7%) (p<0.001). A total of 19.7% of patients showed an improvement in their level of depression, and a total of 46.9% of patients exhibited improvements in their level of anxiety. A significant correlation was observed between sweating and anxiety (p=0.015). CONCLUSION: Patients with HH who experienced improvements in sweating immediately after treatment with oxybutynin exhibited small improvements in their levels of depression and significant improvements in their levels of anxiety and QoL.

Combination of topical agents and oxybutynin as a therapeutic modality for patients with both osmidrosis and hyperhidrosis / Uso combinado de agentes tópicos e oxibutinina para tratamento de pacientes com osmidrose e hiper-hidrose

Summary Introduction: The association of osmidrosis and hyperhidrosis often causes emotional and social problems that may impair the patients' quality of life. The purpose of our study was to analyze the therapeutic results of oxybutynin and topical agents in 89 patients with both osmidrosis and hyperhidrosis. Method: We conducted an observational study at two specialized centers of hyperhidrosis between April 2007 and August 2013. Eighty-nine (89) patients with both osmidrosis and hyperhidrosis were treated with oxybutynin and topical agents. Patients were evaluated before treatment and at 3 and 6 weeks after treatment started, by using the Quality of Life Questionnaire and the Sweating Evolution Scale. Results: Before treatment, 98% of the patients presented with poor or very poor quality of life. After six weeks of treatment, 70% stated their quality of life as being slightly better or much better (p<0.001) and nearly 70% of the patients experienced a moderate or great improvement in sweating and malodor. Improvement in osmidrosis was significantly greater when the axillary region was the first most disturbing site of hyperhidrosis. Conclusion: There was a significant improvement in quality of life and a reduction in sweating and malodor after six weeks of treatment with topical agents and oxybutynin in patients with both hyperhidrosis and osmidrosis. Therefore, clinical treatment should be considered before invasive techniques.

Resumo Introdução: A associação entre osmidrose e hiper-hidrose com frequência causa problemas emocionais e sociais que podem deteriorar a qualidade de vida dos pacientes. O objetivo deste estudo foi analisar os resultados terapêuticos do uso de oxibutinina associada a agentes tópicos em 89 pacientes com osmidrose e hiper-hidrose. Método: Nós conduzimos um estudo observacional em dois centros especializados em hiper-hidrose entre abril de 2007 e agosto de 2013. Oitenta e nove (89) pacientes com osmidrose associada a hiper-hidrose foram tratados com oxibutinina e agentes tópicos. Os pacientes foram avaliados antes do tratamento e após 3 e 6 semanas do início do tratamento, por meio do Questionário de Qualidade de Vida e da Escala de Evolução da Sudorese. Resultados: Antes do tratamento, 98% dos pacientes apresentavam qualidade de vida ruim ou muito ruim. Após seis semanas de tratamento, 70% classificou sua qualidade de vida como sendo pouco ou muito melhor (p<0.001) e aproximadamente 70% dos pacientes relataram melhora moderada ou grande de sudorese e odor. Houve melhora significativamente maior da osmidrose quando a região axilar era o sítio em que a hiper-hidrose mais incomodava. Conclusão: Houve melhora significativa da qualidade de vida e uma redução da sudorese e do odor após seis semanas de tratamento com agentes tópicos e oxibutinina em pacientes com hiper-hidrose associada a osmidrose. Dessa maneira, a terapia clínica deve ser considerada antes de técnicas invasivas.

Oxybutynin as an alternative treatment for hyperhidrosis

Abstract: Hyperhidrosis is the excessive production of sweating, which can be primary and focal or secondary to various pathologies. The exact cause of primary focal hyperhidrosis is still unknown, although a genetic basis is recognized, and its prevalence varies from 1% to 2.8%. The most affected sites are the armpits, palms, soles and face. It causes much discomfort, affects the quality of life, and is estimated to be undervalued by health professionals. Many treatment options are proposed, both clinical and surgical. The aim of this review is to focus on the treatment of hyperhidrosis with oxybutynin, an anticholinergic drug originally used to control overactive bladder.

Long-term results of oxybutynin use in treating facial hyperhidrosis

BACKGROUND: Facial hyperhidrosis can lead to serious emotional distress. Video-assisted thoracic sympathectomy resolves symptoms effectively, though it may be associated with compensatory hyperhidrosis, which may be more common in patients undergoing resection of the second thoracic ganglion. Oxybutynin has been used as a pharmacological approach to facial hyperhidrosis but the long-term results of this treatment are unclear. OBJECTIVE: To evaluate the use of low oxybutynin doses in facial hyperhidrosis patients for at least six months. METHODS: 61 patients were monitored for over six months and assessed according to the following variables: impact of hyperhidrosis on quality of life (QOL) before treatment and after six weeks, evolution of facial hyperhidrosis after six weeks and at the last consultation, complaints of dry mouth after six weeks and on last return visit, and improvement at other hyperhidrosis sites. RESULTS: Patients were monitored for 6 to 61 months (median=17 months). Thirty-six (59%) were female. Age ranged from 17-74 (median:45). Pre-treatment QOL was poor/very poor in 96.72%. After six weeks, 100% of patients improved QOL. Comparing results after six weeks and on the last visit, 91.8% of patients maintained the same category of improvement in facial hyperhidrosis, 3.3% worsened and 4.9% improved. Dry mouth complaints were common but not consistent throughout treatment. More than 90% of patients presented moderate/great improvement at other hyperhidrosis sites. CONCLUSION: Patients who had a good initial response to treatment maintained a good response long-term, did not display tachiphylaxis and experienced improvement on other hyperhidrosis sites. .

Treatment of uncommon sites of focal primary hyperhidrosis: experience with pharmacological therapy using oxybutynin

OBJECTIVES: Primary hyperhidrosis usually affects the hands, armpits, feet and cranio-facial region. Sweating in other areas is common in secondary hyperhidrosis (after surgery or in specific clinical conditions). Oxybutynin has provided good results and is an alternative for treating hyperhidrosis at common sites. Our aim was to evaluate the efficacy of oxybutynin as a treatment for primary sweating at uncommon sites (e.g., the back and groin). METHODS: This retrospective study analyzed 20 patients (10 females) who received oxybutynin for primary focal hyperhidrosis at uncommon sites. The subjects were evaluated to determine quality of life before beginning oxybutynin and six weeks afterward and they were assigned grades (on a scale from 0 to 10) to measure their improvement at each site of excessive sweating after six weeks and at the last consult. RESULTS: The median follow-up time with oxybutynin was 385 days (133-1526 days). The most common sites were the back (n = 7) and groin (n = 5). After six weeks, the quality of life improved in 85% of the subjects. Dry mouth was very common and was reported by 16 patients, 12 of whom reported moderate/severe dry mouth. Five patients stopped treatment (two: unbearable dry mouth, two: excessive somnolence and one: palpitations). At the last visit, 80% of patients presented with moderate/great improvement at the main sites of sweating. CONCLUSION: After six weeks, more than 80% of the patients presented with improvements in their overall quality of life and at the most important site of sweating. Side effects were common (80% reported at least one side effect) and caused 25% of the patients to discontinue treatment. Oxybutynin is effective for treating bothersome hyperhidrosis, even at atypical locations and most patients cope well with the side effects. .

Analysis of oxybutynin treatment for hyperhidrosis in patients aged over 40 years / Análise do tratamento de hiperidrose com oxibutinina em pacientes com mais de 40 anos

Objective : Our aim was to analyze the effectiveness of oxybutynin for hyperhidrosis treatment in patients over 40 years. Methods : Eighty-seven patients aged over 40 years were divided into two groups. One group consisted of 48 (55.2%) patients aged between 40 and 49 years, and another was composed of 39 (44.8%) patients aged over 50 years (50 to 74 years). A comparative analysis of Quality of Life and level of hyperhidrosis between the groups was carried out 6 weeks after a protocol treatment with oxybutynin. A validated clinical questionnaire was used for evaluation. Results : In the younger age group, 75% of patients referred a “partial” or “great” improvement in level of hyperhidrosis after treatment. This number was particularly impressive in patients over 50 years, in which 87.2% of the cases demonstrated similar levels of improvement. Over 77% of patients in both groups demonstrated improvement in Quality of Life. Excellent outcomes were observed in older patients, in which 87.1% of patients presented “slightly better” (41%) or “much better” (46.1%) improvement. Conclusion : Patients aged over 40 years with hyperhidrosis presented excellent results after oxybutynin treatment. These outcomes were particularly impressive in the age group over 50 years, in which most patients had significant improvement in Quality of Life and in level of hyperhidrosis. .

Objetivo : Analisar a efetividade da oxibutinina para tratamento da hiperidrose em pacientes com mais de 40 anos. Métodos : Oitenta e sete pacientes com idade superior a 40 anos foram divididos em dois grupos: o primeiro com 48 pacientes (55,2%), com idades entre 40 e 49 anos. O segundo com 39 pacientes (44,8%), com mais de 50 anos (intervalo: 50 a 74 anos). Uma análise comparativa da Qualidade de Vida e do nível de hiperidrose entre os grupos foi realizada 6 semanas após o início do tratamento com oxibutinina. Para isso, foi utilizado um questionário validado para Qualidade de Vida. Resultados : No grupo mais jovem, 75% dos pacientes referiram melhora “parcial” ou “ótima” no nível de hiperidrose após o tratamento. Esse número foi particularmente impressionante em pacientes acima de 50 anos, sendo que 87,2% apresentaram níveis similares de melhora. Mais de 77% dos pacientes, em ambos os grupos, demonstraram melhora na Qualidade de Vida. Desfechos excelentes foram observados em pacientes mais idosos, dentre os quais 87,1% dos pacientes apresentaram melhora “pouco melhor” (41%) ou “muito melhor” (46,1%). Conclusão : Os pacientes acima de 40 anos com hiperidrose tiveram excelentes resultados com o tratamento com oxibutinina. Esses desfechos foram particularmente importantes nos pacientes com mais de 50 anos, nos quais a maioria apresentou melhora da Qualidade de Vida e da hiperidrose. .

Randomized trial - oxybutynin for treatment of persistent plantar hyperhidrosis in women after sympathectomy

OBJECTIVE: Hyperhidrosis is a common disease, and thoracoscopic sympathectomy improves its symptoms in up to 95% of cases. Unfortunately, after surgery, plantar hyperhidrosis may remain in 50% of patients, and compensatory sweating may be observed in 70%. This clinical scenario remains a challenge. Our objective was to evaluate the effectiveness of oxybutynin in the treatment of persistent plantar hyperhidrosis and compensatory sweating and its effects on quality of life in women after thoracoscopic sympathectomy. METHOD: We conducted a prospective, randomized study to compare the effects of oxybutynin at 10 mg daily and placebo in women with persistent plantar hyperhidrosis. The assessment was performed using a quality-of-life questionnaire for hyperhidrosis and sweating measurement with a device for quantifying transepidermal water loss. Clinicaltrials.gov: NCT01328015. RESULTS: Sixteen patients were included in each group (placebo and oxybutynin). There were no significant differences between the groups prior to treatment. After oxybutynin treatment, there was a decrease in symptoms and clinical improvement based on the quality-of-life questionnaire (before treatment, 40.4 vs. after treatment, 17.5; p = 0.001). The placebo group showed modest improvement (p = 0.09). The outcomes of the transepidermal water loss measurements in the placebo group showed no differences (p = 0.95), whereas the oxybutynin group revealed a significant decrease (p = 0.001). The most common side effect was dry mouth (100% in the oxybutynin group vs. 43.8% in the placebo group; p = 0.001). CONCLUSION: Oxybutynin was effective in the treatment of persistent plantar hyperhidrosis, resulting in a better quality of life in women who had undergone thoracoscopic sympathectomy. .

Effectiveness of oxybutynin for treatment of hyperhidrosis in overweight and obese patients / Eficácia da oxibutina no tratamento de hiperidrose em pacientes com sobrepeso e obesos

OBJECTIVE: Until the present moment, the lack of efficient therapeutic options available for hyperhidrosis treatment in obese patients has left this population without prospect of clinical or quality of life (QOL) improvements. Outcomes of oxybutynin treatment for overweight and obese patients with hyperhidrosis are unknown. This study aims to investigate the results related to clinical and QOL improvements in this specific population, submitted to a 12-week protocol treatment with oxybutynin. METHODS: 559 patients with palmar and axillary hyperhidrosis, routinely followed in this service, were divided into the groups, according to their body mass index (BMI) (< 25 kg/m²; 25 < bmi < 30 kg/m², > 30 kg/m²). Improvements in QOL and in the level of hyperhidrosis were analyzed after 12 weeks of protocol treatment with oxybutynin. These parameters were investigated using a scoring system based on a scientifically validated clinical questionnaire, applied before and after treatment. RESULTS: 67.8% of the overweight sample group and 63% of the obese patients presented "partial" or "great" improvement in the level of hyperhidrosis. Over 65% of patients demonstrated improvement in QOL ("much better" or "slightly better") for all three groups, with no statistical difference between them. The only adverse event associated with oxybutynin was dry mouth, observed in 63.0% of the patients. CONCLUSION: Overweight and obese patients with palmar or axillary hyperhidrosis present significant improvement in QOL after treatment with oxybutynin, and the results are comparable to those of normal weight individuals.

OBJETIVO: A falta de alternativas terapêuticas para o tratamento de pacientes obesos com Hiperidrose hiperidrose deixa essa população sem perspectiva de melhorar suas condições clínicas e qualidade de vida. Resultados do tratamento com oxibutinina especificamenteempacientes com sobrepeso ou obesidade são desconhecidos até o presente momento. Este estudo tem como objetivo investigar os resultados relacionados à melhora clínica e qualidade de vida dessa população, após um protocolo de tratamento de 12 semanas com oxibutinina. MÉODOS: 559 pacientes com hiperidrose palmar e axilar, foram divididos em três grupos, de acordo com seu índice de massa corporal (IMC) (< 25 kg/m²; 25 < IMC < 30 kg/m², > 30 kg/m²). Dados sobre evolução na qualidade de vida e nível de hiperidrose foram avaliados com base em um questionário validado cientificamente, aplicado antes e após o tratamento com oxibutinina. RESULTADOS: 67.8% dos pacientes com sobrepeso e 63% dos obesos apresentaram melhora clínica "grande" ou "parcial" no nível da hiperidrose. Mais de 65% dos pacientes relataram melhora na qualidade de vida ("muito melhor" ou "um pouco melhor") para os três grupos, sem diferença estatística entre eles. O único efeito colateral observado foi boca seca, presente em 63.0% da amostra. CONCLUSÃO: Pacientes com sobrepeso e obesidade portadores de hiperidrose palmar ou axilar apresentaram melhora significativa na qualidade de vida após o tratamento com oxibutinina, sendo os resultados comparáveis aos de indivíduos com peso normal.

Efficacy and safety of tap water iontophoresis for palmoplantar hyperhidrosis

To evaluate the efficacy and safety of tap water iontophoresis [TWI] for the treatment of palmoplantar hyperhidrosis in our local setting. Thirteen patients of idiopathic palmoplantar hyperhidrosis were enrolled in the study from the Department of Dermatology, Lahore Medical and Dental College/Ghurki Hospital and Skin Clinic, Gulberg, Lahore from May 2009 to August 2012. Two patients dropped out, and the study was completed by eleven patients. The patients were treated with TWI three times a week for six weeks and followed up at twelve weeks. Each session lasted for 20 minutes, with the polarity being reversed after 10 minutes. The results were assessed by the hyperhidrosis disease severity index, improvement of sweating on a scale of one to four and the starch-iodine test. Any adverse events were noted. All the patients responded well to the treatment with minimal discomfort. Tap water iontophoresis is a safe, effective, inexpensive and affordable treatment modality for palmoplantar hyperhidrosis. It improves quality of life significantly during treatment.

Oxybutynin treatment for hyperhidrosis: a comparative analysis between genders / Oxibutinina para tratamento de hiperidrose: análise comparativa entre gêneros

OBJECTIVE: To assess the results of palmar and axillary hyperhidrosis treatment in males and females using low doses of oxybutynin. METHODS: A retrospective analysis was conducted in 395 women and 170 men followed up in our service with complaint of palmar and axillary hyperhidrosis. RESULTS: A total of 70% of patients in both groups presented partial or great improvement in the level of hyperhidrosis after treatment. The best results were obtained in the female group, in which 40% classified their improvement as "great". Approximately 70% of the patients in both groups improved their quality of life after medical therapy and 30% presented no change in condition. CONCLUSION: Gender is not a factor that significantly interferes in oxybutynin treatment results. Quality of life indices and clinical improvement level were similar in men and women.

OBJETIVO: Avaliar os resultados do tratamento com baixas doses de oxibutinina em homens e mulheres com hiperidrose palmar e axilar. MÉTODOS: Análise retrospectiva de 395 mulheres e 170 homens acompanhados em nosso serviço com queixa de hiperidrose palmar e plantar, submetidos a um protocolo de 12 semanas de tratamento com oxibutinina. Melhora clínica da hiperidrose e da qualidade de vida foram estudadas por meio de um questionário específico, aplicado antes e após o tratamento. RESULTADOS: Dentre os pacientes em ambos os grupos, 70% apresentaram melhoria parcial ou grande no nível de hiperidrose após o tratamento. Os melhores resultados foram obtidos no grupo feminino, no qual 40% classificaram sua evolução como "ótima". Aproximadamente 70% dos pacientes em ambos os grupos melhoraram sua qualidade de vida após a terapia médica e 30% não apresentaram mudança da condição inicial. CONCLUSÃO: Gênero é um fator que não interfere significativamente nos resultados do tratamento com oxibutinina. Os índices de qualidade de vida e o grau de melhora clínica da hiperidrose foram semelhantes em homens e mulheres.

Hiperhidrosis primaria: tratamiento con oxibutinina / Primary hyperhidrosis treatment with oxybutynin

La hiperhidrosis es la sudoración excesiva que puede ser generalizada o afectar sólo las axilas, las palmas, las plantas o el rostro. La mayoría de las veces es primaria. Si bien existen múltiples alternativas terapéuticas con resultados dispares, en los últimos años se ha comunicado una buena respuesta a la oxibutinina. Se presentan tres niñas con hiperhidrosis primaria que fueron tratadas con este anticolinérgico y tuvieron una excelente respuesta con efectos adversos mínimos o nulos.

Hyperhidrosis is the excessive sweating that may be generalized or limited to armpits, palms, soles or face. Most of the cases are primary. Although there are several therapeutics options available, good results with the use of oxybutynin have been described in the last years. We present three girls affected by primary hyperhidrosis who were treated with this anticholinergic drug and obtained an excellent response with minimal or no adverse effects.

The use of oxybutynin for treating facial hyperhidrosis / O uso da oxibutinina no tratamento da hiperidrose facial

BACKGROUND: Facial hyperhidrosis is a disease that may lead patients to serious emotional disturbances. Video-assisted thoracic sympathectomy provides excellent resolution of facial hyperhidrosis, but is associated with certain complications. The most frequent and important complication is compensatory hyperhidrosis. Especially in patients who have undergone resection of the second thoracic ganglion, the risk of severe compensatory hyperhidrosis is higher, which may cause dissatisfaction with the procedure. OBJECTIVE: The aim of this study was to evaluate the efficacy of the use of low doses of oxybutynin in treating facial hyperhidrosis as well as the level of patient satisfaction with its use. METHODS: 25 patients with facial hyperhidrosis were treated with oxybutynin. The patients underwent 2 evaluations: before and after treatment. These evaluations were used to assess the patients' clinical improvement and quality of life. RESULTS: We observed that more than 75 percent of the patients evolved with an improvement in facial hyperhidrosis, and 52 percent of them presented a great improvement. CONCLUSION: Treatment of facial hyperhidrosis with oxybutynin is a good alternative to sympathectomy, since it presents good results and improves quality of life, in addition to not exposing patients to the risk of experiencing the side effects of sympathectomy.

FUNDAMENTOS: Hiperidrose facial é uma doença que pode levar os pacientes a sérios distúrbios emocionais. A simpatectomia torácica vídeo-assistida proporciona excelente resolução da hiperidrose facial, mas está associada a algumas complicações, sendo a mais freqüente e mais importante a hiperidrose compensatória. Especialmente em pacientes submetidos à ressecção do segundo gânglio torácico, o risco de hiperidrose compensatória grave é maior, o que pode causar insatisfação com o procedimento. OBJETIVO: O objetivo deste estudo foi avaliar a eficácia e a satisfação dos pacientes com o uso da oxibutinina em doses baixas para tratar a hiperidrose facial em uma série grande de pacientes. MÉTODOS: 25 pacientes com hiperidrose facial foram tratados com oxibutinina. Os pacientes foram submetidos a duas avaliações: antes e depois do tratamento. Estas foram usadas para avaliar a melhoria clínica e a qualidade de vida. RESULTADOS: Observou-se que mais de 75 por cento dos pacientes evoluíram com melhora na hiperidrose facial, sendo que 52 por cento deles apresentaram uma grande melhora. CONCLUSÃO: O tratamento da hiperidrose facial com oxibutinina é uma boa alternativa à simpatectomia, visto que apresenta bons resultados e melhora a qualidade de vida, e os pacientes não correm o risco dos efeitos colaterais da simpatectomia.

Simpatectomía torácica en la hiperhidrosis primaria / Thoracic sympathectomy in the treatment of primary hyperhidrosis

La Hiperhidrosis es una afección caracterizada por una excesiva producción de sudor, mediada por el sistema nervioso simpático que se presenta especialmente a nivel axilopalmar y craneofacial. Produce importantes problemas psicosociales y laborales, además de irritación e infecciones a nivel local. El único tratamiento definitivo es la cirugía a través de la simpatectomía torácica bilateral, que se realiza por videotoracoscopía con excelentes resultados estéticos, funcionales y gran satisfacción postoperatoria por parte de los pacientes.

Estudio y cuantificación de la respuesta de la hiperhidrosis palmar y tratamiento con sales de aluminio micropulverizadas / Study and quantification of palmar hyperhidrosis response and treatment with micropulverized aluminum salts

La hiperhidrosis palmar primaria es una enfermedad social y estresante para el paciente, pudiendo tener importantes consecuencias en su autoestima y en sus relaciones interpersonales. Debido a esto, es importante contar con tratamientos que sean efectivos, seguros, sencillos y accesibles para cada paciente. Se necesitan métodos que midan el grado de hiperhidrosis palmar, permitiendo así el seguimiento objetivo de la respuesta clínica al tratamiento.