Tratamento da hiperidrose palmar com onabotulinumtoxinA veiculada por iontoforese ou fonoforese: relato de casos

Andrade, Patrícia Cristina; Flores, Giovana Pagliari; Uscello, Jéssica de Fátima Moreira; Miot, Hélio Amante; Morsoleto, Maria José Misael da Silva

doi:10.1590/s0365-05962011000600037

Cited by 12 publications

(13 citation statements)

References 10 publications

(16 reference statements)

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“…The most widely used is the aqueous solution of aluminum chloride 20-30%, which should be applied preferably during night, two to three times a week. The main undesirable events observed are redness and skin irritation 15 , 48. The tannic acid in solution 2-5% was reported as effective in mild cases.…”

Section: Palmar Hyperhidrosis Treatmentmentioning

confidence: 99%

Palmar hyperhidrosis: clinical, pathophysiological, diagnostic and therapeutic aspects

Romero

Haddad

Miot

et al. 2016

An. Bras. Dermatol.

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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. In this study, the authors discuss clinical findings, pathophysiological, diagnostic and therapeutic issues (clinical and surgical) related to palmar hyperhidrosis.

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Section: Palmar Hyperhidrosis Treatmentmentioning

confidence: 99%

Palmar hyperhidrosis: clinical, pathophysiological, diagnostic and therapeutic aspects

Romero

Haddad

Miot

et al. 2016

An. Bras. Dermatol.

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“…Btx injections are effective and should be considered in those patients who have failed topical and systemic therapies 1,11,20,27,29,35–38,40,41. New forms of administration of Btx may make this option more palatable for patients weary of injections,76–78 especially for those seeking treatment for axillary HH. LC successfully relieves HH and, by virtue of the suctioning mechanism, may be superior to curettage alone for lasting results 14,49,52.…”

Section: Resultsmentioning

confidence: 99%

“…An intriguing investigation by Andrade et al76 evaluated the use of iontophoresis or phonophoresis to facilitate delivery of Btx A percutaneously for palmar HH. They evaluated four patients after ten daily sessions of either phonophoresis- or iontophoresis-mediated Btx administration.…”

Section: New and Emerging Therapiesmentioning

confidence: 99%

“…They evaluated four patients after ten daily sessions of either phonophoresis- or iontophoresis-mediated Btx administration. Improvement of HH lasted for 16 weeks after treatment 76. Because iontophoresis alone is a treatment available for HH, it would have been useful to see a comparison of this combination therapy (iontophoresis or phonophoresis plus Btx A) versus each individual treatment alone.…”

Section: New and Emerging Therapiesmentioning

confidence: 99%

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Management of hyperhidrosis

Stashak¹,

Brewer

2014

CCID

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Primary hyperhidrosis (HH), a condition of sweating in excess of thermoregulatory requirements, affects nearly 3% of the US population and carries significant emotional and psychosocial implications. Unlike secondary HH, primary HH is not associated with an identifiable underlying pathology. Our limited understanding of the precise pathophysiologic mechanism for HH makes its treatment particularly frustrating. However, a wide array of interventions for the treatment of HH have been implemented throughout the world. Herein, we discuss the most extensively studied therapeutic options for primary HH, including systemic oxybutynin, botulinum toxin injections, skin excision, liposuction–curettage, and sympathotomy/sympathectomy. We conclude with a discussion of possible future therapies for HH, including the applications of laser, microwave, and ultrasound technologies.

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“…At the 3-week follow-up, all patients, treated for axillary and palmar hyperhidrosis, reported a significant improvement in Dermatology Life Quality Index (DLQI) score. Andrade et al23 found two efficient non-invasive methods, iontophoresis and phonophoresis, to administer BTX-A in patients with bilateral primary palmar hyperhidrosis. In this study, BTX-A efficacy lasted over 16 weeks after the end of treatment.…”

Section: Discussionmentioning

confidence: 99%

A preliminary study of painless and effective transdermal botulinum toxin A delivery by jet nebulization for treatment of primary hyperhidrosis

Iannitti¹,

Palmieri²,

Aspiro³

et al. 2014

DDDT

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BackgroundHyperhidrosis is a chronic disease characterized by increased sweat production. Local injections of botulinum toxin A (BTX-A) have been extensively used for treatment of primary hyperhidrosis (idiopathic). The current treatment for this condition involves several intradermal injections, resulting in poor patient compliance due to injection-related pain. Therefore, new protocols, including an improved anesthetic regimen, are required.AimWe designed the present study to determine whether JetPeel™-3, a medical device used for transdermal delivery of drugs by jet nebulization, could be used to deliver lidocaine prior to the standard multiple BTX-A injections or deliver lidocaine together with BTX-A in order to determine the protocol giving better results in terms of procedure-related pain, sweating, and patient satisfaction in subjects affected by primary axillary, palmar or plantar hyperhidrosis.Materials and methodsTwenty patients with a visual analog scale (VAS) sweating score ≥ 8 cm were randomized to receive lidocaine 2% (5 mL) delivered by JetPeel™-3 followed by multiple injections of BTX-A (100 units) or lidocaine 2% (5 mL) and BTX-A (50 units) delivered together by JetPeel™-3. Effect of treatment on sweating was measured by VAS (0= minimum sweating; 10= maximum sweating) at 3-month follow-up. Pain induced by the procedure was assessed by VAS (0= minimum pain; 10= maximum pain) immediately after the procedure. Patient satisfaction was assessed at 3-month follow-up using a 5-point scale (1= not at all satisfied; 2= not satisfied; 3= partially satisfied; 4= satisfied; 5= highly satisfied).ResultsBoth treatment modalities reduced sweating at 3-month follow-up, if compared with baseline (all P<0.001). Delivery of lidocaine and BTX-A by JetPeel™-3 resulted in lower procedure-related pain and reduced sweating, if compared with lidocaine delivered by JetPeel™-3 followed by multiple BTX-A injections (all P<0.001). Patient satisfaction with the procedure was higher in the group receiving lidocaine and BTX-A treatment by JetPeel™-3, if compared with lidocaine delivered by JetPeel™-3 followed by multiple BTX-A injections (P<0.001). No side effects were observed in both groups.ConclusionLidocaine and BTX-A can be safely delivered together by JetPeel™-3 to treat primary palmar, plantar and axillary hyperhidrosis, resulting in lower procedure-related pain, improved sweating and higher patient satisfaction, if compared with lidocaine delivered by JetPeel™-3 followed by standard BTX-A injection therapy. Our protocol delivering lidocaine and BTX-A together by JetPeel™-3 requires a reduced quantity of BTX-A, further supporting the use of the transdermal drug delivery by jet nebulization over standard injection therapy for treatment of primary hyperhidrosis.

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Tratamento da hiperidrose palmar com onabotulinumtoxinA veiculada por iontoforese ou fonoforese: relato de casos

Cited by 12 publications

References 10 publications

Palmar hyperhidrosis: clinical, pathophysiological, diagnostic and therapeutic aspects

Palmar hyperhidrosis: clinical, pathophysiological, diagnostic and therapeutic aspects

Management of hyperhidrosis

A preliminary study of painless and effective transdermal botulinum toxin A delivery by jet nebulization for treatment of primary hyperhidrosis

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