Efficacy and Safety of Botulinum Toxin Type A in the Treatment of Palmar Hyperhidrosis: A Double-Blind, Randomized, Placebo-Controlled Study

Lowe, Nicholas J.; Yamauchi, Paul S.; Lask, Gary; Patnaik, Rickie; Iyer, Srinivasan

doi:10.1046/j.1524-4725.2002.02039.x

Cited by 109 publications

(89 citation statements)

References 21 publications

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“…Ekrin ter bezlerini innerve eden sempatik sinirlerden asetilkolin salınımını inhibe ederek terlemeyi azaltır (2). Özellikle aksiller ve palmar hiperhidrozda yaygın olarak kullanılmakla birlikte, frontal ve gustatuvar hiperhidrozda da etkili olduğu bulunmuştur (2,20,21 Özcan ve ark. Hiperhidroz, İyontoforez bölgeye intradermal enjeksiyonundan ortalama 5-7 gün sonra terlemede azalma en üst düzeye ulaşır (2,22).…”

Section: Botulinum Toksin Aunclassified

Hyperhidrosis and Its Treatment: A Safe and Effective Alternative in the Treatment of Palmoplantar Hyperhidrosis, Iontophoresis

Özcan¹,

Güleç²

2011

Turk J Dermatol

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ÖzetPrimer hiperhidroz sebebi bilinmeyen, en sık palmar, plantar ve aksiller bölgede ortaya çıkan, çoğunlukla bilateral ve simetrik olan aşırı terleme ile karakterizedir. Etkilenen bireylerde fiziksel rahatsızlıklar ve psikososyal güçlüklere yol açtığı için etkin bir şekilde tedavi edilmelidir. Ancak, patofizyolojisinin tam olarak anlaşılmaması nedeniyle tedavisi zordur. Topikal ve sistemik ajanlar ile cerrahi ve cerrahi olmayan invaziv teknikler gibi çeşitli seçenekler bulunmaktadır. İyontoforez, iyonize maddelerin elektrik akımı aracılığıyla yüzey dokulara uygulanması işlemidir. Primer hiperhidrozda invaziv olmayan, güvenli, iyi tolere edilen, etkili ve uzun dönem yan etkiler ile kompansatuvar hiperhidroza neden olmayan bir tedavi yöntemidir. Şiddetli palmar ve/veya plantar hiperhidrozda ve topikal tedaviye yanıt vermeyen orta şiddetteki olgularda ilk tedavi seçeneği olarak önerilmektedir. Aksiller hiperhidrozda ise etkinliği düşüktür ve kullanımı pratik değildir. Zaman alıcı olması ve idame tedavisinin gerekliliği ise en önemli dezavantajlarıdır. Bu makalede, hiperhidroz ve başlıca tedavi seçenekleri, iyontoforezin primer hiperhidroz tedavisindeki endikasyonları, etki mekanizması, tedavi protokolü ile yöntemi, yan etkileri ve kontrendikasyonları derlenmiştir. AbstractPrimary hyperhidrosis is characterized by excessive sweating of unknown cause which most commonly involves the palms, soles, and axillae in a bilateral and symmetrical fashion. Since it leads to physical discomfort and psychosocial difficulties in the affected individuals, it should be treated effectively. However, treatment can be challenging as its pathophysiology is poorly understood. There are several treatment options, including topical or systemic medications and surgical or non-surgical invasive techniques. Iontophoresis is the introduction of ionized substances into the surface tissues by means of an electric current. It is a non-invasive, safe, well tolerated, and effective treatment method for primary hyperhidrosis without long-term adverse effects and compensatory hyperhidrosis. Iontophoresis is suggested as a first-line therapy in severe palmoplantar hyperhidrosis and second-line therapy in milder cases that are unresponsive to topical treatments. In axillary hyperhidrosis it is less effective and not practical to use. Being time consuming and requiring maintenance therapy are its most important disadvantages. In this article, hyperhidrosis and the principal treatment options, the indications of iontophoresis for the treatment of primary hyperhidrosis, its mechanism of action, treatment protocol and procedure, adverse effects, and contraindications are reviewed. (Turk J Dermatol 2011; 5: 5-12)

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Section: Botulinum Toksin Aunclassified

Hyperhidrosis and Its Treatment: A Safe and Effective Alternative in the Treatment of Palmoplantar Hyperhidrosis, Iontophoresis

Özcan¹,

Güleç²

2011

Turk J Dermatol

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“…As a result, the maximum recommended dose of BTX is 300-400 U at any one time [16,36]. To prepare BTX for injection, each 100 unit vial should be diluted with 1-4 ml of 0.9% saline to create a final concentration of 2.5-10 U/0.1 ml [37]. Most patients notice a reduction in sweating as early as 2-4 days after injection.…”

Section: Botulinum Toxinmentioning

confidence: 99%

“…A number of small trials have demonstrated the efficacy of BTX for palmar HH. In a small randomized trial [37], and in a nonrandomized series [40], 100% of patients described a reduction in sweating in the BTX-treated hand(s).…”

Section: Botulinum Toxinmentioning

confidence: 99%

“…Described options to help reduce this pain are to reconstitute the BTX with lidocaine [41], needle-free pressurized tissue injection [42] or use of regional nerve blocks. It is notable that in addition to pain, there is a clear risk of palmar BTX injection causing weakness of the intrinsic muscles of the hand, which can be eliminated with a meticulously placed injection high into the dermis [37]. Contraindications for BTX are uncommon, but include hypersensitivity to albumin, peripheral motor neuropathies and neuromuscular junction disorders.…”

Section: Botulinum Toxinmentioning

confidence: 99%

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Hyperhidrosis: clinical presentation, evaluation and management

Schieman¹,

Gelfand²,

Grondin³

2010

Expert Review of Dermatology

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“…Currently, new uses for BTA have been proposed for its blocking action to the cholinergic stimulus in the post ganglial symphathetic innervation and reduction of the production of sweat by the eccrine glands. As such it has also been used for the treatment of palmar and axillary hyperidrosis 10,11 Heat and sweat are factors known to worsen the condition of patients suffering from HHD and frequently exacerbation occurs throughout the months of summer.…”

Section: Introductionmentioning

confidence: 99%

Tratamento da doença de Hailey-Hailey com toxina botulínica tipo A

Bessa

Grazziotin

Manzoni

et al. 2010

An. Bras. Dermatol.

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Two sisters with recurrent lesions, one on axillae and other on the groin, and with limited response to classical treatments were treated with injections botulinum toxin type A. We observed marked improvement in the patient treated in the groin and complete remission in the patient treated in the axillae. It was possible to spare the use of systemic antibiotics and topical corticosteroids. The high cost is a restrictive factor to routine use and large studies are necessary to access efficacy and cost benefit profile. Keywords: Botulinum toxin type A; Combined modality therapy; Pemphigus, benign familial Resumo: Duas irmãs com doença de Hailey-Hailey, com lesões recorrentes -uma em axilas e outra em região inguinal -, e resposta limitada aos tratamentos clássicos. Elas foram tratadas com aplicação de toxina botulínica tipo A. Observamos que houve importante melhora na paciente tratada na região inguinal e remissão completa na paciente em cujas axilas sofreram tratamento. Além disso, foi possível poupar uso de antibióticos sistêmicos e corticoides tópicos. O alto custo é um fator restritivo para uso rotineiro e estudos maiores são necessários para definir eficácia e relação custo-benefício dessa intervenção.

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Efficacy and Safety of Botulinum Toxin Type A in the Treatment of Palmar Hyperhidrosis: A Double-Blind, Randomized, Placebo-Controlled Study

Abstract: BTX-A injections produce significant improvements in palmar hyperhidrosis without a concomitant decrease in grip or dexterity, or the occurrence of serious adverse events.

Cited by 109 publications

References 21 publications

Hyperhidrosis and Its Treatment: A Safe and Effective Alternative in the Treatment of Palmoplantar Hyperhidrosis, Iontophoresis

Hyperhidrosis and Its Treatment: A Safe and Effective Alternative in the Treatment of Palmoplantar Hyperhidrosis, Iontophoresis

Hyperhidrosis: clinical presentation, evaluation and management

Tratamento da doença de Hailey-Hailey com toxina botulínica tipo A

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