Incidence, severity, and impact of hyperhidrosis in people with lower-limb amputation

Abstract

Abstract-To assess the incidence and severity of selfreported hyperhidrosis in patients with amputation and understand its effects on prosthetic fit or function, a cross-sectional survey of patients at two amputee clinics was performed.Responses from 121 subjects with lower-limb amputation were analyzed. Of these subjects, 66% reported sweating to a degree that it interfered with daily activities, as measured by the Hyperhidrosis Disease Severity Scale. There was a significant association between sweating and interference with prosthetic fit and function. Sweating was more severe in cases of transtibial amputations, patients under the age of 60 yr, warm weather, and vigorous activity. There was no relationship between severity of sweating and time since amputation, etiology of amputation, duration of daily prosthetic use, or reported ability to perform functional tasks. Subjects reported trying multiple interventions, but the self-reported effectiveness of these treatments was low. Hyperhidrosis, a common problem associated with prosthetic usage, varies in severity and often interferes with daily activities. Sweating severity is associated with poor prosthetic fit and function. Risk factors include younger age and transtibial amputation status. Treatment strategies generally lack efficacy. The results of this study may provide guidance for future interventions and treatment options.

Residual Limb Hyperhidrosis Managed by Botulinum Toxin Injections, Enhanced by the Iodine‐Starch Test: A Case Report

“…It correlates well to quantitative measurements of sweat production [7]. In patients with amputation, it correlates well with patient‐reported interference of sweating with prosthetic fit and function [2]. In this case, documenting an HDSS of 3 despite antiperspirant treatment proved invaluable in obtaining insurance authorization for the botulinum toxin procedure.…”

“…Antiperspirants such as aluminum chloride salts generally are considered first‐line treatment for hyperhidrosis of other areas [7]. Although there is a paucity of data supporting their use in residual limb hyperhidrosis, it is a reasonable first step and sometimes effective per patient reports [2]. However, their use can be limited by either lack of effectiveness and/or a tendency to cause skin irritation, as in this case.…”

“…Hyperhidrosis of the residual limb is a common problem in patients with amputations [1‐4]. It can have a detrimental effect on quality of life [5], leading to reduced prosthetic fit/function [2] and difficulty with skin irritation [6]. Antiperspirants such as aluminum chloride salts generally are considered first‐line treatment for hyperhidrosis of other areas [7].…”

“…Hyperhidrosis, or excessive sweating, of the residual limb is reported in up to 70% of patients with amputations [1‐4] and is associated with reduced quality of life [5], reduced prosthetic fit and function [2], decreased satisfaction with their prosthesis [4], and skin irritation [6]. Evidence‐based strategies for the assessment and management of residual limb hyperhidrosis are lacking, although dermatologists use a well‐established, evidence‐based algorithm for treatment of axillary and other forms of hyperhidrosis [7].…”

Prosthesis management of residual-limb perspiration with subatmospheric vacuum pressure

“…People with lower-limb amputation often complain about uncomfortable residual-limb skin temperatures and the accumulation of perspiration within their prostheses [1][2][3][4][5][6]. Even short bouts of walking can cause substantial increases in residual-limb skin temperatures [7][8] and result in cumulative increases throughout the course of a typical day [9].…”