Treatment of primary axillary hyperhidrosis with a cream formulation of oxybutynin chloride 10%

Abstract

histology and molecular fungal diagnosis were obtained. The DNA-chip-based technology detected Trichophyton benhamiae, and systemic antifungal administration of fluconazole led to rapid improvement within 11 days. The diagnosis of deep trichophytia was later confirmed by histopathological examination.In all cases, diagnosis of tinea was made using multiplex PCR and histopathological findings (in two cases), whilst microscopic detection was inconclusive, and results from culture were still pending when therapeutic decisions had to be taken. The molecular dematomycosis array is a novel and practical method to detect fungal infections within 1-2 days. It is characterized by a high sensitivity (82%) and specificity (91%). By contrast, the sensitivity of direct microscopy and culture are significantly lower (Bieber et al., submitted). Furthermore, it is a non-invasive method, allows species identification and swabs can be used to obtain material for analysis.Overall, this case series underscores the relevance of molecular diagnosis of fungal skin infections, which in the near future should improve the management tinea. AcknowledgementThe patients in this manuscript have given written informed consent to the publication of their case details.

Hyperhidrosis: A Review of Recent Advances in Treatment with Topical Anticholinergics

“…Three patients reported mild application site irritation that resolved within 2 weeks after stopping application, two patients reported xerostomia that lasted one day, and one patient reported constipation and blurry vision that was temporally associated with opioid use after elective surgery. In comparison to the gel formulation, the cream formulation of oxybutynin was examined in a small number of patients and was found to have good efficacy assessed by a reduction in hyperhidrosis disease severity scale (HDSS) and tolerability [ 22 ].…”

Management of primary plantar hyperhidrosis with botulinum toxin type A: A retrospective case series of 129 patients

“…Although treatment may be individualized, most authors and expert panels suggest a step-by-step approach beginning with topical antiperspirants, topical anticholinergics, followed by iontophoresis or BoNT-A injections. [9][10][11][12][13][14][15][16] A recent randomized placebo-controlled trial evaluating the efficacy of oxybutynin 10% gel in patients with focal hyperhidrosis reported a significant reduction of sweating rates, HDSS and DLQI in 12 of 16 patients with PPH who completed the 4 weeks of treatment. 17 In severe cases, systemic anticholinergic agents may be employed, while endoscopic lumbar sympathectomy remains usually the option of last resort.…”

“…There are several therapeutic modalities currently available for the treatment of PPH. Although treatment may be individualized, most authors and expert panels suggest a step‐by‐step approach beginning with topical antiperspirants, topical anticholinergics, followed by iontophoresis or BoNT‐A injections 9–16 . A recent randomized placebo‐controlled trial evaluating the efficacy of oxybutynin 10% gel in patients with focal hyperhidrosis reported a significant reduction of sweating rates, HDSS and DLQI in 12 of 16 patients with PPH who completed the 4 weeks of treatment 17 .…”

Oral oxybutynin chloride therapy in the management of hidradenitis suppurativa: A prospective study

“…Since 1988, it is becoming an established therapeutic option for focal and generalized hyperhidrosis with limited side-effects including xerophthalmia xerostomia, constipation, headache, urinary retention, tachycardia and orthostatic hypotension. [7][8][9] Hidradenitis suppurativa is a complex multifactorial disease characterized by a challenging management that requires a combined approach of medical (mainly antibiotic and biological agents) and surgical therapy. However, lifestyle modification, smoking cessation, weight loss and reduction of factors that can exacerbate HS such as sweat are essential to contain disease acute flares.…”