 |
|
Focal Hyperhidrosis
Effective Treatment With Intracutaneous Botulinum Toxin
Markus Naumann, MD;
Uta Hofmann, MD;
Ilka Bergmann, MD;
Henning Hamm, MD;
Klaus V. Toyka, MD;
Karlheinz Reiners, MD
Arch Dermatol. 1998;134:301-304.
Objective To evaluate the effect of intracutaneous injections of botulinum toxin type A on excessive focal hyperhidrosis.
Design Therapeutic before-and-after trial over 4 months.
Setting Neurological and dermatological university departments.
Patients Eleven patients with excessive axillary, palmar, or plantar hyperhidrosis fulfilling the following criteria: (1) local and systemic drug therapy had failed to improve their symptoms; (2) the patients were severely disabled with respect to their occupation and social activities; and (3) a successful treatment by botulinum toxin would obviate the need for destructive surgical procedures.
Interventions Three mouse units of botulinum toxin (Botox) per 4-cm2 skin area was injected intracutaneously in 16 axillae, 8 palms, and 2 soles.
Main Outcome Measures Reduction of hyperhidrosis as documented by the Minor iodine-starch test and gravimetrical assessment of local spontaneous sweat production measured over 1 minute.
Results In all patients, botulinum toxin completely abolished sweating in the injected areas (P<.001) within 3 to 7 days. No relevant adverse effects occurred and no clinical recurrence of hyperhidrosis was observed within the follow-up period of up to 5 months. Occasionally, subclinical reactivation of sweat gland function was observed 4 months after treatment.
Conclusions Intracutaneous botulinum toxin seems preferable to any hitherto used conservative or surgical procedures and may become the therapy of choice in pathological focal hyperhidrosis.
From the Departments of Neurology (Drs Naumann, Toyka, and Reiners) and Dermatology (Drs Hofmann, Bergmann, and Hamm), Bayerische Julius-Maximilians-Universität, Würzburg, Germany.
|
