Subject: Treatment of Hyperhidrosis
Date: 11/18/1999E-MOVE reports live from International Conference 1999: Basic and Therapeutic Aspects of Botulinum and Tetanus Toxins, 15-18 November, 1999 in Orlando, Florida. This conference is sponsored by WE MOVE in conjunction with the Movement Disorder Society, and funded in part by unrestricted grants from Allergan, Athena Neurosciences, and Ipsen Ltd. Abstracts of platform and poster presentations are scheduled to appear in a future issue of Movement Disorders.
1. Three-year follow-up on effectiveness and safety of botulinum toxin (BT) in severe axillary hyperhidrosis.
M Dendorfer, B Worle, S Breit, M Schaller, G Kirk, M Heckmann.
Article Abstract: 2412
According to this open-label study, in patients with severe, recalcitrant axillary hyperhidrosis, intradermal injections of botulinum toxin (BTX-A) type A (250U Dysport® per axilla) are a highly effective and safe therapeutic option. Reinjections administered due to recurrence of sweating were requested variably after 3 to 26 months (mean 5.4 months, N=26). The authors state that after initial treatment, two injections per year with 250U Dysport® per axilla may be sufficient to control hyperhidrosis and that there was no induction of antibodies or non-response to BTX-A noted during the 3-year follow-up period.
2. Botulinum toxin serotype A effect on gustatory flushing and sweating after parotid gland surgery.
R Eleopra, V Tugnoli, R Marchese Ragona, R Quatrale.
Article Abstract: 2599
According to this report on a study of 15 patients (age 20 to 28 years), botulinum toxin type A (BTX-A) is a highly effective, safe, and long-lasting therapy for gustatory sweating, or Frey’s syndrome, and flushing. Treatment with BTX-A was well tolerated with no reported adverse events. The authors state that BTX-A can be recommended as the treatment of choice to correct both gustatory sweating and flushing subsequent to parotid surgery. The sweat areas were identified using the Minor’s iodine test; flushing amount was evaluated through skin flow detection testing (Laser-Doppler Periflux System). Evaluations were conducted before and after BTX-A treatment (1 to 2 mouse units of BOTOX® or 3 to 6 mouse units of Dysport®). The authors comment that further study is needed to understand the particular characteristics of flushing observed in patients with Frey’s syndrome as well as the pathogenesis of gustatory sweating.
3. Botulinum toxin A for amputation stump-associated hyperhidrosis.
U Wollina, H Konrad, T Graefe, J Thiele.
Abstract ID: 2566
According to this case report, treatment with botulinum toxin type A (BTX-A) is an effective, non-irritating therapy for stump hyperhidrosis and accompanying discomfort in lower leg amputees. The ongoing use of a leg prosthesis may cause some discomfort, contact dermatitis, bacterial or mycologic infections (e.g., folliculitis, dermatophytosis, etc.), or sweating inside the socket. This patient, a 58-year-old male with a lower leg amputation due to childhood osteomyelitis, received 100U BOTOX® in hyperhidrotic areas, as identified by marking with Minor’s iodine-starch testing. Subsequent to therapy, the patient returned to the use of the prosthesis, thus avoiding crutches, wheelchair, or confinement to bed.
4. Long-term follow up after botulinum toxin treatment for palmar and axillary hyperhidrosis.
P Schnider, E Moraru, B Voller, H Kittler, E Auff.
Abstract ID: 3033
This study reports confirmation of the safety and long-term effectiveness of local intracutaneous injections of botulinum toxin type A (BTX-A) in reducing palmar and axillary hyperhidrosis, with repeated injections necessary to maintain anhydrotic effect over a period of time. Long-term effects were observed in 32 patients with axillary hyperhidrosis (mean age 32.2 years) and 19 patients with palmar hyperhidrosis (mean age 33.9 years). The total dose per treatment session ranged between 250 and 400 mU BTX (Dysport) over a mean period of 14.6 months (SD 5.6, range 4-33). Anhydrotic effect lasted longer for axillary than for palmar hyperhidrosis. Four patients with palmar hyperhidrosis noted weakness of the small hand muscles.
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