- The relationship between preoperative psychological evaluation and compensatory sweating. [Journal Article]
- JCJ Cardiothorac Surg 2018 May 18; 13(1):42
- CONCLUSIONS: The results of this study showed that patients with primary palmar hyperhidrosis are more likely to have mild or moderate mental disorders, and that postoperative compensatory sweating may impact the satisfaction of surgery. In addition, the personality characteristics of patients are related to compensatory sweating.
- Mindfulness-Based Cognitive Hypnotherapy and Skin Disorders. [Journal Article]
- AJAm J Clin Hypn 2018; 61(1):34-44
- Mindfulness-based cognitive hypnotherapy integrates mindfulness, cognitive-behavioral therapy, and hypnotherapy to improve physical, emotional, mental, and/or spiritual aspects of skin disorders. Med...
Mindfulness-based cognitive hypnotherapy integrates mindfulness, cognitive-behavioral therapy, and hypnotherapy to improve physical, emotional, mental, and/or spiritual aspects of skin disorders. Meditation, including mindfulness meditation, and hypnosis both utilize trance phenomena to help produce focalization and specific improvements in skin disorders through psycho-neuro-endocrine-immunologic mechanisms. Hypnosis, cognitive hypnotherapy, focused meditation, and mindfulness meditation are discussed with respect to improving various skin disorders including acne, acne excoriée, alopecia areata, atopic dermatitis, congenital ichthyosiform erythroderma, dyshidrotic dermatitis, erythema nodosum, erythromelalgia, furuncles, glossodynia, herpes simplex, hyperhidrosis, ichthyosis vulgaris, lichen planus, neurodermatitis, nummular dermatitis, postherpetic neuralgia, prurigo nodularis, pruritus, psoriasis, rosacea, trichotillomania, urticaria, verruca vulgaris, and vitiligo. Their integration into mindfulness-based cognitive hypnotherapy is then discussed and illustrated with improvement in a patient with systemic lupus erythematosus.
- Histopathological Evidence of the Efficacy of Percutaneous Ethanol Injection in the Treatment of Axillary Osmidrosis: A Promising New Procedure. [Journal Article]
- SASkin Appendage Disord 2018; 4(2):98-101
- Axillary osmidrosis (AO) is a common disease, affecting patients psychologically and influencing their quality of life. The medical approach to AO remains controversial, ranging from conservative med...
Axillary osmidrosis (AO) is a common disease, affecting patients psychologically and influencing their quality of life. The medical approach to AO remains controversial, ranging from conservative medical to surgical choices. We describe the successful treatment of AO and axillary hyperhidrosis (AH) using percutaneous ethanol injection (PEI) in a 30-year-old patient with AO and AH who did not respond to topical and systemic medication. We also describe the clinical efficacy of PEI by presenting our experience with histopathological evidence of necrosis of the sweat glands.
- Dermoscopy of Yellow Concretions on Axillary Hair. [Journal Article]
- SASkin Appendage Disord 2018; 4(2):86-89
- Metyrapone-responsive ectopic ACTH-secreting pheochromocytoma with a vicious cycle via a glucocorticoid-driven positive-feedback mechanism. [Journal Article]
- EJEndocr J 2018 May 15
- In ectopic ACTH-secreting pheochromocytoma, combined ACTH-driven hypercortisolemia and hyper-catecholaminemia are serious conditions, which can be fatal if not diagnosed and managed appropriately, es...
In ectopic ACTH-secreting pheochromocytoma, combined ACTH-driven hypercortisolemia and hyper-catecholaminemia are serious conditions, which can be fatal if not diagnosed and managed appropriately, especially when glucocorticoid-driven positive feedback is suggested with a high ACTH/cortisol ratio. A 46-year-old man presented with headache, rapid weight loss, hyperhidrosis, severe hypertension and hyperglycemia without typical Cushingoid appearance. Endocrinological examinations demonstrated elevated plasma and urine catecholamines, serum cortisol and plasma ACTH. Moreover, his ACTH/cortisol ratio and catecholamine levels were extremely high, suggesting catecholamine-dominant ACTH-secreting pheochromocytoma. Computed tomography revealed a large right adrenal tumor. 18F-FDG positron emission tomography showed uptake in the area of the adrenal tumor, while 123I-metaiodobenzylguanidine scintigraphy showed no accumulation. His plasma ACTH level paradoxically became elevated after a dexamethasone suppression test. After metyrapone administration, not only serum cortisol but also plasma ACTH levels were exponentially decreased almost in parallel, suggesting a glucocorticoid-driven positive-feedback regulation in this rapidly exacerbated ectopic ACTH-producing pheochromocytoma. Interestingly enough, plasma catecholamine levels were also decreased by metyrapone, although they remained extremely high. He became severely dehydrated due to hypoadrenalism requiring hydrocortisone supplementation. His clinical signs and symptoms were improved, and right adrenalectomy was performed uneventfully, resulting in complete remission of pheochromocytoma and Cushing's syndrome. A glucocorticoid-driven positive-feedback regulation in this ectopic ACTH-secreting pheochromocytoma created a vicious cycle with rapid exacerbation of both hypercortisolemia and hypercatecholaminemia with extremely elevated plasma ACTH level. Metyrapone was clinically effective to stop this vicious cycle; nonetheless, great care must be taken to avoid hypoadrenalism especially when hypercatecholaminemia remained.
- Early investigations in drug delivery of onabotulinumtoxinA using combined fractional ablative laser with impact ultrasound versus injections of onabotulinumtoxinA for palmar hyperhidrosis: a right-left comparison trial. [Letter]
- BJBr J Dermatol 2018 May 14
- SIR, we evaluated whether laser-assisted drug delivery (LADD) of onabotulinumtoxinA using combined fractional ablative laser with impact ultrasound was capable of reducing palmar sweat production. Pa...
SIR, we evaluated whether laser-assisted drug delivery (LADD) of onabotulinumtoxinA using combined fractional ablative laser with impact ultrasound was capable of reducing palmar sweat production. Palmar hyperhidrosis is a common disorder with substantial negative impact on quality of life. Palliative non-surgical treatments include antiperspirants, iontophoresis, oral anticholinergic drugs, and intradermal injection of botulinum toxin (BTX). Antiperspirants, although convenient, require repeated applications and cause skin irritations. Iontophoresis is effective in some cases, but it requires lengthy treatments. This article is protected by copyright. All rights reserved.
- Adjusting oral oxybutynin medication for hyperhidrosis to reflect seasonal temperature variations. [Journal Article]
- DTDermatol Ther 2018 May 08; :e12615
- Most studies of oral oxybutynin (OOx) for the treatment of hyperhidrosis (HH) have assumed a stable treatment protocol, without taking into account adverse effects (AE) or seasonal variations in temp...
Most studies of oral oxybutynin (OOx) for the treatment of hyperhidrosis (HH) have assumed a stable treatment protocol, without taking into account adverse effects (AE) or seasonal variations in temperature. The objective is to evaluate adjusting the dose of OOx according to the time of year. Prospective study of patients who began OOx for HH between 2007 and 2017, and maintained treatment for at least 1 year, with a progressively increasing dose was performed. All patients were recommended to vary the dose of medication according to the time of year. Baseline epidemiological data, the response to treatment and AE were analyzed. About 122 patients were included (average age of 33.8 years). Up to 60.7% varied the dose. Significantly better results were obtained in the group that varied the dose. Twenty patients suspended the treatment in winter. Among them the adjusted OR was 3.04 (95% CI 1.24-7.45) for an excellent response. The frequency of AE was 74.6% with no differences among groups. Most patients are able to control their HH without requiring the same dose of OOx throughout the year. Given that the possible AE of OOx are dose-dependent, it seems reasonable to vary it according to the time of year.
- Efficacy of Miniuniportal Video-Assisted Thoracoscopic Selective Sympathectomy (Ramicotomy) for the Treatment of Severe Palmar and Axillar Hyperhidrosis. [Journal Article]
- TCThorac Cardiovasc Surg 2018 May 08
- CONCLUSIONS: Miniuniportal VATS ramicotomy represents a feasible surgical technique with a very high success and satisfaction rate. Therefore, this approach should be considered as the method of choice for the treatment of patients with severe therapy-refractory palmar and axillary hyperhidrosis.
- Needlescopic Video-Assisted Thoracic Bilateral T4 Sympathicotomy for the Treatment of Primary Palmar Hyperhidrosis: An Analysis of 200 Cases. [Journal Article]
- TCThorac Cardiovasc Surg 2018 May 01
- CONCLUSIONS: Needlescopic video-assisted thoracic bilateral T4 sympathicotomy could reach an excellent and immediate result of treating PPH. It is a safe, convenient, and minimally invasive method appropriate for wide clinical use.
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- A long-term evaluation of postoperative moist hands after R4/R4+5 sympathectomy for primary palmar hyperhidrosis. [Journal Article]
- JTJ Thorac Dis 2018; 10(3):1532-1537
- CONCLUSIONS: PMH occurred in over half of patients after R4 or R4+5 sympathectomy, but most of these patients were satisfied with the surgical results. R4+5 appears to be a better option for palmar hyperhidrosis with lower incidence of PMH and compensatory hyperhidrosis.