title: Selective degeneration of sudomotor fibers in Ross syndrome and successful treatment of compensatory hyperhidrosis with botulinum toxin.
abstract: We report a 5-year follow-up of a patient with Ross syndrome. A biopsy of the anhidrotic skin immunostained with protein gene product 9.5 visualized by confocal microscopy revealed selective loss of sudomotor fibers, whereas epidermal innervation remained intact, providing the first morphologic evidence of selective loss of sudomotor fibers in this syndrome. Among the different treatment strategies employed for the patient's disabling segmental hyperhidrosis, intracutaneous injection of botulinum toxin A was the most helpful.
authors.affiliation: Neurologische Universitätsklinik, Würzburg, Germany.
authors.forename: I
authors.initials: I
authors.lastname: Bergmann
authors.forename: M
authors.initials: M
authors.lastname: Dauphin
authors.forename: M
authors.initials: M
authors.lastname: Naumann
authors.forename: P
authors.initials: P
authors.lastname: Flachenecker
authors.forename: W
authors.initials: W
authors.lastname: Müllges
authors.forename: M
authors.initials: M
authors.lastname: Koltzenburg
authors.forename: C
authors.initials: C
authors.lastname: Sommer
mesh_terms: D000222:Adaptation, Physiological / Q000502:physiology; D000328:Adult; D001341:Autonomic Nervous System / Q000503:physiopathology; D019274:Botulinum Toxins, Type A / Q000627:therapeutic use*; D002799:Cholinergic Fibers / Q000502:physiology*; D004594:Electrophysiology; D006801:Humans; D006945:Hyperhidrosis / Q000188:drug therapy* / Q000473:pathology / Q000503:physiopathology*; D007271:Injections, Intradermal; D008297:Male; D009410:Nerve Degeneration / Q000503:physiopathology*; D009465:Neuromuscular Agents / Q000627:therapeutic use*; D011680:Pupil; D012021:Reflex, Abnormal / Q000502:physiology; D012867:Skin / Q000473:pathology; D013545:Sweat Glands / Q000294:innervation*; D013577:Syndrome
chemical_list: D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A