Primary palmoplantar hyperhidrosis and thoracoscopic sympathectomy: a new objective assessment method.
BACKGROUND
This study was conducted to establish an objective approach to evaluate symptoms and sweat production in patients with primary palmoplantar hyperhidrosis (PPH) and assess their response to bilateral thoracoscopic sympathectomy (BTS).


METHODS
We conducted two institutional review board-approved studies. We performed a one-time evaluation of healthy volunteers (controls) with three questionnaires (Hyperhidrosis Disease Severity Scale, Dermatology Life Quality Index, and Short Form-36) and measurement of transepidermal water loss (TEWL; g/m(2)/h). We evaluated PPH patients with these same tools before and 1 month after BTS and compared them with controls.


RESULTS
We evaluated 35 controls (mean age, 23.0 +/- 3.3 years) and 45 PPH patients (mean age, 26.5 +/- 12.3 years); 18 PPH patients underwent BTS and the 1-month postoperative evaluation. Hyperhidrosis Disease Severity Scale and Dermatology Life Quality Index scores were higher in PPH patients than in controls (p < 0.0001), but normalized after BTS. Short Form-36 scale scores were lower in PPH patients than in controls (p < 0.05), but improved significantly after BTS. Compared with controls, preoperative TEWL values were significantly higher in PPH patients (palmar: 142.7 +/- 43.6 PPH vs 115.8 +/- 48.7 controls, p = 0.011; plantar: 87.5 +/- 28.8 PPH vs 57.7 +/- 24.7 controls, p < 0.0001). After BTS, palmar TEWL values were significantly lower (49.1 +/- 29.8, p < 0.0001). Plantar TEWL did not change significantly (77.6 +/- 46.6, p = 0.52).


CONCLUSIONS
PPH patients should be objectively evaluated with standardized quality of life measures and TEWL measurements before and after treatment. We believe that this objective practical approach provides a benchmark for clinical practice and research.
Tetteh
Hassan A
HA
Division of Thoracic and Foregut Surgery, Department of Surgery, University of Minnesota, Minneapolis, Minnesota 55455, USA.
Groth
Shawn S
SS
Kast
Teri
T
Whitson
Bryan A
BA
Radosevich
David M
DM
Klopp
Amy C
AC
D'Cunha
Jonathan
J
Maddaus
Michael A
MA
Andrade
Rafael S
RS
D000328:Adult; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D006945:Hyperhidrosis / Q000175:diagnosis* / Q000601:surgery*; D008297:Male; D017060:Patient Satisfaction; D011300:Preoperative Care / Q000379:methods; D011336:Probability; D011446:Prospective Studies; D011788:Quality of Life; D012016:Reference Values; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D013562:Sympathectomy / Q000379:methods*; D013906:Thoracoscopy / Q000379:methods*; D016896:Treatment Outcome; D055815:Young Adult