Botulinum toxin: a treatment for compensatory hyperhidrosis in the trunk.
BACKGROUND
Severe compensatory hyperhidrosis (CH) in the trunk occurs after sympathectomy in some patients. Limited treatment options for these cases have been proposed, and the overall results have been disappointing, but injection of botulinum toxin-A (BTX-A) is an emerging, reliable treatment method for focal hyperhidrosis.


OBJECTIVE
To demonstrate the efficacy, longevity, and safety of BTX-A injection for severe truncal sweating in CH patients who were refractory to conventional treatment.


METHODS
Seventeen patients were injected with 100 to 500 U of BTX-A in the truncal area. After the follow-up period, the Hyperhidrosis Disease Severity Scale (HDSS) for efficacy and the Dermatology Life Quality Index (DLQI) were measured for improvement in patients' quality of life.


RESULTS
The baseline mean HDSS score+/-standard deviation was 3.6+/-0.5, and the sweating resolved within 5 days. The effect was sustained for 2 to 8 months (4.1+/-1.5 months) and the baseline DLQI score of 9.4+/-2.0 fell to 2.8+/-1.0. No serious side effects or adverse events resulted from the treatment.


CONCLUSIONS
BTX-A injection was a well-tolerated, effective, and safe method for treating severe truncal CH, although the considerable cost and limited duration of the treatment effects were major disadvantages.
Kim
Won Oak
WO
Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul, South Korea. wokim@yumc.yonsei.ac.kr
Kil
Hae Keum
HK
Yoon
Kyung Bong
KB
Noh
Ko Un
KU
D000328:Adult; D019274:Botulinum Toxins, Type A / Q000008:administration & dosage*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006945:Hyperhidrosis / Q000188:drug therapy*; D007267:Injections; D008297:Male; D009498:Neurotoxins / Q000008:administration & dosage*; D012189:Retrospective Studies; D013909:Thorax; D013997:Time Factors; D016896:Treatment Outcome
D009498:Neurotoxins; D019274:Botulinum Toxins, Type A