title: Intradermal botulinum toxin a for peristomal hyperhidrosis: a case study.
abstract: BACKGROUND
  Peristomal hyperhidrosis can interfere with pouch adherence, resulting in pouch leakage and peristomal skin damage.
  
  
  METHODS
  A patient with autonomic dysregulation resulting in excessive sweating (hyperhidrosis) experienced difficulty with adherence of her ileostomy appliance. Two hundred units of botulinum toxin A (BTX-A) were injected in the dermis of the surrounding skin in order to improve adherence of her pouching system and alleviate moisture of her peristomal skin.
  
  
  RESULTS
  Following BTX-A injection, the typical wear time of her pouching system improved from less than 24 hours to 120 hours. Peristomal moisture-associated skin damage resolved almost completely. These effects lasted 3 months. A repeat intradermal BTX-A injection had a similar positive effect.
  
  
  CONCLUSIONS
  Peristomal hyperhidrosis can be controlled with BTX-A intradermal injections, improving patient pouch adherence and alleviating moisture-associated skin damage.
authors.affiliation: Kristen Kalkbrenner, PA-C, Department of Surgery, Mayo Clinic Arizona, Phoenix. Kyle Sanniec, MHA, MA, Department of Surgery, Mayo Clinic Arizona, Phoenix. Lyndsey Bryant, PA-C, Department of Surgery, Mayo Clinic Arizona, Phoenix. Jacques Heppell, MD, Department of Surgery, Mayo Clinic Arizona, Phoenix. Heather McEntarffer, RN, WOCN, Department of Nursing, Mayo Clinic Arizona, Phoenix. Alanna Rebecca, MD, Department of Surgery, Mayo Clinic Arizona, Phoenix.
authors.forename: Kristen
authors.initials: K
authors.lastname: Kalkbrenner
authors.forename: Kyle
authors.initials: K
authors.lastname: Sanniec
authors.forename: Lyndsey
authors.initials: L
authors.lastname: Bryant
authors.forename: Jacques
authors.initials: J
authors.lastname: Heppell
authors.forename: Heather
authors.initials: H
authors.lastname: McEntarffer
authors.forename: Alanna
authors.initials: A
authors.lastname: Rebecca
mesh_terms: D000328:Adult; D019274:Botulinum Toxins, Type A / Q000187:drug effects / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D006945:Hyperhidrosis / Q000150:complications*; D007271:Injections, Intradermal / Q000706:statistics & numerical data*; D054047:Surgical Stomas / Q000009:adverse effects*
chemical_list: C586826:DWP450; D019274:Botulinum Toxins, Type A