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Treatment of compensatory hyperhidrosis after sympathectomy with botulinum toxin and anticholinergics

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Abstract

Purpose

Compensatory hyperhidrosis (CH) is the most common adverse complication of sympathectomy. It often has a major negative impact on life quality. No efficient treatment of CH is available. We report nine cases of CH after sympathectomy, which were treated with botulinum toxin A/B (BTX) and anticholinergics.

Methods

The patients responded to a dermatology life quality index (DLQI) questionnaire before injections with BTX and 3 weeks after treatment. At the follow-up visit, the participants also ranked the effect of the treatment on a five-grade scale. Three patients had residual sweating after BTX treatment, and received additional anticholinergics at the follow-up visit. Those subjects eventually had a third evaluation with the DLQI.

Results

The DLQI score was, on average, 16.4 before treatment and decreased to 4.8 after BTX injections. Eight out of nine patients were satisfied with the treatment. The average DLQI score decreased to 2.2 when the patients with residual sweating (n = 3) received additional anticholinergics. Adverse events from BTX were mild and temporary, but dry mouth was substantial in one patient using anticholinergics.

Conclusions

A combination of BTX A/B and anticholinergics alleviated the hyperhidrosis with minor side-effects. We consider this treatment safe, effective, and well tolerated.

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Conflict of interest

Carl Swartling is a shareholder in Hidroskliniken i Sverige AB. Alma Rystedt has received travel cost support in relation to conferences from Merz.

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Authors and Affiliations

  1. Department of Medical Sciences, Dermatology and Venereology, Uppsala University, Uppsala, Sweden

    Anna Karlsson-Groth & Carl Swartling

  2. Hidrosis Clinic, Warfvinges väg 35, BV, 112 51, Stockholm, Sweden

    Alma Rystedt & Carl Swartling

Authors
  1. Anna Karlsson-Groth
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  2. Alma Rystedt
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  3. Carl Swartling
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Correspondence to Carl Swartling.

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Karlsson-Groth, A., Rystedt, A. & Swartling, C. Treatment of compensatory hyperhidrosis after sympathectomy with botulinum toxin and anticholinergics. Clin Auton Res 25, 161–167 (2015). https://doi.org/10.1007/s10286-015-0278-x

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  • DOI: https://doi.org/10.1007/s10286-015-0278-x

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