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Palmar hyperhidrosis treated by noninvasive ultrasound stellate ganglion block

Palmare Hyperhidrose-Therapie durch nicht-invasive Stellatum-Blockade mittels therapeutischem Ultraschall

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Summary

Focal palmar hyperhidrosis is a common and often debilitating eccrine sweat gland disorder with negative impact on quality of life and self-esteem. For treatment of recalcitrant cases, a stellate ganglion block is a nonsurgical alternative. Although this method has only a temporary effect, surgical risks can be avoided. The usual way to perform the block is by ultrasound-guided injection of local anesthetics. Here we describe the use of therapeutic ultrasound at 0.8 MHz for stellate ganglion block. Ultrasound was applied for 1 min unilaterally every other day for 6 days. The efficacy was monitored by video capillaroscopy and Minor’s iodine starch test. Treatment was well tolerated and no adverse effects were noted. Sweating was stopped and capillary blood flow increased. The effect lasted for several weeks.

Zusammenfassung

Die fokale palmare Hyperhidrose ist eine häufige und oftmals hinderliche Erkrankung der ekkrinen Schweißdrüsen mit negativen Auswirkungen auf die Lebensqualität und das Selbstwertgefühl. Für therapieresistente Fälle stellt die Stellatum-Blockade eine nicht-chirurgische Alternative dar. Obwohl die Wirkung zeitlich begrenzt ist, können chirurgische Risiken vermieden werden. Wir beschreiben die Verwendung von therapeutischem 0,8 MHz-Ultraschall für eine Stellatum-Blockade. Der Ultraschall wurde für eine Minute unilateral jeden zweiten Tag für insgesamt sechs Tage eingesetzt. Die Effizienz wurde durch Video-Kapillaroskopie und den Minor-Test objektiviert. Die Behandlung wurde gut vertragen, unerwünschte Nebenwirkungen traten nicht auf. Das übermäßige Schwitzen wurde gestoppt und der kapilläre Blutfluß gesteigert. Die Wirkung hielt einige Wochen an.

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Authors and Affiliations

  1. Center of Physical and Rehabilitative Medicine, Academic Teaching Hospital Dresden-Friedrichstadt, Friedrichstrasse 41, 01067, Dresden, Germany

    Birgit Heinig

  2. Department of Dermatology and Allergology, Academic Teaching Hospital Dresden-Friedrichstadt, Friedrichstrasse 41, 01067, Dresden, Germany

    Andrè Koch M.D. &  Uwe Wollina M.D.

Authors
  1. Birgit Heinig
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  2. Andrè Koch M.D.
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  3. Uwe Wollina M.D.
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Correspondence to Uwe Wollina M.D..

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Conflict of interest

B. Heinig, A. Koch, and U. Wollina declare that they have no competing interests.

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Heinig, B., Koch, A. & Wollina, U. Palmar hyperhidrosis treated by noninvasive ultrasound stellate ganglion block. Wien Med Wochenschr 168, 250–253 (2018). https://doi.org/10.1007/s10354-016-0468-8

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  • DOI: https://doi.org/10.1007/s10354-016-0468-8

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