Muscle Weakness in Treatment of Palmar Hyperhidrosis With Botulinum Toxin Type A: Can It Be Prevented?
November 2014 | Volume 13 | Issue 11 | Editorials | 1315 | Copyright © November 2014
Anargyros Kouris MD MSc,1Charitomeni Vavouli MD,1 Vasiliki Markantoni MD1, Georgios Kontochristopoulos MD PhD1
1Department of Dermatology and Venereology, Hospital “Andreas Sygros”, Athens, Greece
of the palms between sexes associated with diverse occupational conditions or hobbies could probably contribute to the development of MW. Muscle weakness was observed in muscles close to the injection site. This indicated that the spread of BTX-A impaired neuromuscular transmission in the intrinsic muscles of the hand, but it did not affect proximal forearm muscles used for handgrip movements.
Our study shows that 75U-100U per palm of BTX-A-injected intradermally drastically reduced sweat secretions in patients with hyperhidrosis. In order to decrease the possible complications, we suggest that the physicians should be well trained in the subcutaneous or intradermal injection technique and different foci of hyperhidrosis should be treated in separate sessions. In addition, we recommend that low dosages of BTX-A be used per injection site and that the number of sites to be injected be determined according to hand size.
BTX-A remains a reliable therapeutic method-for focal palmar hyperhidrosis.-Local side effects such as MW do not seem to be a restrictive factor, probably due to their mild and-transient nature.
The authors have no conflicts of interest to declare.
- Ito K, Yanagishita T, Ohshima Y, Tamada Y, Watanabe D. Therapeutic effectiveness of botulinum toxin type A based on severity of palmar hyperhidrosis. J Dermatol. 2011;38:859-63
- Lowe NJ, Yamauchi PS, Lask GP et al. Efficay and safety of Botulinum Toxin Type A in the treatment of palmar hyperhidrosis: a double-blind, randomized, placedo-controlled study. Dermatol Surg. 2002;28:822-7
- Schnider P, Moraru E, Kittler H, et al. Treatment of focal hyperhidrosis with botulinum toxin type A: long-term follow-up in 61 patients. Br J Dermatol. 2001;145:289-93
- Vadoud-Seyedi J, Heenen M, Simonart T. Treatment of idiopathic palmar hyperhidrosis with Botulinum Toxin. Report of 23 cases and review of the literature. Dermatology. 2001:203:318-21
- Solish N, Bertucci V, Dansereau A, Hong HC, Lynde C, Lupin M, Smith KC, Storwick G; Canadian Hyperhidrosis Advisory Committee. A comprehensive approach to the recognition, diagnosis, and severity-based treatment of focal hyperhidrosis: recommendations of the Canadian Hyperhidrosis Advisory Committee. Dermatol Surg. 2007;33:908-23