BACKGROUND: This study was designed to evaluate the effectiveness of T3 sympathicotomy in treatment of palmar hyperhidrosis. MATERIAL AND METHOD: During the period of June to December 1998, 50 patients (24 females and 26 males) suffering from palmar hyperhidrosis either in isolation (n=37) or in combination with axillary hyperhidrosis (n=13) were operated. The mean age of the patients was 20 years. The bilateral sympathetic trunks were severed on the 3rd rib (2nd and 3rd ganglia) for the isolated palmar hyperhidrosis and on the 3rd and 4th ribs for the combined type using electrocoagulation scissors. A linear analogue scale was used to assess the degree of sweating on the palms, face, trunk, and feet (ranged 0 to 10:0 = anhidrosis: 10 = excessive sweating) as well as the patient's satisfaction with the surgery (ranged 0 to 10:0 = regret; 10 = completely satisfied). RESULT: All of the patients were relieved from palmar hyperhidrosis. A mean palmar sweat production score after T3 sympathicotomy was 1.5+/-0.8. Some degree of compensatory sweating had occurred in 39 patients (78%) with a mean score of 3.4+/-1.6. Gustatory sweating occurred in 2 patients (4%). The mean score of the patient's satisfaction after the surgery was 8.5+/-1.2. CONCLUSION: Palmar hyperhidrosis can be successfully relieved by the T3 sympathicotomy. When considering the advantages of T3 sympathicotomy with respects to a better preservation of facial sympathetic function, less occurrence of severe compensatory sweating, and lower incidence of gustatory sweating. We recommend T3 sympathicotomy as a treatment of choice for palmar hyperhidrosis.
Electrocoagulation ; Female ; Foot ; Humans ; Hyperhidrosis* ; Hypohidrosis ; Incidence ; Ribs ; Sweat ; Sweating ; Sweating, Gustatory ; Thoracoscopy

Two patients with gustatory hyperhidrosis complaining of discomfort during usual activities were relieved of sweating by using anticholinergic benztropine. Herein, we report two cases of gustatory hyperhidrosis treated with benztropine.
Benztropine* ; Humans ; Hyperhidrosis ; Sweat ; Sweating ; Sweating, Gustatory*

No abstract available.
Hidradenitis Suppurativa* ; Hidradenitis* ; Humans ; Serratia marcescens* ; Serratia* ; Skin*

Hidradenitis suppurative is a chronic, refractory and recurrent dermatological disease. The disease should be managed by targeted surgical intervention on the basis of medical treatment. Currently, the surgical treatment methods include local treatments like incision and drainage, unroofing, laser therapy, intense pulsed light therapy, photodynamic therapy, as well as complete lesion resection such as skin-tissue saving excision with electrosurgical peeling and extended excision. The clearance range, therapeutic effect, postoperative complications, and recurrence risk vary among the different treatment methods. Local treatments cause less damage, but have high recurrence rates, and are mainly for mild to moderate hidradenitis suppurative patients. Complete lesion resections have relatively low recurrence rates, but may bring more surgical injuries, and postoperative reconstructions are needed, which are mainly for moderate to severe hidradenitis suppurative patients. In this article, the surgical treatment principles and various surgical treatment methods of hidradenitis suppurative are reviewed, to provide a reference for the diagnosis and treatment of this disease in clinical practice.
Humans ; Hidradenitis Suppurativa/complications* ; Hidradenitis/complications* ; Drainage ; Postoperative Complications ; Skin

BACKGROUND: It has been known that the most effective treatment method of hyperhidrosis is video-assisted thoracoscopic sympathetic nerve block. Postoperative compensatory hyperhidrosis and anhidrosis are major factors that decrease the postoperative satisfaction. Although sympathetic rami have been selectively blocked to decrease the complications, technical difficulties and excessive bleeding have prevented the universal application. MATERIAL AND METHOD: Three pre-fixative cadavers were dissected before clinical application. Bilateral sympathetic chains were exposed in supine position after the whole anterior chest wall was removed. Second and third sympathetic rami were blocked using clips. After the sympathetic chains including ganglia were removed, we evaluated the extents of rami block. Twenty-five patients were subjected to the clinical application. Surgeries were performed in semi- fowlers position under general anesthesia and bilateral ventilation. 2 mm thoracoscopy and 5 mm trocar were introduced through third and fourth intercostal space, respectively. Second and third sympathetic rami were blocked using thoracoscopic clips. The postoperative complications, satisfaction, and compensatory hyperhidrosis rate were evaluated retrospectively. RESULT: Sympathetic rami were completely blocked in cadaver dissection study. Hyperhidrosis symptom was improved in all patients without operative complication. Operative time was shorter than that of traditional ramicotomy. All patients, except four, were satisfied with postoperative palmar hyperhidrosis. Compensatory hyperhidrosis was more severely happened in fifteen patients (60%). The remaining six patients had no complaint. Two patients had a minimal degree of gustatory hyperhidrosis. CONCLUSION: This operative method had shorter operative time and less complication rate, compared with traditional ramicotomy. Operative success rate was similar to the traditional sympathicotomy; lower extent and occurrence rate of compensatory hyperhidrosis. The thoracic sympathetic rami clipping was suggested as an alternative method for treatment of palmar hyperhidrosis.
Anesthesia, General ; Autonomic Nerve Block ; Cadaver* ; Ganglia ; Hemorrhage ; Humans ; Hyperhidrosis* ; Hypohidrosis ; Operative Time ; Postoperative Complications ; Retrospective Studies ; Supine Position ; Surgical Instruments ; Sweating, Gustatory ; Sympathetic Nervous System ; Thoracic Wall ; Thoracoscopy ; Ventilation

Hidradenitis Suppurativa/therapy* ; Humans ; Singapore/epidemiology*

Hidradenitis suppurativa is a rare disease which represents a chronic suppurative and scarring process, affecting the apocrine glands due to persistent bacterial infection and apocrine dysfunction. We have experienced a case of hidradenitis suppurativa, 22-year-old female which involved both axillary region. Diagnosis was established by clinical characteristicsymptoms, histopathological findings and bacteriological examinations.
Apocrine Glands ; Bacterial Infections ; Cicatrix ; Diagnosis ; Female ; Hidradenitis Suppurativa* ; Hidradenitis* ; Humans ; Rare Diseases ; Young Adult

Hidradenitis suppurativa is a rare disorder that is characterized by recurrent chronic skin infections and the formation of sinus tracts and considerable scaring. A 37-year-old man presented with a hard posterior neck mass. Multiple pus-producing sinuses were detected in the skin covering the mass. MRI demonstrated an ill-defined, soft tissue mass with multiple variable sized cystic lesions. The soft tissue mass measured 12x10x4 cm in the subcutaneous fat layer, it contained multifocal cystic lesions that revealed higher signal intensity on both the T1- and T2-weighted images, as compared with the adjacent neck muscles. The mass was not enhanced on the post-contrast T1 weighted images. Some of the cystic lesions extended to the skin. The mass was removed surgically and confirmed to be hidradenitis suppurativa.
Adult ; Hidradenitis Suppurativa* ; Hidradenitis* ; Humans ; Magnetic Resonance Imaging ; Neck Muscles ; Neck* ; Skin ; Subcutaneous Fat

Hidradenitis Suppurativa (HS) is a chronic relapsing disease that involves the apocrine gland-bearing skin. It results in sinus tract formation, fibrosis and scarring. Many different treatments for HS have been reported, including topical and systemic antibiotics, intralesional steroids, systemic retinoids, hormonal therapies and immnunosuppressive agents, but they all have limited beneficial effects. Surgical treatments, including wide exteriorization with secondary intention, a skin graft and a flap can be effective treatments for recalcitrant HS. We present here the case of a 26-year-old man with recurred inguinal and axillary HS, and this was treated with secondary healing and a split thickness skin graft after exteriorization. Based on our experience, it is suggested that secondary healing and a split thickness skin graft after exteriorization are effective for recalcitrant HS with multiple interconnected tracts and abscesses.
Abscess ; Adult ; Anti-Bacterial Agents ; Cicatrix ; Fibrosis ; Hidradenitis ; Hidradenitis Suppurativa ; Humans ; Intention ; Retinoids ; Skin ; Steroids ; Transplants

Hidradenitis suppurativa is a chronic, relapsing suppurative disease of the apocrine sweat glands that principally affects the axillary and anogenital regions. The etiology of this disorder remains unknown. As conservative treatment usually does not prevent recurrence, surgical treatment is the method of choice, particularly for advanced case. We report a 25-year-old male patient who presented with a 7-year history of abscesses with foul-smelling discharge from his axilla. After failed medical therapy, he was referred for surgery. We performed a wide excision of the axilla with a split thickness skin graft after 1 week. The patient has been doing well, and there has been no relapse for about ayear after the operation.
Abscess ; Adult ; Axilla ; Hidradenitis ; Hidradenitis Suppurativa ; Humans ; Male ; Recurrence ; Skin ; Sweat Glands ; Transplants