Treatment of focal idiopathic hyperhidrosis with Botulinum Toxin Type A: clinical predictive factors of relapse-free survival

J Eur Acad Dermatol Venereol. 2011 Aug;25(8):917-21. doi: 10.1111/j.1468-3083.2010.03880.x. Epub 2010 Nov 4.

Abstract

Background: No material about the identification of predictive clinical factors of therapeutic response to Botulinum Toxin Type A (BTX-A) in focal idiopathic hyperhidrosis has been found.

Objective: To evaluate if age, sex, extension rate of hyperhidrotic area, localization, disease-related impairment of life quality, number of previous local, non-invasive treatments different from BTX-A, and duration of disease, may affect the relapse-free survival (RFS) after a BTX-A treatment in palmar and axillary focal idiopathic hyperhidrosis.

Methods: Forty-one patients suffering from palmar hyperhidrosis, and 38 patients suffering from axillary hyperhidrosis received intradermal injections of BTX-A. All patients were clinically screened before and after treatment; they were followed for 15 months after it, according to Hyperhidrosis Disease Severity Scale (HDSS), Minor's test, and DLQI test, to state disease severity, and disease-related impairment of quality of life.

Results: The duration of therapeutic effect of BTX-A is not significantly influenced by age (P = 0.783), sex (P = 0.762), extension of hyperhidrotic area (P = 0.770), site of involvement (P = 0.402), disease-induced impairment of life quality (P = 0.745), number of previous therapies (P = 0.730), or site of involvement (P = 0.402). In palmar idiopathic hyperhidrosis, patients with a longer disease history show a shorter duration of RFS after a treatment with BTX-A (P = 0.01).

Conclusions: Patients suffering from palmar hyperhidrosis have a longer lasting disease, and a length of disease more than 20 years in these patients influences the RFS after BTX-A treatment.

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Aged
  • Axilla
  • Botulinum Toxins, Type A / therapeutic use*
  • Disease-Free Survival
  • Female
  • Follow-Up Studies
  • Hand
  • Humans
  • Hyperhidrosis / drug therapy*
  • Hyperhidrosis / pathology*
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • Neuromuscular Agents / therapeutic use*
  • Quality of Life
  • Severity of Illness Index
  • Sex Factors
  • Time Factors
  • Young Adult

Substances

  • Neuromuscular Agents
  • Botulinum Toxins, Type A