Botulinum toxin A and B for treatment of palmoplantar hyperhidrosis

Abstract

<p>Background: Hyperhidrosis is characterized by unpredictable, uncontrollable and excessive sweating. It occurs at rest and is not related to temperature. Hyperhidrosis is a common disorder that has a negative impact on quality of life. The aim of this quality assurance study was to investigate how treatment of palmoplantar hyperhidrosis with botulinum toxin A and botulinum toxin B led to improvement of patient reported outcome measures related to QoL. <p>Method: A total of 35 patients with palmar and/or plantar hyperhidrosis who had received BTX-A (Dysport®) and BTX-B (NeuroBloc®) for palmar hyperhidrosis and BTX-B for plantar hyperhidrosis were included in this study. Palms were injected with a median dose (low-high) of 400 (100-550) units BTX-A and a median dose (low-high) of 200 (200-500) units. BTX-B was used in the thenar and hypothenar areas to avoid muscle weakness. In the soles a median dose (low-high) of 600 (475-1000) units BTX-B was injected. <p>Results: At follow-up two weeks post treatment, patients’ Dermatology Life Quality Index (DLQI) score improved from 13 to 2 (p<0,001). <p>Conclusion: We found that BTX-A and BTX-B treatment for palmar hyperhidrosis and BTX-B treatment for plantar hyperhidrosis led to a substantial improvement of QoL. This was achieved using highly diluted BTX-B as the mainstay of the treatment protocol. The cost issue as a major objection to treatment of palmoplantar hyperhidrosis with neurotoxins, can therefore be silenced using our treatment protocol.