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Abstract: A 30-year-old man with excessive sweating on the palms of his hands and the soles of his feet and armpits, with odor, as well as erythema and folliculitis, sought medical attention because of the severe impact on interpersonal communication. The clinical symptoms and other tests clearly indicate that the condition is hyperhidrosis. It is caused by genetic factors or emotional changes, temperature changes, and dietary factors. The patient has a good prognosis after systematic treatment.
Basic information】Male, 30 years old
Disease Type】Hyperhidrosis
Hospital】Wuhan University Central South Hospital
Date of consultation】February 2020
Treatment plan】Medication (Botulinum toxin type A for injection)
Treatment Period】1 local injection, follow-up after 1 week
【Treatment effect】Significant improvement of excessive sweating
I. Initial consultation
When we first saw the patient, he always had a tissue in his hand to wipe his sweat. He reported that he started to sweat more on his palms, soles and armpits when he was a child, especially after strenuous exercise or crying, but his parents did not pay attention to it at that time. The symptoms of excessive sweating did not improve with age, and the application of antiperspirant products did not improve the effect, and even symptoms such as odor and local erythema and folliculitis appeared, but the indicators of physical examination were normal, so the patient came to the hospital. The initial diagnosis was hyperhidrosis, probably due to genetic factors, and the symptoms persisted or even worsened due to the lack of effective intervention for a long time.
Treatment history
The patient was suffering from primary hyperhidrosis, which is mainly related to genetic factors and generally cannot be cured clinically. The topical drugs commonly used clinically to drink oral drugs may have some obvious adverse reactions, and the patient expressed difficulty in accepting them. After the patient agreed and understood the treatment away, the patient’s palms, soles of the feet and axillae and other sweaty parts were routinely disinfected and injected, and the patient left the hospital after 30 minutes of observation without discomfort, and was asked to follow up after 1 week.
III. Treatment effect
After the local injection of botulinum toxin type A, the symptoms of excessive sweating were significantly improved in about 1 week, and there were no other uncomfortable symptoms, and the patient reported that he was no longer worried about interpersonal communication and was satisfied with the treatment effect.
IV. Notes
I was very happy to see the patient’s symptoms improve, and I told the patient that he should pay attention to the following aspects after discharge from the hospital.
1. Patients should try to wear loose, breathable clothes as well as shoes and socks on a daily basis, and pay attention to changing and bathing regularly.
2, try to avoid crowded places, and learn to control emotions, release stress, avoid mental tension, anxiety, etc..
3, usually as far as possible to avoid eating spicy and stimulating food, while it is recommended to quit smoking and limit alcohol, so as not to produce stimulation resulting in increased sweating.
4, sweating symptoms recurrent or gradually or aggravated, should actively go to the regular hospital for treatment, to avoid affecting the normal interpersonal interaction.
V. Personal insight
Hyperhidrosis is a relatively common disease in clinical practice, but it is also relatively easy to ignore. The distress caused by excessive sweating may lead to anxiety and nervousness, and in severe cases, it may lead to social impairment or even induce autism, etc. I hereby urge patients with such diseases to actively seek medical treatment. I am also sincerely happy for the young man in this case, who has become talkative and cheerful after his symptoms were controlled by medication injections.