Bechara Falk G, Gambichler Thilo, Bader Armin, Sand Michael, Altmeyer Peter, Hoffmann Klaus
Departments of Dermatology, Ruhr-University Bochum, Germany.
J Am Acad Dermatol. 2007 Aug;57(2):207-12. doi: 10.1016/j.jaad.2007.01.035. Epub 2007 Mar 26.
Focal axillary hyperhidrosis (FAH) is a benign functional disorder that may lead to social and psychologic handicap. Hence, the improvement of quality of life is a major aim of therapy. Several studies evaluating the quality of life before and after application of topical agents, injections with botulinum toxin, and thoracoscopic sympathectomy have been reported. However, changes of quality of life after minimally invasive surgical procedures such as suction-curettage (SC) have not been investigated so far.
We sought to evaluate the quality of life in patients with FAH before and after SC using the validated Dermatology Life Quality Index (DLQI).
In all, 51 patients who underwent SC were followed up for 9 months. The DLQI was completed by the patients before and 9 months after surgery. In addition, scores for patient satisfaction and improvement of FAH were applied.
The median DLQI score before treatment was 12 (range: 9-18). Nine months after surgery a significant decrease of the DLQI score was observed (median: 4; range: 2-8) resulting in a relative reduction and improvement of the DLQI score of 63.4% (range: 33-83; P < .05), respectively. A significant sweat reduction was reported in 68.6% of patients experiencing a decrease of sweating of at least 75% after SC. Moreover, 78.4% of the patients were very or completely satisfied with the surgical procedure.
Only severe cases of hyperhidrosis, refractory to conservative therapy, were included. No objective outcome measure (eg, gravimetry) was included.
Our data support results of previous studies demonstrating that FAH is associated with considerably reduced quality of life. SC is an effective surgical therapy option that can largely reverse the disabilities experienced by patients with excessive axillary sweating.
局灶性腋窝多汗症（FAH）是一种良性功能性疾病，可能导致社交和心理障碍。因此，提高生活质量是治疗的主要目标。已有多项研究评估了外用药物、肉毒杆菌毒素注射及胸腔镜交感神经切除术应用前后的生活质量。然而，迄今为止，尚未研究过诸如刮吸术（SC）等微创手术后生活质量的变化。
我们试图使用经过验证的皮肤病生活质量指数（DLQI）评估FAH患者在SC前后的生活质量。
总共51例行SC的患者接受了9个月的随访。患者在手术前和手术后9个月完成DLQI。此外，还应用了患者满意度评分和FAH改善评分。
治疗前DLQI评分中位数为12（范围：9 - 18）。手术后9个月观察到DLQI评分显著降低（中位数：4；范围：2 - 8），DLQI评分相对降低和改善分别为63.4%（范围：33 - 83；P <.05）。68.6%的患者报告出汗显著减少，SC后出汗减少至少75%。此外，78.4%的患者对手术非常满意或完全满意。
仅纳入了对保守治疗无效的严重多汗症病例。未纳入客观结局指标（如重量测定）。
我们的数据支持先前的研究结果，表明FAH与生活质量显著降低相关。SC是一种有效的手术治疗选择，可在很大程度上扭转腋窝多汗症患者所经历的功能障碍。
