Caplin David, Austin Jordan
J Drugs Dermatol. 2014 Apr;13(4):449-56.
Primary Focal Axillary Hyperhidrosis (PHH) is a chronic disorder of excessive underarm sweat that causes significant impairment of an individual's daily activities. Multiple studies have established the psychosocial burden of PHH and its negative impact on quality of life. Current first-line therapies include the use of topical aluminum chloride with limited efficacy. Second line therapy includes the use of Botulinum toxin, which is effective, but duration is limited to 6-7 months.
The purpose was to evaluate the long term efficacy and safety of the Nd:YAG 1440 nm wavelength with a unique delivery fiber (SideLaze) and the Smartlipo TriPlex device (Cynosure Inc).
Fifteen subjects were recruited to an approved Institutional Review Board study. Outcome measures were comprised of clinical and quantitative evaluation of functional impairment. This included HDSS scale, physician and subject evaluation, and digital photography of before and after starch iodine tests utilizing image processing and analysis software. Subjects received a single treatment and were evaluated at 1 week and at 3, 6, and 12 months post treatment. Responders were defined as those that scored an HDSS score of 1 or 2 post-treatment. Those that were non-responsive at 6 months received a second treatment.
All patients responded to treatment with 72% reporting a two-point HDSS score improvement and 28% reporting a 1-point improvement at 1-year follow-up. The average HDSS score improvement was 1.9/3.0. Three of the 15 patients at 6 months received a second treatment. The HDSS average score for all patients remained statistically stable at 1-year follow-up.
Treatment of axillary hyperhidrosis with the 1440 nm Nd:YAG-pulsed laser combined with a targeted fiber and temperature-sensing device provides a safe and minimally invasive approach to the treatment of axillary hyperhidrosis with minimal side effects and long-term efficacy.
原发性局灶性腋窝多汗症（PHH）是一种导致腋下过度出汗的慢性疾病，会严重影响个人的日常活动。多项研究证实了PHH的心理社会负担及其对生活质量的负面影响。目前的一线治疗方法是使用外用氯化铝，但疗效有限。二线治疗方法是使用肉毒杆菌毒素，其效果显著，但持续时间仅限于6至7个月。
评估采用独特传输光纤（SideLaze）的1440纳米波长掺钕钇铝石榴石激光和Smartlipo TriPlex设备（赛诺秀公司）的长期疗效和安全性。
招募了15名受试者参加一项经机构审查委员会批准的研究。疗效指标包括功能障碍的临床和定量评估。这包括多汗症疾病严重程度评分量表（HDSS）、医生和受试者评估，以及利用图像处理和分析软件对淀粉碘试验前后进行数码拍照。受试者接受单次治疗，并在治疗后1周、3个月、6个月和12个月进行评估。有反应者定义为治疗后HDSS评分为1或2的患者。6个月时无反应的患者接受第二次治疗。
所有患者对治疗均有反应，在1年随访时，72%的患者报告HDSS评分改善了2分，28%的患者报告改善了1分。HDSS评分的平均改善为1.9/3.0。15名患者中有3名在6个月时接受了第二次治疗。所有患者的HDSS平均评分在1年随访时保持统计学稳定。
采用1440纳米掺钕钇铝石榴石脉冲激光结合靶向光纤和温度传感设备治疗腋窝多汗症，提供了一种安全、微创的治疗方法，副作用最小且具有长期疗效。
