Shelley W B, Hurley H J
Acta Derm Venereol. 1975;55(4):241-60. doi: 10.2340/0001555555241260.
Axillary hyperhidrotics is reviewed from the standpoint of anatomical factors, physiological mechanisms and the history of methods of control. Anhydrous aluminum chloride and anhydrous zirconium tetrachloride are shown to be superior topical agents for partial control of axillary sweating when applied as a powder or in anhydrous nonreactive vehicles. Complete anhidrosis as demonstrated by sustained garment armpit dryness could be achieved in hyperhidrotics within 48 hours by the following trinary antiperspirant system: (1) a saturated solution of aluminum chloride hexahydrate or zirconyl chloride in absolute ethanol or isopropyl alcohol, (2) application to the dry axilla at times of sleep or other prolonged non-sweating period, (3) water vapor occlusion of area for 6 to 8 hours by means of Saran wrap. The hypothesis is presented that metallic antiperspirants act by reflux entrance into the terminal intraepidermal eccrine duct, slowly combining with the intraductal keratin, to produce a fibrillar contraction (super contraction) of keratin and hence functional closure, not histologically evident. This altered keratin is shed weeks later, with the consequent return of ductal patency and sweating.
从解剖学因素、生理机制及控制方法的历史等角度对腋窝多汗症进行了综述。当以粉末形式或在无水惰性载体中应用时，无水氯化铝和无水四氯化锆被证明是局部控制腋窝出汗的优等药物。通过以下三元止汗系统，多汗症患者可在48小时内实现持续衣物腋窝干燥所证明的完全无汗：（1）六水合氯化铝或氧氯化锆在无水乙醇或异丙醇中的饱和溶液；（2）在睡眠或其他长时间无汗期涂抹于干燥的腋窝；（3）用保鲜膜对该区域进行6至8小时的水汽封闭。提出的假说是，金属止汗剂的作用方式是反流进入终末表皮内汗腺导管，与导管内角质蛋白缓慢结合，从而使角质蛋白产生纤维状收缩（超级收缩），进而实现功能性封闭，这在组织学上并不明显。这种改变的角质蛋白在数周后脱落，随后导管恢复通畅并重新出汗。
