الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Hyperhidrosis is an increased sweating beyond that required to return body temperature to normal. It can have a deeply dramatic effect on a patient’s quality of life, resulting in real impairments of body activities, social interactions and occupational activities.The treatment options for primary hyperhidrosis involve a range of topical or systemic medications, psychotherapy and surgical or non-surgical invasive techniques.The aim of the work was to evaluate the efficacy and tolerability of botulinum toxin type A in the treatment of bilateral primary palmar hyperhidrosis.All patients were subjected to detailed history taking including the age, occupation, detailed dermatological examination, medical history, history of hyperhidrosis, family history and previous treatment.Ten patients with bilateral primary palmar hyperhidrosis were included in this study. The patients were subjected to one treatment session with 100 µ of Botulinum toxin in each palm. Clinical assessment was done by sympathetic skin response test, iodine starch test and hyperhidrosis disease severity scale (HDSS) before BTX-A injection and re-evaluated after one week, four, eight, twelve then sixteen weeks periods.The studies revealed statistically that, at base line, the hyperhidrosis patients had shorter SSR latency than that of the control subjects and there was an increase in SSR latency of hyperhidrosis patients after Botulinum toxin type A injection.There were no significant relation between severity of hyperhidrosis and sex nor family history and there was a significant gradual reduction in sweat production after Botulinum toxin type A injection documented by significant decrease in iodine starch test grading and significant decrease in hyperhidrosis disease severity scale.
Some adverse effects occurred in some patients, but, these side effects were all simple, transient and easily treated.Treatment of palmar hyperhidrosis by Botulinum toxin type A in this study was effective but the maximum improvement persists up to between 6 to 11 months. Also, this modality was proved to be safe and effective in treating palmar hyperhidrosis in the pediatric and adolescence age. Conclusively, Botulinum toxin type A is a promising treatment modality for primary palmar hyperhidrosis. It seems to be an effective and safe alternative to current topical and systemic palmar hyperhidrosis therapies.