• Journal of Chest Surgery
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• v.28 no.7
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• pp.684-688
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• 1995

Hyperhidrosis, one of the abnormalities in autonomic nervous system, has been treated with dermatologic principles or thoracic sympathectomy via conventional axillary thoracotomy or dorsal spinal approach. But these techniques were rather ineffective or invasive. Recently, VATS is widely applied in thoracic surgical area, and hyperhidrosis is not the exception of these cases.From May 1993 to August 1994, 30 patients with bilateral palmar hyperhidrosis underwent bilateral thoracic [T2, T3 sympathectomy with thoracoscopic surgery at Seoul National University Hospital. There were 20 men and 10 women and the mean age was 23.0 years.Mean operating time was 115 min and there was no thoracotomy conversion. Operative complications were anesthetic overdose in 1, Horner`s syndrome in 1, and small amount of residual pneumothorax in 6. Mean postoperative hospital stay was 2.3 days [range from 1 to 4 days and postoperative analgesics were required in 17 cases with a single dose.Sweating amount was measured in 12 patients, showing significantly decreased amount from 284.5 mg preoperatively to 18.9 mg postoperatively in 5 minutes [p=0.004 . There was no recurrence during mean 6 months follow up. Twenty two patients [73.3 % complained moderate compensatory hyperhidrosis on the trunk.In conclusion, all patients were greatly satisfied with those results including no more palmar sweating, less pain, better cosmetics, short hospital stay. In addition, recent use of sweating amount measurement and intraoperative temperature monitoring could make this technique more accurate, so we easily applied thoracoscopic sympathectomy with minimal risk.

• The Journal of Internal Korean Medicine
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• v.37 no.4
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• pp.601-608
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• 2016

Objectives: The purpose of this study was to investigate the efficacy of Shihogayonggolmoryo-tang (SYT) in combatting excessive sweating.Methods: The electronic medical records (EMR) of patients who attended the Department of Korean Internal Medicine, Stroke and Neurological Disorders Center from December 2014 to April 2016 were reviewed. Excessive sweating was graded and compared before and after the administration of SYT in 32 patients.Results: The average grade for excessive sweating of the 32 patients significantly decreased from 2.47±0.62 to 1.03±0.86 after the SYT treatment.Conclusions: These results provide evidence that SYT may be effective in combatting excessive sweating.

• Journal of Sasang Constitutional Medicine
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• v.30 no.4
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• pp.33-52
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• 2018

Objectives The purpose of this study was to analyze the clinical characteristics of patients with hyperhidrosis who visited a Korean medicine hospital, and provide information on treated hyperhidrosis, based on Sasang Constitutional medicine. Methods A retrospective review was made of the electronic medical record (EMR) charts for 157 Korean patients with hyperhidrosis (90 male, 67 female), who first visited hospital from January 1, 2013 to December 31, 2017. The following information was collected: sex, age, height, weight, body mass index (BMI) and clinical data (diagnosis, area of onset, duration of illness, aggravating factors, medication, healing process, et al). Results There were many patients with hyperhidrosis, in the other of So-Yang type (57.3%), Tae-Eum type (35.0%) and So-Eum type (7.6%). The proportion of male was higher than female. The most common area of hyperhidrosis was hands and feet (44.0%), followed by generalized whole body (27.4%) and head and face (25.5%). The cure rate of hyperhidrosis was 32.2%, and effectiveness rate of that was 72.7%. In individual patients, the better the usual health condition expressed by original symptoms, the higher the possibility of treatment success, with shortened duration of treatment and reduced total drug dose. The most frequent treatment modality in patients was that consistently improved, and this duration of treatment was statistically significantly shorter than that experienced worsening of excessive sweating during treatment period (p<0.001). Conclusions This study provides some original information on the Korean patients with hyperhidrosis, and suggests the suitability of Sasang Constitutional medicine as treatment methods for hyperhidrosis.

• The Journal of Internal Korean Medicine
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• v.43 no.2
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• pp.294-302
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• 2022

This work reports the case of a middle cerebral artery infarction patient with hyperhidrosis and left upper extremity paresthesia whose condition improved following Korean medicine treatment. The patient was hospitalized for 10 days and treated with herbal medicine, mainly Hwanggigyeji-tang, and acupuncture, electroacupuncture, and moxibustion. The hyperhidrosis was clinically classified and the patient's subjective discomfort in this regard was also checked. A subjective percentage of strength and sensation in the left extremity was evaluated to assess the clinical effects of the treatment. After treatment, the hyperhidrosis classification improved from Grade 3 to Grade 0, and the patient's subjective discomfort was greatly improved and continued for the two weeks after discharge. In addition, subjective strength and sensation improved by 20% and 5%, respectively, compared to time of admission. These results suggest that Korean medicine is effective in treating paresthesia after stroke and long-lasting hyperhidrosis.

• The Journal of Pediatrics of Korean Medicine
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• v.36 no.3
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• pp.75-86
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• 2022

Objectives The purpose of the study is to review the trend of clinical trials conducted in China with oral herbal medicine treatment on childhood primary hyperhidrosis. Methods We searched the randomized controlled trials (RCTs) with oral herbal medicine treatment on childhood primary hyperhidrosis from the China National Knowledge Infrastructure (CNKI). The demographic data, duration of illness, intervention, treatment period, outcome and composition of herbal medicine were analyzed for this study. Results A total of five RCTs were selected and analyzed. The effectiveness of the oral administration of herbal medicines on childhood primary hyperhidrosis was found to be significant. In one study, there was no statistical difference between the treatment group and the control group when curative effect was evaluated two weeks after the intervention; however, the treatment group showed a statistically higher curative effect than the control group at one and two months after intervention, and also one month after the intervention was terminated. Conclusions Oral herbal medicine has been shown to be an effective treatment for childhood primary hyperhidrosis, and it takes at least one month for the administered oral herbal medicines to take effect. However, further well-designed large-scale randomized controlled trials are needed to confirm the efficacy and safety of oral herbal medicines in childhood primary hyperhidrosis.

• Clinical Pain
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• v.20 no.2
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• pp.135-140
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• 2021

MiraDry^®, a microwave thermolysis device, is comparably new non-surgical agent in the field of eradication of sweat glands for treating axillary hyperhidrosis and osmidrosis. So far, altered sensation, swelling, and compensatory sweating are widely known as adverse effects of MiraDry^®. Of the few reported MiraDry^®-induced neuropathy cases, median and ulnar neuropathies are common. Although, one case has described radial nerve and posterior cord damage with maximized stimulation intensity, musculocutaneous nerve damage induced by MiraDry^® has not been reported. Here, we report a case of a 30-year-old woman experiencing left hand weakness after receiving MiraDry^® at a local dermatology clinic. Left brachial plexopathy, mainly involving the median nerve and the musculocutaneous nerve with partial axonotmesis, was confirmed by electrodiagnostic studies. Ultrasound evaluation showed corresponding results. This is the first case report of the musculocutaneous neuropathy by MiraDry^®.

• The Journal of the Society of Stroke on Korean Medicine
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• v.19 no.1
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• pp.31-40
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• 2018

■ Objectives The purpose of this case study is to report the effectiveness of Korean medicine in the treatment of chronic hyperhidrosis. ■ Methods The patient was diagnosed as a Soeumin Mang-yang Syndrome, and treated with Korean medical treatment such as Sungyangikgibuja-tang and acupuncture treatment. The severity of symptom was assessed using Numerical Rating Scale (NRS) and follow-up of Hyperhidrosis Quality of Life Index (HidroQOL) ■ Results After treatment, the severity of hyperhidrosis was decreased from NRS 10 to NRS 2, HidroQOL score was also decreased from 32 to 19. ■ Conclusion Korean medical treatment for hyperhidrosis was effective in decreasing the NRS and HidroQOL score. The results suggest that Korean medical combined treatment including Sungyangikgibuja-tang and acupuncture treatment can be a effective option for treating hyperhidrosis.

• The Journal of Internal Korean Medicine
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• v.29 no.2
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• pp.359-374
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• 2008

Objective : Hyperhidrosis is a condition characterized by excessive sweating. Some studies suggest that hyperhidrosis is associated with autonomic nervous system dysfunction. Hyperhidrosis is often accompanied by hypersensitivity, tension, irritability, heat flashes, fatigue, etc. This study was designed to evaluate the correlation between Oriental Medicine diagnosis and the autonomic nervous system function in patients with hyperhidrosis using Heart Rate Variability (HRV) analysis. Methods : 23 palmar and plantar hyperhidrosis patients and 10 systemic hyperhidrosis patients were recruited and evaluated by Oriental Medicine diagnostic questionnaire and HRV analysis. The Oriental Medicine diagnostic questionnaire used a three-dimensional diagnosis that classified patients into Cold or Heat Syndrome, Yin or Yang Syndrome, and Deficiency or Excess Syndrome. Measured indices of HRV used the frequency domain analysis(i.e. TP, VLF, LF, HF and LF/HF ratio). Also, measure indices of HRV adjusted for aging effects were evaluated. Results : Cold/Heat Syndrome was not associated with hyperhidrosis prevalence nor the HRV analysis in hyperhidrosis patients. The Yang Syndrome group(78.8%) was more strongly correlated than the Yin Syndrome group(21.2%), and character of Yang was correlated with the adjusted TP and adjusted LF. The LF/HF ratio in the Excess Syndrome group was significantly higher than the LF/HF ratio in the Deficiency Syndrome group. Conclusion : Hyperhidrosis was not associated with the Cold/Heat Syndrome, but was found to be closely associated with the Yang Syndrome. The LF/HF ratio was significantly higher in the Excess Syndrome group than in the Deficiency Syndrome group in hyperhidrosis patients.

• The Korean Journal of Pain
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• v.9 no.2
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• pp.399-402
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• 1996

Endoscopic transthoracic sympathectomy (ETS) has recently become estabilished as a successful treatment for severe palmar and axillary hyperhidrosis. Descriptions have been published of neurolytic, operative and alternative endoscopic procedures involving thermocoagulation, laser coagulation, or or nonvideo-assisted ganglionectomy using equipment not widely available, with low morbidity and excellent results. All methods have advantage and disadvantages. A 19-year-old male who suffered from severe hyperhidrosis on face, palms and axillary areas, has been initially treated with stellate ganglion block in other pain clinic. He was transfered to our pain clinic for endoscopic thoracic sympathectomy. The patient was intubated left side 34 Fr. double lumen tube and positioned left semi-lateral position for right sympathectomy. Right side pneumothorax was created by clamping the ipsilateral side of the double lumen tube and aspiration of air. 11-mm trocar was introduced through incision at the third intercostal space in anterior axillary line, and then additional two 11-mm and 5-mm trocar was introduced through second and fifth intercostal space in mid axillary line. The lung was gently retracted and the parietal pleura over the heads of the appropriate ribs excised using 5-mm sharp insulated coagulating microprocesss. The T4, T3, and T2 ganglions, as well as accompanying rami communicantes, and other branchs arising from upper thoracic nerves to the brachial plexus and surrounding tissues were carefully dissected, coagulated. During sympathectomy, skin temperature of middle was continuously monitored. Elevation of palmar skin temperature intraoperatively indicated an adequate sympathectomy with a definite therapeutic effect. A No. 28 Fr. thoracotomy tube was introduced through a troca under video guidance, placed under water seal after the lung was reinflated. the controlateral side was performed same procedure. After bilateral sympathectomy, chest tubes were removed, and then, he was discharged 2 days after operation with great satisfaction. The ETS provides a well-tolerated, cost-effective alternative to thoracic sympathectomy for primary hyperhidrosis and sympathetic mediated neuropathic pain disorder. And T2 ganglion is considered the key ganglion for the treatment of primary hyperhidrosis. The low incidence of compensatory sweating may by explained by the limited extent of the sympathectomy.

• Journal of Korean Neurosurgical Society
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• v.30 no.8
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• pp.992-997
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• 2001

Objectives : Essential hyperhidrosis is a common condition characterized by excessive body sweating. Excessive sweating beyond what is necessary to maintain normal body temperature need not be considered pathological unless it interferes with one's occupation and/or life-style. The existing non-operative therapeutic options seldom give sufficient relief or show a transient effect. In this regard, the thoracic sympathectomy may provide a definitive cure. In the past, surgical procedures were highly invasive and caused significant morbidity, but the minimally invasive thoracoscopic procedure provided detailed visualization of sympathetic ganglia and is associated with minimally postoperative morbidity. Nowadays, thoracoscopic transthoracic sympathectomy is accepted as the treatment of choice for essential hyperhidrosis. In palmar hyperhidrosis, however, the level of sympathetic chain to be blocked has been somewhat obscure. It is assumed that the incidence of compensatory hyperhidrosis may closely related to the extent of thoracic sympathectomy. Material & Methods : To compare the results of posterior midline approach with endoscopic sympathectomy, and the results of T2 with T2, 3 sympathectomy or sympathicotomy, we retrospectively studied 62 patients treated for palmar hyperhidrosis between September 1993 and May 2000. We reviewed medical records and recently interviewed the patients by telephone calls. Results : The treatment effect of T2 sympathectomy is no different from T2, 3 sympathectomy. But, the incidence of compensatory hyperhidrosis is less in the T2 sympathectomy group than the T2, 3 sympathectomy group. Conclusion : Thoracoscopic sympathectomy is considered a simple, safe, and effective method for treating palmar hyperhidrosis, with a shorter operation time, fewer hospital days, and a better cosmetic result, as compared with the open approaches. However, sympathicotomy seems to provide the advantages of a limited extent of denervation and the resultant decrease of compensatory hyperhidrosis compared to sympathectomy.