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Treatment of axillary bromhidrosis in adolescents by combining electrocauterization with ultrasound-guided botulinum toxin type A injection

  • Author Footnotes
    1 Wanying Chen and Xiaoyu Zhang are co-first authors.
    Wanying Chen
    Footnotes
    1 Wanying Chen and Xiaoyu Zhang are co-first authors.
    Affiliations
    Department of Plastic Surgery, The Third Hospital of Jilin University, No.126, Xiantai Street, Erdao District, Changchun, Jilin 130000, China
    Search for articles by this author
  • Author Footnotes
    1 Wanying Chen and Xiaoyu Zhang are co-first authors.
    Xiaoyu Zhang
    Footnotes
    1 Wanying Chen and Xiaoyu Zhang are co-first authors.
    Affiliations
    Department of Gastrointestinal and Colorectal Surgery, The Third Hospital of Jilin University, No.126, Xiantai Street, Erdao District, Changchun, Jilin 130000, China
    Search for articles by this author
  • Lianbo Zhang
    Correspondence
    Corresponding authors.
    Affiliations
    Department of Plastic Surgery, The Third Hospital of Jilin University, No.126, Xiantai Street, Erdao District, Changchun, Jilin 130000, China
    Search for articles by this author
  • Yingying Xu
    Correspondence
    Corresponding authors.
    Affiliations
    Department of Ultrasound, The Third Hospital of Jilin University, No.126, Xiantai Street, Erdao District, Changchun, Jilin 130000, China
    Search for articles by this author
  • Author Footnotes
    1 Wanying Chen and Xiaoyu Zhang are co-first authors.
Published:April 18, 2021DOI:https://doi.org/10.1016/j.bjps.2021.03.089

      Summary

      The aim of this study is to investigate the efficacy of treatment-combined electrocauterization after removal of apocrine sweat glands with ultrasound-guided (BOTOX) injection for adolescents with axillary bromhidrosis. From January 2015 to January 2018, 90 adolescents with axillary bromhidrosis were recruited and randomly divided into three groups (group A, B, and C). Patients in group A underwent electrocauterization after removal of apocrine sweat glands, patients in group B received ultrasound-guided BOTOX injection, and patients in group C had electrocauterization after the removal of apocrine sweat glands followed by ultrasound-guided BOTOX administration after two weeks. All patients were followed up for one year. The percentages of axillary malodor score at twelve months after treatments compared with pre-operation for group A, group B, and group C were 20.2%, 27.5%, and 12.5%, respectively. Significant statistical differences were observed in changes of axillary malodor score among the three groups at three, six, nine and twelve months postoperatively. Satisfaction rates of group A, group B, and group C were 90.0%, 93.3%, and 96.7%, respectively. The side effects after surgery in group A were similar to group C, and no side effect was observed in group B. One-year postoperative scar formation rate of group A was 16.7%, which was significantly higher than that of group B (0) and group C (6.66%). Combination of electrocauterization after removal of apocrine sweat glands with ultrasound-guided BOTOX injection showed better treatment effects.

      Keywords

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      References

        • Semkova K.
        • Gergovska M.
        • Kazandjieva J.
        • Tsankov N.
        Hyperhidrosis, bromhidrosis,and chromhidrosis: fold (Intertriginous) dermatoses.
        Clin Dermatol. 2015; 33: 483-491
        • Lonsdale-Eccles A.
        • Leonard N.
        • CM L
        Axillary hyperhidrosis: eccrine or apocrine?.
        Clin Exp Dermatol. 2003; 28: 2-7
        • Bovell D.L.
        • Corbett A.D.
        • Holmes S.
        • Macdonald A.
        • Harker M.
        The absence of apoeccrine glands in the human axilla has disease pathogenetic implications, including axillary hyperhidrosis.
        Br J Dermatol. 2007; 156: 1278-1286
        • Seo S.H.
        • Jang B.S.
        • Oh C.K.
        • Kwon K.S.
        • Kim M.B.
        Tumescent superficial liposuction with curettage for treatment of axillary bromhidrosis.
        J Eur Acad Dermatol Venereol. 2008; 22: 30-35
        • Rompel R.
        • Scholz S.
        Subcutaneous curettage vs. injection of botulinum toxin A for treatment of axillary hyperhidrosis.
        J Eur Acad Dermatol Venereol JEADV. 2001; 15: 207-211
        • Bechara F.G.
        • Sand M.
        • Tomi N.S.
        • Altmeyer P.
        • Hoffmann K.
        Repeat liposuction-curettage treatment of axillary hyperhidrosis is safe and effective.
        Br J Dermatol. 2007; 157: 739-743
        • Wu W.-.H.
        • Ma S.
        • Lin J.-.T.
        • et al.
        Surgical treatment of axillary osmidrosis: an analysis of 343 cases.
        Plast Reconstr Surg. 1994; 94: 288-294
        • He J.
        • Wang T.
        • Dong J.
        Excision of apocrine glands and axillary superficial fascia as a single entity for the treatment of axillary bromhidrosis.
        J Eur Acad Dermatol Venereol. 2012; 26: 704-709
        • Wu C.-.J.
        • Chang C.-.K.
        • Wang C.-.Y.
        • Liao Y.-.S.
        • Chen S.-.G.
        Efficacy and safety of Botulinum Toxin A in axillary bromhidrosis and associated histological changes in sweat glands: a prospective randomized double-blind side-by-side comparison clinical study.
        Dermatol Surg. 2019; 45: 1605-1609
        • Heckmann M.
        • Teichmann B.
        • Pause B.M.
        • Plewig G.
        Amelioration of body odor after intracutaneous axillary injection of Botulinum Toxin A.
        Arch Dermatol. 2003; 139: 57-59
        • Wang T.
        • Dong J.
        • He J.
        Long-term safety and efficacy of Botulinum Toxin A treatment in adolescent patients with axillary bromhidrosis.
        Aesthetic Plast Surg. 2018; 42: 560-564
        • Wang Y.
        • Sun P.
        • Leng X.
        • et al.
        A new type of surgery for the treatment of bromhidrosis.
        Medicine. 2019; 98: e15865
        • He J.
        • Wang T.
        • Zhang Y.
        • Dong J.
        Surgical treatment of axillary bromhidrosis by combining suction-curettage with subdermal undermining through a miniature incision.
        J Plast Reconstr Aesthet Surg. 2018; 71: 913-918
        • Solish N.
        • Bertucci V.
        • Dansereau A.
        • et al.
        A comprehensive approach to the recognition, diagnosis, and severity-based treatment of focal hyperhidrosis: recommendations of the Canadian Hyperhidrosis Advisory Committee.
        Dermatol Surg. 2007; 33: 908-923
        • Goldman A.
        • Wollina U.W.E.
        Subdermal Nd-YAG laser for axillary hyperhidrosis.
        Dermatol Surg. 2008; 34: 756-762
        • Perng C.K.
        • Yeh F.-.L.
        • Ma H.
        • et al.
        Is the treatment of axillary osmidrosis with liposuction better than open surgery?.
        Plast Reconstr Surg. 2004; 114: 93-97
        • Park Y.J.
        • Shin M.-.S.
        What is the best method for treating osmidrosis?.
        Ann Plast Surg. 2001; 47: 303-309
      1. Tung T.C., Wei F.C. Excision of subcutaneous tissue for the treatment of axillary osmidrosis 1997: 50: 61.

        • Wang R.
        • Yang J.
        • Sun J.
        A minimally invasive procedure for axillary osmidrosis: subcutaneous curettage combined with trimming through a small incision.
        Aesthetic Plast Surg. 2005; 39: 106-113
        • Fan Y.M.
        • Wu Z.H.
        • Li S.F.
        • Chen Q.X.
        Axillary osmidrosis treated by partial removal of the skin and subcutaneous tissue en bloc and apocrine gland subcision.
        Int J Dermatol. 2001; 40: 714-716
        • Buffoli B.
        • Rinaldi F.
        • Labanca M.
        • et al.
        The human hair: from anatomy to physiology.
        Int J Dermatol. 2014; 53: 331-341
        • Shelley W.B.
        • Hurley Jr H.J
        The physiology of the human axillary apocrine sweat gland.
        J Investig Dermatol. 1953; 20: 285-297
        • He J.
        • Wang T.
        • Dong J.
        Effectiveness of botulinum toxin A injection for the treatment of secondary axillary bromhidrosis.
        J Plast Reconstr Aesthet Surg. 2017; 70: 1641-1645