11

HyperhidrosisHyperhidrosis A True Affl ictionA True Affl iction HRQoL in HyperhidrosisHRQoL in Hyperhidrosis

ByBy Aliaa El-HusseinyAliaa El-Husseiny

22

Primary hyperhidrosis of palms, Primary hyperhidrosis of palms, soles, axilla and forehead soles, axilla and forehead Affects 1% of populationAffects 1% of population (in USA, 2.8%)(in USA, 2.8%)

begins during childhood or begins during childhood or just after pubertyjust after puberty

a family historya family history

bilateral and symmetricalbilateral and symmetrical

Anxiety, heat and exertion Anxiety, heat and exertion

55

Hyperhidrosis Hyperhidrosis is notis not a serious medicala serious medical problem problem butbut i t is a serious social it is a serious social problemproblem

Mean DLQI scoresMean DLQI scores 5.8 to 5.8 to 6.86.8

(Harlow et al., British J Dermatol,2000)

10

9.5

8.6

6.7

6.3

6.4

5.9

5.5

0 2 4 6 8 10 12

psoriasis

urticaria

scabies

eczema

acne

hyperhidrosis

lichen planus

leg ulcer

DRQoL in adults

10

9.5

8.6

6.7

6.3

6.4

5.9

5.5

0 2 4 6 8 10 12

Psoriasis

Urticaria

Scabies

Urticaria

Acne

Hyperhidrosis

Lichen planus

Leg ulcer

DLQI

How Hyperhidrosis Affects Life?

99

DD aily Lifeaily Life

Hands and feetHands and feetbecome slippery become slippery

Holding objectsHolding objects Playing favorite sportsPlaying favorite sports Writing a letter or Writing a letter or

reading the mailreading the mail Driving may be Driving may be

dangerous dangerous

1010

In children: interfere In children: interfere with learning , using with learning , using computers or musical computers or musical instrumentsinstruments

PatientsPatients often take lots often take lots of showers , change of showers , change their clothes multiple their clothes multiple times a day times a day

Never wear some Never wear some colors or sandals colors or sandals

1111

Career SuccessCareer Success

How I am going to

handshake the

interviewer

1212

Social EmbarrassmentSocial Embarrassment

Reluctant to share Reluctant to share a hug, to dance, to a hug, to dance, to get close and even get close and even avoid simple avoid simple handshake handshake

1313

Insensitive family and friends reactionsInsensitive family and friends reactions Additional anxietyAdditional anxiety

More sweatingMore sweating

1414

Interpersonal RelationshipInterpersonal Relationship

Spend less time with Spend less time with friendsfriends

Reluctant in social and Reluctant in social and business settingsbusiness settings

Afraid of being Afraid of being repulsed by other sexrepulsed by other sex

1515

Psychological Well-beingPsychological Well-being

Patients lose Patients lose confidence in their confidence in their ability to socialize or ability to socialize or interact with othersinteract with others

become frustrated and become frustrated and

withdrawnwithdrawn

1616

Skin diseasesSkin diseases

IntertrigoIntertrigo ErythrasmaErythrasma Trichomycosis axillaris Trichomycosis axillaris BromohidrosisBromohidrosis Dermatitis Dermatitis Pitted keratolysisPitted keratolysis

1717

When patients seek When patients seek medical advise medical advise

(Läuchli and Burg,2007)

1919

2020

Treatment with BTX-A led to improvement in Treatment with BTX-A led to improvement in

QOL (mean DLQI 1.2-2.5) in all patients QOL (mean DLQI 1.2-2.5) in all patients

EBM 2

HH QoL5.8-6.8

HH QoL1.2-2.5

WITH BOTOX

2121

BTX-A improved patients in al l aspectsBTX-A improved patients in al l aspects

EBM 1

(Naumann et al, 2001)

Satisfaction rate: Satisfaction rate: 97% in palmar hyperhidrosis 97% in palmar hyperhidrosis 95% in axil lary hyperhidrosis 95% in axil lary hyperhidrosis

EBM 2

How dermatologists How dermatologists should see should see

hyperhidrosishyperhidrosis

Every effort must be done to provide help and hope to patients

HH career career successsuccess

psychological well-beingpsychological well-being

personal personal relat ionshipsrelat ionships

Patients daily l i fePatients daily l i fe

2525

Yes Yes

Help is availableHelp is available

2626

Thank youThank you