Tumescent liposuction with dermal curettage for treatment of axillary osmidrosis and hyperhidrosis. Dermatologic Surgery (et al.)

摘要

Letter to the Editor: The recent article by Lee and coworkers contained fascinating and promising data about the treatment of focal axillary hyperhidrosis with suction-curettage. Based on 9 years of experience with the described technique, we would like to add some interesting observations and information. Lee and colleagues1 showed a reduction of axillary hyperhidrosis measured by patients' subjective evaluation. We propose that efficacy of suction-curettage should be evaluated with at least one objective method if scientific studies are performed. Before suction-curettage, we use gravimetry and an iodine-starch test allowing us to evaluate the severity of hyperhidrosis and the sweat reduction after surgery. In our clinical routine, a modified iodine-starch test has proved itself as helpful for assessment of therapeutic effectiveness. ISO-A4 copy paper is intermingled with nonpulverized iodine crystal for 5 days in a sealed container (1 g of jodum purum per 50 pages of copy paper). The hyperhidrotic area appears on the copy paper, revealing a violet-blue color, similar to the coloring of standard iodine-starch tests. For quantification we use a plastic foil with standardized grids (1 X 1 cm} that is placed on the copy paper enabling an exact measurement of the hyperhidrotic area in cm~2. This technique enables a quick assessment of the hyperhidrotic area before and after therapy.