Skip to main content
eScholarship
Open Access Publications from the University of California

Scholarly Works (229 results)

  • Article
Dermatology Online Journal, Volume 22, Issue 10 (2016)
Hyperhidrosis, or abnormally increased sweating, is a condition that may have a primary or secondary cause. Usually medication- induced secondary hyperhidrosis manifests with generalized, rather than focal sweating. We report a 32-year-old woman with a history of palmoplantar hyperhidrosis for 15 years who presented for treatment and was prescribed oral glycopyrrolate. One month later, the palmoplantar hyperhidrosis had resolved, but she developed new persistent craniofacial sweating. After an unsuccessful trial of clonidine, oxybutynin resolved the craniofacial hyperhidrosis. To our knowledge, this is the first case of compensatory hyperhidrosis secondary to glycopyrrolate reported in the literature. The case highlights the importance of reviewing medication changes that correlate with new onset or changing hyperhidrosis. It also demonstrates a rare drug adverse effect with successful treatment.
    Cover page: Glycopyrrolate-induced craniofacial compensatory hyperhidrosis successfully treated with oxybutynin: report of a novel adverse effect and subsequent successful treatmentCreative Commons 'BY-NC-ND' version 4.0 license
    • Article
    • Peer Reviewed
    Dermatology Online Journal, Volume 23, Issue 6 (2017)

    Klippel-Trenaunay syndrome (KTS) is a rare, clinically variable congenital disorder involving capillary malformations, soft tissue or bone hypertrophy, and venous malformations or varicose veins. We report a 28-year-old man who presented with a hypertrophic right arm as well as markedly increased ipsilateral axillary hyperhidrosis and erythematous patches on the back, chest, and arm. This case of KTS is unusual because our patient presented with a markedly increased unilateral axillary hyperhidrosis ipsilateral to the hypertrophic limb.

      Cover page: Klippel-Trenauney syndrome with axillary hyperhidrosisCreative Commons 'BY-NC-ND' version 4.0 license
      • Article
      • Peer Reviewed
      Dermatology Online Journal, Volume 23, Issue 12 (2017)
      We present a 57 year-old man presented with generalized hyperhidrosis and widespread, smooth, flesh colored papules on the torso and extremities.Histological examination from multiple biopsies demonstrated morphologic alteration of the eccrine glands with an apocrine phenotype, suggesting eitherapocrine metaplasia or the presence of “apoeccrine glands.” The morphologic similarities between eccrine, apocrine, and apoeccrine as they relate to ourpatient’s histologic findings are discussed. We consider secondary causes of generalized hyperhidrosis, which may also play a role in this patient’s presentation. Treatment and further workup are discussed, whilemanagement of this patient remains in progress.
        Cover page: Generalized hyperhidrosis secondary to presumed eccrine gland dysfunction with possible apocrine metaplasia.Creative Commons 'BY-NC-ND' version 4.0 license
        • Article
        • Peer Reviewed
        Dermatology Online Journal, Volume 25, Issue 11 (2019)
        Unilateral hyperhidrosis of neurological origin has been associated with head trauma, cerebral palsy, spinal cord injury, peripheral neuropathy, lesions of the hypothalamus, and cerebral or brainstem strokes. In this report, we describe a 61-year-old man with isolated sweating on the left side of his entire body. A right-sided brainstem meningioma producing mass effect is suspected as the underlying etiology.
          Cover page: Unilateral hyperhidrosis secondary to brainstem meningioma producing mass effectCreative Commons 'BY-NC-ND' version 4.0 license
          • Article
          Dermatology Online Journal, Volume 22, Issue 6 (2016)

          Background: Botulinum toxin type A (BTX-A) injections are an effective treatment for controlling hyperhidrosis at sites of amputation. Hyperesthesia associated with amputated limbs is a major barrier to performing this procedure under local anesthesia.

          Objective: To present a novel method for improving local anesthesia with BTX-A injections.

          Methods & Results: A 29-year-old military veteran with a below-the-knee amputation of his right leg was suffering from amputation site hyperhidrosis, which was impeding his ability to comfortably wear a prosthesis. Prior to presenting to our clinic, the patient received one treatment of BTX-A injections to his amputation stump while under general anesthesia for surgical repair of trauma-related injuries. In our dermatology clinic, we repeated the procedure using topical lidocaine-prilocaine (30 gm total) for local anesthesia. This provided effective relief of hyperhidrosis for 6 months, but the procedure was very painful (9/10 intensity). We repeated the same procedure 6 months later, using ice in addition to topical lidocaine-prilocaine (30 gm) for local anesthesia; this resulted in reduced pain (3/10 intensity) for the patient.

          Conclusions: We suggest using ice in combination with a topical anesthetic as an effective method for pain control that avoids general anesthesia in treating amputation-associated hyperhidrosis.

           

            Cover page: Effective local anesthesia for onabotulinumtoxin A injections to treat hyperhidrosis associated with traumatic amputationCreative Commons 'BY-NC-ND' version 4.0 license
            • Article
            • Peer Reviewed
            Dermatology Online Journal, Volume 22, Issue 3 (2016)
            Postoperative complications present in many forms and can cause great morbidity and even mortality in patients who experience them. Frey syndrome is an example of a postoperative complication in which aberrant nerve regeneration following parotidectomy leads to hyperhidrosis induced by gustatory stimuli. We present a unique but similar case of aberrant nerve regeneration and resulting hypersecretion that emerged 6-7 months following perineoplasty and labial reduction for lichen sclerosus in a 53-year-old woman. An exhaustive investigation ruled out genitourinary causes of her symptoms. Pads, tampons, and surgical procedures provided no relief. We propose that the mechanism of her excessive watery secretions is similar to that which causes Frey syndrome: iatrogenic damage to nerves that aberrantly regenerate to innervate local structures involved in secretory control. The parallels between our patient’s condition and Frey syndrome are evident in the duration between surgery and onset of symptoms and the response to treatment with onabotulinum toxin, highlighting a shared cholinergic pathway. Onabotulinum injections are well tolerated by patients with localized hyperhidrosis and symptom control typically lasts several months. In this manuscript we present a novel mode of delivery of onabotulinum toxin topically to a mucosal region. With these treatments, the patient's hyperhidrosis-like symptoms remain well controlled for 3-4 months, at which point she returns to clinic for treatment. The patient did not experience symptomatic relief until this unique treatment plan was initiated. Her case illustrates the need for further understanding of recalcitrant postoperative complications involving local structures controlling liquid secretion, such as sweat glands and vascular plexuses.
              Cover page: Innovative use of chemodenervation in the treatment of postoperative genital hyperhidrosis-like symptomsCreative Commons 'BY-NC-ND' version 4.0 license
              • Article
              • Peer Reviewed
              Dermatology Online Journal, Volume 20, Issue 9 (2014)
              We report a case of axillary trichobacteriosis in a 34-year-old patient whose complaints were bromhidrosis and hyperhidrosis axillaris. The condition can be diagnosed clinically; dermoscopy may be useful and reveal typical signs.
                Cover page: Trichobacteriosis: contribution of dermoscopyCreative Commons 'BY-NC-ND' version 4.0 license
                • Article
                • Peer Reviewed
                UC San Diego Previously Published Works (2020)
                The World Health Organization estimates the number of people suffering from depression to be over 264 million. Current monoamine transmission modulating therapeutics, even with proper adherence and acceptable tolerability, are not effective for nearly one third of the patients, leading clinicians to explore other therapeutic options such as electroconvulsive therapy, transcranial magnetic stimulation, ketamine infusions, and, more recently, glabellar botulinum toxin, BoNT, injections. The scale and mechanism of antidepressant action of BoNT is unclear and maybe hypothetically attributed to the disruption of proprioceptive facial feedback reinforcing negative emotions. Here we verify the antidepressant effect of botulinum toxin by analysis of over 40 thousand BoNT treatment reports out of thirteen million postmarketing safety reports in the FDA Adverse Event Reporting System, FAERS. The results of the analysis indicate that patients who received BoNT injections to treat hyperhidrosis, facial wrinkles, migraine prophylaxis, spasticity, and spasms, had a significantly lower number of depression reports when compared to patients undergoing different treatments for the same conditions. These findings suggest that the antidepressant effect of BoNT is significant, and, surprisingly, is observed for a broad range of injection sites.
                  Cover page: Postmarketing safety surveillance data reveals antidepressant effects of botulinum toxin across various indications and injection sitesCreative Commons 'BY' version 4.0 license
                  • Article
                  • Peer Reviewed
                  Dermatology Online Journal, Volume 24, Issue 6 (2018)
                  Fibrous hamartoma of infancy (FHI) is a rare benign soft tissue tumor with a triphasic organoid histologic appearance. The authors present a case of a 21-month-old healthy girl with a slowly growing flesh-colored subcutaneous plaque 12cm in size on the lower back, with overlying hypertrichosis. A punch biopsy revealed a proliferation of spindle cells infiltrating the dermis and hypodermis organized in a dense storiform pattern with a strong diffuse positivity for CD34. The diagnosis of congenital dermatofibrosarcoma protuberans (DFSP) was considered and an excision was performed. Histopathologic analysis showed an extensive poorly demarcated mass infiltrating the dermis and hypodermis, composed of different components: a monomorphous fibroblastic/myofibroblastic component, a mature adipose component, and an immature mesenchymal basophilic component. The clinical aspects with the histologic and immunohistochemical features led to the diagnosis of giant fibrous hamartoma of infancy. In our case the strong diffuse CD34 positivity was a diagnostic pitfall leading to an incorrect hypothesis of congenital DFSP. The characteristic triphasic histology of FHI was missed owing to the small size of the punch biopsy. This article highlights the importance of being aware of the CD34+ dermal mesenchymal tumor differential diagnosis and the necessity of appropriate size biopsies to avoid sampling error.
                    Cover page: Giant fibrous hamartoma of infancy: pitfall of CD34 positive dermal mesenchymal tumorCreative Commons 'BY-NC-ND' version 4.0 license
                    • Article
                    • Peer Reviewed
                    Dermatology Online Journal, Volume 15, Issue 4 (2009)
                      Top