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Antiperspirant for hyperhidrosis
Axillary hyperhidrosis surgery
Causes of hyperhidrosis
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Craniofacial hyperhidrosis
Define hyperhidrosis
Focal hyperhidrosis
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Antiperspirant for hyperhidrosis

Hyperhidrosis is to sweat excessive beyond the physiological need. It affects generally the palms , Axillae, and the soles and can affect the face, the groin, and the legs. The symptoms appear generally in the antiperspirant for hyperhidrosis and they auxillary hyperhidrosis can cause the social and psychological problems, thus as Educational and professional difficulties. Between 0,6% and 1% of the general population is affected for hyperhidrosis. (1)

 

The people with hyperhidrosis of palm grove can be ashamed by having hands or to be hesitant to greet on account of having wet excessively palms, often being felt as if they should they wipe the palms In its first clothes. The people with hyperhidrosis of palm grove can have difficulty that has in objects or instruments or can have keyboards of computer to utilize of difficulty, the typewriters, or the feathers. The roles that handle can arrive at to be wet, and objects of metal that they utilize can come be repeated rusty times. The individuals with hyperhidrosis of palm grove can find the difficult to play a musical instrument or to carry out a work that requires the carrying of gloves (p.and., tratante of food, nurse of perioperative).

 

The patients with hyperhidrosis of palm grove can find that they aggravate dermatitis of eczematous, and they can have a predisposition to bacterial infections and micóticas. As they turned out, these people can come be retreats socially and they suffer of the Low own love. They can develop still the psychiatric problems, the disorders such as Social of the anxiety.

 

The FISIOLOGIA TO SWEAT

 

Sweating is a physiological answer to reheat of body. It is controlled for the heat the center Regulatory in the hypothalamus. When the temperature of the ascents of the environment, the body is auxillary hyperhidrosis refreshed for vasodilatation of the cutaneous blood vessels and the production of the Sweat. The sweat then evaporates of the surface of the skin and refreshes the body. (2)

 

The glands sudaríparas are the structures tubulares that consist of a deep portion rolled up inside the dermis that secret the sweat and a conduit because the sweat travels to the skin. Cholinergic nice fibers of nerve in or near the glandular cells removes the secreción of the Sweat.

 

The antiperspirant for hyperhidrosis portion of the secret gland a liquid called precursor secreción. The concentrations of the components of this liquid are modified as The trips of liquid by the conduit to the pore. When glands sudaríparas are stimulated normally, the secreción of precursor passes slowly by the conduit where most of the content of sodium and chloride is reabsorbed. The concentration of sodium and chloride can fall as low as 5 mEq by the liter. This reduces the osmotic pressure of the liquid, and most of the water is reabsorbed, thus concentrating other ions in the liquid.

 

In sweating normal, the urea, lactic acid, and ions of potassium are concentrated very. When the glands sudaríparas are stimulated totally by the nice nervous system, the large quantities of secreción of precursor are formed. The sweat flows so quickly by the conduit that small of the water and lightly more than one half of the sodium and the chloride is reabsorbed, leaving sodium and chloride the concentrations as high as 50 to 60 mEq by the liter. In these situations, a large loss of chloride of sodium and water can occur. (3)

 

The human body contains two types of glands sudaríparas -- apocrine and eccrine. Their location and characteristics differ lightly.

 

Glands sudaríparas of Apocrine. The glands auxillary hyperhidrosis of apocrine are limited to the axillae, the halos of the, of the area of anogenital, and of the meatus auditory external. They are simple pipes and rolled up and are 10 larger times than glands of eccrine. The sweat of these glands is milky, contains the grease and the cholesterol, and can have a strong smell. The glands of apocrine begin to function in the pubertad.

 

Glands sudaríparas of Eccrine. The glands of eccrine are presents in the entire surface of the body but they are very numerous in the palms, the soles of the feet, the face, axillae, and, to a smaller degree, the back and the chest. They are rolled up glands tubulares that open in the skin by pores. These glands sudaríparas have a rich supply of blood and they are innervated by the nice nervous system (Figure 1). The nerves stimulate the glands to secrete a liquid of plasma since is antiperspirant for hyperhidrosis (ie, 0,3% to 0,5% of chloride of the sodium) and contains small quantities of potassium, lactic acid, the glucose, and the urea. The cells of Myoepithelial, by their contraction, they help in the expulsion of the sweat. Acetylcholine and other agents of cholinergic enlarge to sweat. The agents of the atropina and anticholinergic inhibit sweating. (4)

 

 

The CAUSES OF HYPERHIDROSIS

 

There are many causes of hyperhidrosis. It can be caused for

 

* the emotional factors,

* a tepid environment,

* the exercise,

* the tepid auxillary hyperhidrosis clothes,

* the medical conditions (p.and., the fever, thyrotoxicosis, mellitus of diabetes, the hypoglycemia, the giantism, and acromegaly, pheochromocytoma, the cardiovascular disorders, the illness of Hodgkin),

* the medicines,

* toxins,

* the abuse of substance,

* the respiratory failure,

* wounds of intrathoracic or hypothalamic,

* the tumors of carcinoide,

* the injuries of the spinal cord, and

* Dysautonomia family (p.and., syndrome of Riley-Day -- a to occur congenital inherited of the illness mainly in children of Ashkenazic Jewish decent and characterized by a decrease in the number of small fibers unmyelinated autonomous and peripheral that carry the pain, the temperature, and the sensations of the flavor; syndrome of Nail-Kneecap -- a disorder inherited of multisystem characterized by nails of dystrophic, by hypoplastic or absent kneecaps, and by the Renal).

 

Hyperhidrosis can be cold induced, taste (ie, stimulated eating), the sense of smell (ie, stimulated by strong smells), compensatory (ie, the areas of the body arrive at to be affected by hyperhidrosis after the areas originally affected by hyperhidrosis have been interrupted by the surgery or other media), or idiopathic. (5) that This article discusses the processing for the idiopathic or hyperhidrosis primary of palm grove.

 

PROCESSING

 

The processing should be directed in the fundamental cause provided that possible. The individuals affected antiperspirant for hyperhidrosis should carry the light clothes, maintains the environment refreshes, and supplies of new chloride of water and sodium lost by sweating. The trite applications of chloride of aluminum or chlorhydroxide of aluminum can be utilized to block the openings of the conduits of the sweat. They should be reapplied frequently (ie, three to four times for day) because to sweat excessive clears the conduits.

 

A 20% of solution of the alcohol of hexahydrate of chloride of aluminum auxillary hyperhidrosis is the solution more trite cash. It blocks the openings to the conduits of the sweat and should be applied at night, covered with plastic wraps, and washed in the morning. The needs of the skin for to be dried completely before application. The solution is utilized newspaper, weekly, or provided that needed. The rashes of the skin can result of this processing; therefore, should not be applied to the freshly shaved skin. Glutaraldehyde (6) and the acid tánico can be utilized also tritely, but they can cause cutaneous irritation and decoloración brownish of skin.

Iontophoresis can create a temporary obstruction of the conduit of the sweat. This is reached directing an electric current moderated by the skin in a superficial water the current bath. The electric current shakes the glands sudaríparas, and they pair producing the sweat temporarily. The machine of iontophoresis is utilized for 20 minutes a few times to the week and can cause to sweat stop for weeks. It can be utilized at home but is only useful for palms, for the feet, and for axillae. (7) the Surgical eradication of glands sudaríparas of apocrine of axillary is carried out rarely and can have as a result the infection, hidradenitis, and to mark. (8) it applied Locally astringent (p.and., permanganate of potassium) can provide the temporary local relief. The antitranspirant with you leave aluminum can be utilized also to block the conduits.

 

The medicines of Anticholinergic, just as atropina, oxyphencyclimine, glycopyrrolate, and bromide of propantheline, inhibits the parasympathetic effects, but these often cause dry mouth, the vision clouded, or the constipation. These medicines are taken generally several times for day. The patients can utilize them to treat regularly to control to sweat or only when in the situations that causes to sweat excessive, to speak just as public or meetings of business. Multiple medicines and the schedules are tried to determine a schedule of the processing that works better for the individual patient, depending on the severity of their hyperhidrosis.

 

The toxin auxillary hyperhidrosis injections botulínica are utilized at times for the hyperhidrosis focal of the axillae, of the palms, and of the feet. Toxin of toxin botulínica is a neurotoxina powerful that blocks the terminals of nerve of cholinergic. Is cash only in the place of injection and can be painful and costly. The injections are generally cash for three to 12 months. (9) In 1998, neurologists and antiperspirant for hyperhidrosis German utilized injections of intracutaneous of toxin of toxin botulínica in 11 patients with hyperhidrosis focal. Sweating was revoked completely in all patients in three to seven days, but to some reactivation of the function of gland sudarípara was observed four months after the processing. the Biofeedback (10), the hypnosis, and the psicoterapia have been dealt with variable results. Early in the 20th century, the irradiation of the skin was utilized to be atrophied the glands sudaríparas; nevertheless, this processing has been abandoned. (11)

 

When to sweat is halfway through by the nice nervous system, sympathectomy selective appears to be the method more cash to be undone permanently to patients of hyperhidrosis of palm grove. Sympathectomy (12) revokes to sweat of eccrine in areas supplied by fibers of post-ganglionic. In the past, an open surgical technique was utilized. This was carried out generally way transthoracic, way supraclavicular, way transcervical, way transaxillary, or way the surgery thoracic number. These surgeries implied the long hospital remains, the large scars, the morbosidad enlarged, and the long recuperative periods for patients.

 

THORACOSCOPIC SYMPATHECTOMY

 

The arrival of the surgery of thoracoscopic has done the surgical processing for the hyperhidrosis of a lot more attractive palm grove. The procedure is carried out generally in a base of outpatient, with the patient going home some few hours after the surgery. After the procedure, the patients have two scars of an-inch hidden in the axillae. Currently, the patients that experience this procedure in New York the Presbyterian Hospital , New York , has earned the relief of the auxillary hyperhidrosis. The patients are referred for antiperspirant for hyperhidrosis or they refer to itself to this program. Many patients have learned about this procedure in the Internet or of other patients that have benefited of the surgery.

 

EVALUACION OPERATING

 

The surgeon sees and he evaluates the patient upon carrying out a recognition and to take a medical history. The or she they explain the surgical procedure, the potential complications, and the effects from the side to the patient and they obtain the consent reported writing for the surgery and a consent for the blood products administration if necessary. The patients that experience typically this procedure are in their years twenty and thirty. They find that this condition for to be shaming and believes that its lives has been affected negatively by the condition. The surgeon plans the patient for the optional surgery and he sends her or she to the preadmission that tests area of the hospital for analysis of blood (p.and., complete to count of blood; time of prothrombin; partial time of thromboplastin; the rate of auxillary hyperhidrosis of eosinophil; sodium, the potassium, the chloride, the glucose, and the levels of the carbon dioxide; nitrogen of urea of blood; creatinine; calcium; the. The profile of the thyroid is drawn to exclude the illness of thyroid as a cause of the hyperhidrosis. A x-ray thoracic and electrocardiogram they are carried out also. The supplier of the interview anesthesia care to the patient, explains its plans for the anesthesia, and obtains the consent reported. The supplier of the care of anesthesia instructs the patient for eat not neither to drink after the midnight the night before the surgery; nevertheless, antiperspirant for hyperhidrosis other special preparations are you needed.

 

 

CARE of PREOPERATIVE

 

In the day of the surgery, the patient arrives in the ambulatory unit of the surgery (ASU) one and a-media hours before surgery is planned. In the ASU, the patient changes in a robe of the hospital, and in the nurse that admits he takes the essential signs and he verifies the graphic for a history and the recognition, for the work of blood, and for forms signed of consent. The nurse carries out an evaluation of systems of the patient that includes

 

1. the general health of patient,

2. some prior surgery,

3. the conditions or the existing medical incapacities,

4. the routine medicines, and

5. the position of the embarrassment, if applicable.

 

The or she they ask the patient about allergies, inclusive those to medicines, to the food, and to the latex. The nurse verifies that the surgery will be bilateral and that the patient will accept a transfusion of blood, if necessary. The nurse asks that the patient remove all jewels, the dentures, hearing assistants, the contact lenses, and any other prosthesis. The view or the view damaged patients are permitted to retain their aids of the heating or eyeglasses to the induction. The auxillary hyperhidrosis nurse verifies that the patient has an escort to take it or his home after the recovery



 
   
   
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