NOVEL APPROACHES TO TREATING HYPERHIDROSIS ADELAIDE A. HEBERT, MD THE UTHEALTH McGOVERN MEDICAL SCHOOL HOUSTON, TEXAS

Transcription

1 DISCLOSURE NOVEL APPROACHES TO TREATING ADELAIDE A. HEBERT, MD THE UTHEALTH McGOVERN MEDICAL SCHOOL HOUSTON, TEXAS WILL DISCUSS OFF LABEL INDICATIONS ALL MONIES FOR RESEARCH WERE PAID TO THE UTHEALTH McGOVERN MEDICAL SCHOOL HOUSTON ADVISORY BOARD DEMIRA GSK DYSAUTONOMIA FINALLY ON THE RADAR SCREEN FOR CLINICAL TRIALS 68 STUDIES LISTED IN clinical trials.gov NOT ALL DEAL WITH DERMATOLOGIC ASPECTS OF THE DISEASE FEW DEAL WITH PEDIATRIC DYSAUTONOMIA DYSAUTONOMIA GROUP OF DISEASES THAT INCLUDE: POSTURAL ORTHOSTATIC SYNDROME (POTS) MULTIPLE SYSTEM ATROPHY AUTONOMIC FAILURE AUTONOMIC NEUROPATHY 1

2 TERAZOSIN IN TREATMENT OF ANTIDEPRESSANT INDUCED ECESSIVE SWEATING TERAZOLIN ALPHA BLOCKER, PERIFERAL USED IN BENIGN PROSTATIC HYPERTROPHY ANTAGONIZES PERIFERAL ALPHA 1 ADRENERGIC RECEPTORS METABOLIZED IN THE LIVER BY CYP450 BOTULINUM TOXIN TYPE A TOPICAL GEL LASER THERAPY 1440 nm LASER ASSISTED SELECTIVE PHOTOTHERMOLYSIS FOR AXILLARY Nd:YAG FOR AXILLARY ULTHERA FOR AXILLARY MIRADRY AXILLARY FRACTIONATED MICRONEEDLE RADIOFREQUENCY FOR TREATMENT OF PRIMARY AXILLARY 2

3 UMECLIDINIUM TOPICAL THERAPY WITH 14 C UMECLIDINIUM DRM04 FOR PRIMARY AXILLARY WIPES MANAGEMENT OF PALMAR WITH HYDROGEL BASED IONTOPHORESIS ANT 1207 FOR PRIMARY AXILLARY OXYBUTININ SYSTEMIC PALMAR PLANTAR LONG TERM USE STUDY OXYBUTININ GEL PRIMARY FOCAL IN ADOLESCENTS AND YOUNG ADULTS 3

4 PRIMARY PEDIATRIC : A REVIEW OF CURRENT TREATMENT OPTIONS GELBARD, C EPSTEIN H, HEBERT AA PEDIATR DERMATOL 2018; 25 (6): SPECIAL CONSIDERATIONS FOR CHILDREN WITH Bohaty BR, Hebert AA Dermatologic Clinics 2014 Oct; 32(4): Hyperhidrosis: review of recent advances and new therapeutic options for primary hyperhidrosis. Brown AL, Gordon J, Hill S. Curr Opin Pediatr Aug;26(4): Gatto Braganca GM, Lima SO, Pinto Neto AF, Marques LM, et al. An Bras Dermatol. 2014;89(2): PRIMARY CAN LEAD TO MOOOD CHANGES DUE TO THE INCONVENIENCE CAUSED BY THE DISORDER HOSPITAL ANXIETY AND DEPRESSION SCALE 197 PTS 4

5 ANXIETY INCREASED : 49.6% DEPRESSION NOT INCREASED: 11.2% ANXIETY AND DEPRESSION RESULTS: NO LINK TO: GENDER AGE AMOUNT OF AFFECTED AREAS ASSOCIATION NOTED: BETWEEN DEPRESSION AND ANXIETY ANXIETY: MOSTLY MILD TO MODERATE MENTAL HEALTH WORLDWIDE: CAUSE OF DISABILITY: 30.8% OF ALL THE YEARS LIVED WITH THE DISEASE MENTAL HEALTH ANXIETY : MOST COMMON FORM OF MENTAL DISORDER INCIDENCE RATE OF 25 TO 30% MENTAL HEALTH DEPRESSION: FOURTH MOST COMMON CAUSE OF DISABILITY IN THE WORLD SECOND LEADING CAUSE OF INABILITY TO WORK SECOND ONLY TO HEART DISEASE 5

6 IONTOPHORESIS USED SINCE 1930 S USES ELECTRIC CURRENT TO INTRODUCE IONS INTO BODY THROUGH ACROSYRINGIUM WHERE RESISTANCE IS LOWEST IN THE SKIN MAY INVOLVE OBSTRUCTION OF ECCRINE DUCTS IONTOPHORESIS FRED LEVITT, MD LEWIS STOLMAN, MD 83% pts responded favorably USE: MINUTES / SESSION 2 3 X / WEEK THEN MAINTENANCE 1 X / WEEK IONTOPHORESIS IONTOPHORESIS WORKS BEST FOR PALMAR SOME PTS REPORT REDUCTION IN PLANTAR AS WELL HIDREX USA 1 8 HIDREXUSA TOLL FREE 6

7 7

8 WEB SITE 8