Document Detail

Selective sweat gland removal with minimal skin excision in the treatment of axillary hyperhidrosis: a retrospective clinical and histological review of 15 patients.
MedLine Citation:
PMID:  16792762     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Limited axillary skin excision and selective sweat gland removal from adjacent skin (Shelley's procedure) is currently rarely used for hyperhidrosis. OBJECTIVES: To determine whether this technique is a good way of permanently reducing axillary sweating. METHODS: This was a prospective, open, nonrandomized trial of the therapy, conducted in a university dermatology department. A small skin ellipse, parallel to the skin crease lines, was excised from the centre of the area of maximal sweating. The wound edges were undermined to the extent of maximal sweating and the skin reflected. Large visible sweat glands attached to the undersurface of the adjacent skin could be readily identified and were snipped off using scissors. We treated 15 axillae in eight patients with axillary hyperhidrosis. Sweat reduction was assessed by the patients who estimated the percentage reduction in sweating postoperatively. The scar appearance was graded by the surgeon. Haematoxylin and eosin-stained transverse sections of eight axillary skin ellipses from five subjects were examined histologically to establish the size, position and depth of the sweat gland tissue. RESULTS: All of the patients responded to treatment: mean sweat reduction was 65% (range 40-90%). Mean follow up was 1.3 years (range 0.1-6) and sweat reduction was maintained over this period. Histological material was available from five patients: sweat glands lay slightly deeper than hair follicles; glandular tissue occupied an average thickness of 3.5 mm in the 5-mm thick piece of skin. Apocrine gland lobules were more numerous and larger than eccrine gland lobules. Both gland types were in close apposition and did not occupy distinctly different depths within the skin. CONCLUSIONS: Local surgery using limited axillary skin excision and selective sweat gland removal remains one of the safest ways of permanently reducing axillary sweating.
C M Lawrence; A A Lonsdale Eccles
Publication Detail:
Type:  Clinical Trial; Journal Article    
Journal Detail:
Title:  The British journal of dermatology     Volume:  155     ISSN:  0007-0963     ISO Abbreviation:  Br. J. Dermatol.     Publication Date:  2006 Jul 
Date Detail:
Created Date:  2006-06-23     Completed Date:  2006-10-17     Revised Date:  2007-06-25    
Medline Journal Info:
Nlm Unique ID:  0004041     Medline TA:  Br J Dermatol     Country:  England    
Other Details:
Languages:  eng     Pagination:  115-8     Citation Subset:  IM    
Department of Dermatology, Royal Victoria Infirmary, Medical School, University of Newcastle upon Tyne NE1 4LP, UK.
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MeSH Terms
Apocrine Glands / pathology,  surgery
Eccrine Glands / pathology,  surgery
Hyperhidrosis / pathology,  surgery*
Prospective Studies
Retrospective Studies
Skin / pathology,  surgery*
Sweat Glands / pathology,  surgery*
Treatment Outcome
Comment In:
Br J Dermatol. 2007 Feb;156(2):398-9   [PMID:  17223898 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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