Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with primary axillary hyperhidrosis characterized by excessive, uncontrollable sweating localized to the axillae. Symptoms are bilateral, persistent, and interfere with daily activities and social interactions. Onset during adolescence/early adulthood. No history of secondary causes (e.g., thyroid dysfunction, malignancy, or medication-induced). Patient reports frequent staining of clothing and psychological distress.
Clinical Examination Findings
Axillary examination reveals visible moisture, maceration of the skin, and staining of the patient's clothing. Hyperhidrosis Disease Severity Scale (HDSS) score: [1-4]. Minorโs starch-iodine test performed, demonstrating a hyper-secretory area of [X] cm by [Y] cm. No signs of secondary infection, fungal dermatitis, or axillary lymphadenopathy. Skin integrity is intact despite chronic moisture.
Treatment Protocol
Treatment plan initiated for Axillary Hyperhidrosis: 1. Topical antiperspirants (Aluminum Chloride Hexahydrate 20%). 2. Botulinum Toxin Type A injections (onabotulinumtoxinA) administered via intradermal grid pattern (approx. 50 units per axilla). 3. Discussion of surgical options including suction-curettage or endoscopic thoracic sympathectomy (ETS) if conservative measures fail. Follow-up scheduled in 2 weeks to assess efficacy and potential side effects.