• Archives of Plastic Surgery
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• v.35 no.5
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• pp.569-573
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• 2008

Purpose: Surgical excision of the subcutaneous tissues, with or without skin excision in the axillary hair-bearing area, has been the treatment of choice in treating osmidrosis for several decades. However, long periods of postoperative immobilization of a shoulder joint, partial necrosis of skin flaps or the possibility of hematoma and scars have occurred frequently. So we used $XPS^{(R)}$ microresector(Shaver) in procedure which requires removal of soft tissue for comparing results between surgical excision and the laters. Methods: From January 2007 to February 2008, a total of 20 patients(8 male and 12 female) underwent $XPS^{(R)}$ microresector(Shaver) assisted aspiration for treating osmidrosis. The mean age of the subjects was 21.9, and we tried to analyze some advantages of $XPS^{(R)}$ microresector(Shaver). Results: The average operation time was 61.6 minutes. This results can show that the patients who received $XPS^{(R)}$ microresector(Shaver) assisted aspiration can accomplish better outcomes than any other procedures in terms of operation time at least. Moreover, no significant postoperative complications occurred in our studies. Subjects have been followed up from 2 months to 1 year and among these patients, no one suffered from critical complications. Conclusion: In brief, $XPS^{(R)}$ microresector(Shaver) is able to shorten the time of operation and simplify the procedures relatively and this device has more superiorities in wound healing by maintaining of vascularized dermal skin flaps. It means that $XPS^{(R)}$ microresector (Shaver) can prevent flap necrosis, axillary hair loss and minimalize scarring and bleeding. Thus, we expect that these advantages can lead to better patient's comfort and self-confidence than several previous procedures.

• Archives of Plastic Surgery
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• v.40 no.4
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• pp.440-444
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• 2013

Background Axillary osmidrosis is characterized by unpleasant odors originating from the axillary apocrine glands, resulting in psychosocial stress. The main treatment modality is apocrine gland removal. Until now, of the various surgical techniques have sometimes caused serious complications. We describe herein the favorable outcomes of a new method for ablating apocrine glands by minimal subdermal shaving using sclerotherapy with absolute ethanol. Methods A total of 12 patients underwent the procedure. The severity of osmidrosis was evaluated before surgery. Conventional subdermal shaving was performed on one side (control group) and ablation by means of minimal subdermal shaving and absolute ethanol on the other side (study group). Postoperative outcomes were compared between the study and control groups. Results The length of time to removal of the drain was 1 day shorter in the study group than in the control group. There were no serious complications, such as hematoma or seroma, in either group, but flap margin necrosis and flap desquamation occurred in the control group, and were successfully managed with conservative treatment. Six months after surgery, we and our patients were satisfied with the outcomes. Conclusions Sclerotherapy using absolute ethanol combined with minimal subdermal shaving may be useful for the treatment of axillary osmidrosis. It can reduce the incidence of seroma and hematoma and allow the skin flap to adhere to its recipient site. It can degrade and ablate the remaining apocrine glands and eliminate causative organisms. Furthermore, since this technique is relatively simple, it takes less time than the conventional method.

• Archives of Plastic Surgery
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• v.36 no.6
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• pp.727-734
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• 2009

Purpose: The Inaba's procedure, the treatment of osmidrosis axillae, has the advantages of low recurrent rate and easy to learn, yet it produces early postoperative discomfort and scar formation by tie - over dressing. The authors modified the Inaba's procedure by using delayed suture of the incision wound and omitting tie - over dressing. The comparative study of Inaba's procedure and its modification was performed to confirm the advantages of modified procedure. Methods: The study contains the retrospective analysis of the medical records of 296 patients with osmidrosis who were treated using the Inaba's procedure from December, 1996 to February, 2007. The study also contains the prospective analysis of 20 patients, from March, 2007 to July, 2008, who were treated by the modified Inaba's procedure with delayed suture of the incision wound and gentle pressure dressing instead of tie - over dressing. The operative results of two groups were compared and verified by Mann - Whitney U test(SPSS 12.0). Results: The incidence of complications was 14.5% in the Inaba's procedure, whereas 6.2% in the modified Inaba's procedure. Both procedures have the same basic surgical procedure in terms of the location of incision site and subdermal shaving of the sweat glands, and therefore similar good results were obtained in the aspect of postoperative axillary odor, recurrent rate and postoperative condition of axillary hair. Certainly, the modified Inaba's procedure had better outcome in each element of PSS(Patient Scar Self-Rating Scale), compared to the Inaba's procedure. In addition, the modified Inaba's procedure showed a statistical significance in dressing - related pain reduction and overall satisfaction. Conclusion: The modified Inaba's procedure had advantages of decreased early postoperative complications such as hematoma, discomfort and pain caused by tie - over dressing, and decreased scar formation. However, the drawback was delayed suture of the incision wound after 48 hours.

• Archives of Plastic Surgery
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• v.32 no.6
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• pp.723-726
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• 2005

Osmidrosis axillae is a distressing problem characterized by foul odor at the axillae due to excessive apocrine sweat gland secretion. We introduce a new non-surgical method using a specially insulated needle and high frequency electrocoagulator. From September 2001 to January 2005, 52 patients were treated with this procedure for osmidrosis axillae. In authors' procedure, insulated needle which was designed to protect skin and dermal layer was inserted into the deep dermis of axilla area and apocrine sweat glands were removed by electrocoagulation. Fifty two patients were evaluated more than 6 months after surgery. Among these patients, 48 patients received secondary coagulation procedure. After second operation, all patients were satisfied with postoperation results. We conclude that our method has several advantages such as 1) short operation time, 2) no necessity of postoperative immobilization of shoulder joints, 3) no need of hospitalization, 4) minimal scarring and no bleeding, 5) prevention of skin necrosis, 6) a safer operative method for recurred cases as a secondary method.

• Journal of Korean Neurosurgical Society
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• v.37 no.4
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• pp.272-274
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• 2005

Objective: Surgical treatment of focal axillary hyperhidrosis is often unsatisfactory because of compensatory hyperhidrosis. The purpose of this study is to evalute the effect of decreased sweating production using 20% aluminum chloride on axillary hyperhidrosis. Methods: From February to December, 2002, 10 patients (mean age 25.2 male 2, female 8) with clinical diagnosis of axillary hyperhidrosis were treated by 20% aluminum chloride solution. Until the desired degree of symptom relief was obtained, they were educated to apply every day and thereafter, the agent would be applied as often as is necessary. We analyzed patient's satisfaction and application time at onset of desired dryness, application interval to maintain the relief of symptom and side effects. Results: Aluminum chloride solution was effective in treatment of axillary hyperhidrosis showing excellent result in 60% of patients and good in 40%. Application time at onset of desired dryness ranged from 1 to 6 days(mean 3 days). Application interval to maintain the relief of symptom ranged from 5 to 45 days(mean 12 days). There were no significant complications but just mild irritation and miliaria in seven patients. Conclusion: 20% aluminum chloride solution is the simple, safe and less expensive method for initial treatment for axillary hyperhidrosis not accompanying osmidrosis.

• Archives of Plastic Surgery
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• v.32 no.3
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• pp.314-318
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• 2005

For treatment of full thickness skin defects caused by trauma or infections, skin grafts or flaps have been the treatment of choice to date. However, in patients who are not candidates for surgery, either due to his general conditions or refusal to receive treatment, supportive methods have been the only means of care, which inherently caused psychological trauma to the patient due to uncertainties of ultimate outcome and the length of treatment. This study aimed to heal full thickness skin defects through application of topical epidermal growth factor in patients who have received 2 to 3 weeks of conservative management using medifoam $B^{(R)}$ without improvement. Six patients from March 2002 to July 2004 were enrolled. The mean size of defects was $5.4{\times}4.6cm$ in 4 patients with carcinoma and $6.4{\times}4.1cm$ in 2 patients with osmidrosis. Commercially available 0.005% EGFR solution was used, and dressing was performed once daily. All patients benefitted from the use of EGF, with closure of skin defects taking an average of 28 days in cancer patients and 22.5 days in osmidrosis cases. EGF can be used as a supportive mean of treatment in the inoperable patients with skin defects, with resultant hastening of healing shortening duration of treatment.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.17 no.2
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• pp.31-38
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• 2004

This study was carried out to investigate the effects herbal extracts on the skin inflammatory reactions. Among the herbal ingredients of herbal extracts, ethanol extract of Glycyrrhizae Radix showed potent radical scavenging activity, more than 86$\%$ at a concentration of 0.01$\%$, tested by DPPH(I,1-diphenyl-2-picryl-hyrazyl) method. And ethanol extract of Aurantii Immaturus Fructus inhibited the lipopolysaccharide-induced release of nitric oxide(NO), 99$\%$ at 50㎍／㎖, by the macrophage RAW 246.7 cells. In addition, the ethanol extracts of Sophorae Radix, Glycyrrhizae Radix showed antibacterial activities on Propionibacterium acnes that causes acne, Sophorae Radix, Glycyrrhizae Radix and Aurantii Immaturus Fructus on Corynebacterium xerosis that cause osmidrosis axillae, Glycyrrhizae Radix and Aurantii Immaturus Fructus on Staphylococcus aureus that was reported to cause impetigo and atopic disease. Taken together, I expect that herbal extracts may be used as a drug for treatment on skin inflammation.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.17 no.2
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• pp.39-47
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• 2004

This study was carried out to investigate the effects YSTG on the skin inflammatory reactions. Among the herbal ingredients of YSTG, ethanol extracts of Cinnamoni Ramulus, Polygoni Avicularis Herba and Scutellariae Radix showed potent radical scavenging activity, more than 90$\%$ at a concnentration of 0.01$\%$, tested by DPPH(I,1-diphenyl-2-picryl-hyrazyl) method. And ethanol extract of Saussureae Radix inhibited the lipopolysaccharide-induced release of nitric oxide(NO), 86$\%$ at 50㎍／㎖, by the macrophage RAW 246.7 cells. In addition, the ethanol extracts of Cinnamoni Ramulus and Polygoni Avicularis Herba showed antibacterial activities on Staphylococcus aureus that was reported to cause impetigo and atopic disease, Cinnamoni Ramulus, Saussureae Radix and Plantaginis Semen on Propionibacterium acnes that causes acne, and Cinnamoni Ramulus on Candida albicans that causes cadidiasis, Saussureae Radix on Corynebacterium xerosis that cause osmidrosis axillae. Taken together, I expect that YSTG may be used as an effective drug for treatment on skin inflammation.

• Journal of Chest Surgery
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• v.36 no.4
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• pp.297-299
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• 2003

Thoracoscopic syrnpathicotomy is effective in treating not only palmar hyperhidrosis, but, also in treating axillary hyperhidrosis. In previous studies in Korea, sympathicotomy was focused on combinations including the End to 4th sympathetic chains (R2, 3, 4). Using a minimally invasive technique, the results of sympathicotomy of the 4th and 5th chains (R4, 5) of five patients, from February to August, 2002, for axillary hyperhidrosis without osmidrosis, were reviewed. All patients had a successful operation, their profuse sweating ceased. Three patients suffered from some degree of compensatory sweating. Among the three patients, only one patient suffered from moderate compensatory sweating over his back and thighs. Thoracoscopic R4, 5 sympathicotomy offers a very appealing method in the treatment for axillary hyperhidrosis in patients who have profuse axillary sweating.

• Clinical Pain
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• v.20 no.2
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• pp.135-140
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• 2021

MiraDry^®, a microwave thermolysis device, is comparably new non-surgical agent in the field of eradication of sweat glands for treating axillary hyperhidrosis and osmidrosis. So far, altered sensation, swelling, and compensatory sweating are widely known as adverse effects of MiraDry^®. Of the few reported MiraDry^®-induced neuropathy cases, median and ulnar neuropathies are common. Although, one case has described radial nerve and posterior cord damage with maximized stimulation intensity, musculocutaneous nerve damage induced by MiraDry^® has not been reported. Here, we report a case of a 30-year-old woman experiencing left hand weakness after receiving MiraDry^® at a local dermatology clinic. Left brachial plexopathy, mainly involving the median nerve and the musculocutaneous nerve with partial axonotmesis, was confirmed by electrodiagnostic studies. Ultrasound evaluation showed corresponding results. This is the first case report of the musculocutaneous neuropathy by MiraDry^®.