Failure of Sweat Gland Curettage to Relieve Axillary Hyperhidrosis: A Salutary Lesson

Abstract

Introduction

Several treatment options are available for primary hyperhidrosis. Selection for individual patients is influenced by symptom severity, success rates and the relative risk of compensatory hyperhidrosis.

Case report

A 24-year-old female presented with a 10-year history of palmar, pedal and axillary hyperhidrosis. Following recurrent relapse after botulinum toxin (BOTOX^®) injections for axillary hyperhidrosis bilateral axillary sweat gland curettage was performed with immediate procedural success. At 6 month follow-up recurrent hyperhidrosis was reported affecting both axillae. A starch-iodine test showed a rim of persisting sweating at the periphery of both axillae.

Discussion

Curettage is generally performed without specific identification of sweat gland distribution, perhaps explaining the recurrence in this patient. In contrast, a starch–iodine test is used to guide administration of BOTOX^® for hyperhidrosis. We propose pre-operative use of this technique before axillary curettage.