Deri ve Zührevi Hastalıklar/Makale Koleksiyonu

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Psöriasisde Tamamlayıcı ve Alternatif Tıp Yöntemleri Kullanımı ve Beslenmeyle Olan İlişki: Bir Anket Çalışması
(Selçuk Üniversitesi, 2019 Ocak) İslamoğlu, Zeynep Gizem Kaya; Demirbaş, Abdullah; Demirbaş, Gözde Ulutaş; Sarı, Nihal; Zekey, Emre
Amaç: Bu çalışmayla dermatoloji polikliniğimize başvuran psöriasis hastalarının Tamamlayıcı ve Alternatif Tıp (TAT) yöntemleri hakkındaki bilgi ve yaklaşımları ile psöriasis hastalığının besinlerle olabilecek ilişkisini değerlendirmeyi amaçladık. Gereç ve Yöntem: Çalışmamız Mayıs 2018-Temmuz 2018 tarihleri arasında dermatoloji polikliniğine psöriasis nedeniyle başvuran 111 hasta ile anket çalışması olarak planlandı. Anket soruları hastalarla poliklinik ortamında yüz yüze soru-cevap şeklinde uygulandı. Bulgular: Çalışmamıza gönüllü olarak katılan 111 hastanın 58'i (%52,3) erkek, 53'ü (%47,7) kadın idi. Ankete katılanların 59’u(%53,2) herhangi bir TAT yöntemi kullanmadığını,52’si(%46,8) ise kullandığını bildirdi. Kullanan ve kullanmayanlar arasında cinsiyet, eğitim düzeyi, hastalık süresi, yaşadığı yer açısından istatistiksel olarak anlamlı farklılık saptanmadı. Ancak yaş olarak kullananların yaş ortalamasının kullanmayan gruptan anlamlı olarak düşük olduğu bulundu(t(109)=2.484; p=0.015<0,05). En sık kullanılan TAT yönteminin topikal uygulanılan bitkisel ürünler(%32,4) olduğunu belirledik. En sık kullanılan topikal bitkisel ürün kantoron yağı idi. TAT yöntemlerine en sık başvurma nedeninin yakın çevre (%63,5) olduğunu gözlemledik. %69,2’lik bir oranla sorulmadığı takdirde kullandığı TAT yöntemi ile ilgili doktora bilgi vermediği gözlendi. Hastaların %60,4’ü besinlerle hastalık arasında tespit ettikleri bir etkileşim olmadığından bahsetti. Sonuç: Katılımcıların sıklıkla bitkisel ürünleri tercih ettiği, bunları en sık yakın çevresinden duyduğu, kullandığı takdirde büyük çoğunluğunun bunu doktorundan gizlediği, TAT kullanmayan grubun psöriasis hastalığında daha yüksek olduğu ve besinlerle ilişkinin etyopatogenezde düşük bir olasılık olduğu sonuçlarına vardık.
The effects of isotretinoin therapy on the biliary system
(WILEY, 2020) Saylam Kurtipek, Gülcan; UlutaşDemirbaş, Gözde; Demirbaş, Abdullah; Sarı, Nihal; Zekey, Emre; Tuncez Akyürek, Fatma; Güngör, Gökhan
The aim of the present study was to investigate the potential effects of isotretinoin on the biliary system in patients with acne vulgaris receiving isotretinoin therapy. This was a preliminary retrospective study involving 40 patients with severe acne vulgaris who attended the dermatology clinic and were administered different doses (20 or 30 mg/day) of isotretinoin. Serum levels of AST, ALT, ALP, GGT, total bilirubin, direct bilirubin, and indirect bilirubin at the beginning and at the first month of therapy were scanned, recorded, and statistically analyzed. Total and indirect bilirubin levels at the first month of treatment in 30 patients, receiving isotretinoin at a dose of 20 mg/day, were significantly lower compared to the baseline values (p = .02 and p = .03, respectively), whereas AST and GGT serum levels were significantly higher (p = .003 and p = .006 respectively). No significant reduction in total and indirect bilirubin levels was detectable at the first month of treatment in 10 patients receiving isotretinoin at a dose of 30 mg/day; however, AST, ALP, and GGT levels were significantly elevated in these patients (p = .023; p = .004; and p = .001, respectively). To our knowledge, there is no previous study investigating the effects of isotretinoin on the biliary system, and, therefore, the present study is a preliminary one. Our findings implicate that low dose (20 mg/day) isotretinoin therapy can potentially reduce total and indirect bilirubin levels. Long-term, large-scale, prospective studies with patients receiving different doses of isotretinoin may provide more reliable information regarding the bilirubin lowering effects of isotretinoin and optimum dosing for achieving this clinical effect.
Gabapentin treatment in notalgia paresthetica: a preliminary report
(WILEY, 2020) Tan, Funda Uysal; Koc, Rabia Soylu; Durmaz, Emel Erkek Özturk; Akyürek, Fatma Tuncez
Notalgia paresthetica (NP) is an isolated sensory neuropathyinvolving the dorsal spinal nerves. The typical presentation is anitching, well-circumscribed, hyperpigmented patch located uni-laterally on the scapular region occasionally accompanied byparesthesia and/or hyperesthesia. The pathogenesis remains early because of adverse effects (severe nausea-vomiting, irri-tability-mood disturbance, and ataxia).
Evaluating nail thickness and stiffness with shear-wave elastography in nail psoriasis: A preliminary study
(WILEY, 2020) Islamoğlu, Zeynep Gizem Kaya.; Uysal, Emine.; Demirbaş, Abdullah.; Islamoğlu, Necat.
Introduction Psoriasis is a chronic, relapsing skin disease affecting millions of people worldwide. Nail changes have been reported to occur in up to 40% of patients with mild psoriasis and 50%-70% with severe disease. Shear-wave elastography (SWE) is a new non-invasive ultrasonic technique that evaluates thickness and stiffness of tissues. Aims To evaluate nail plate thickness and stiffness of patients with psoriasis and determine whether there are differences among psoriatic patients with and without nail involvement, and to investigate the feasibility of using SWE in assessing this disease. Materials and Methods Nail plate thickness and stiffness were investigated in 54 patients with psoriasis and 58 healthy controls. SWE was performed with an Aplio 500 ultrasound system. Results Increased nail plate thickness was observed more often in the affected nails of psoriatic patients compared to non-affected nails of patients and controls. Stiffness was similar in both groups. Conclusions Our study is the first report to evaluate the SWE scores in nail psoriasis. While it may not provide reliable information for diagnosis, it can be used for follow-up treatment.
Can shear wave ultrasound elastography be a useful tool for determining the tumor extent of basal cell carcinomas pre-operatively? A preliminary study
(WILEY, 2020) Unal, Mehmet.; İslamoğlu, Zeynep Gizem Kaya.; Öztürk, Mehmet.; Uysal, Emine.; İslamoğlu, Necat.
[Abstract not Available]
Second-to-fourth digit ratio and seborrheic dermatitis in males: A cross-sectional study
(Sociedade Brasileira de Dermatologia, 2019) Kaya İslamoğlu, Zeynep Gizem
Background: Seborrheic dermatitis is a common disease characterized by the erythematous plaques with oily-yellow desquamation. Increased sebaceous gland activity by androgenic hormones has played a role in the etiology of the disease. The second-to-fourth digit (2D:4D) ratio is thought to be a marker of prenatal androgen exposure. Objectives: To investigate the association between 2D:4D ratios and seborrheic dermatitis in a male population. Methods: Healthy male controls and patients with seborrheic dermatitis were included in this study. One hundred seborrheic dermatitis patients and 120 healthy controls, aged 17-59, were enrolled. A digital Vernier caliper was used to measure the finger lengths. Seborrheic dermatitis severity was assessed using the Seborrheic Dermatitis Area and Severity Index (SDASI). results: The 2D:4D ratios of the patients (x? = 0.977) were significantly lower than those of the controls (x? = 1.050) for right hands (t = 6.948; p = 0.000; > 0.05). No similar relationship was found between the 2D:4D ratio for left hands (t = 0.901; p = 0.368; > 0.05). Seborrheic dermatitis severity was negatively correlated with 2D:4D ratios of right hands (r = -0.391; p = 0.000-0.05). study liMitations: One of the main limitations of this study was the small sample, which got a head of us from acquiring certain findings about the 2D:4D ratio and seborrheic dermatitis. The other limitation is that the patient selection did not reflect the general population, as a single clinic was studied. conclusion: To the authors’ knowledge, this is the first study examining the relationship between 2D:4D ratios and seborrheic dermatitis. The result of this study may indicate a line of investigation and can support the theory of prenatal androgen exposure. © 2019 by Anais Brasileiros de Dermatologia.
Serpentine supravenous hyperpigmentation related to carboplatin and vinorelbine chemotherapy: A case report
(WILEY, 2019) Akyurek, Fatma Tuncez; Sari, Nihal; Ugurluoglu, Ceyhan; Kurtipek, Gulcan Saylam
Serpentine supravenous hyperpigmentation (SSH) is a unique type of chemotherapy-associated drug eruption, characterized by hyperpigmentation along the superficial venous network. Histopathology reveals an increase in melanin production without destruction of basal cells of the epidermis or dermal inflammatory infiltrate. Herein, we describe a patient who developed SSH after repeated intravenous infusions with carboplatin and vinorelbine; two medications that have been uncommonly reported in association with SSH previously.
Significant reduction in bilirubin levels in a patient with Gilbert's Syndrome under isotretinoin treatment for Acne vulgaris: A new area of use for isotretinoin
(WILEY, 2019) Kurtipek, Gulcan Saylam.; Sarı, Nihal.; Akyurek, Fatma Tuncez.
[Abstract not Available]
Nail digital dermoscopy in onychomycosis: a correlation with clinical type, gender, and culture examination
(ERCIYES UNIV SCH MEDICINE, 2019) Islamoglu, Zeynep Gizem Kaya; Demirbas, Abdullah; Unal, Mehmet; Findik, Duygu
Objective: Onychomycosis (OM) is a common disease that covers both tinea unguium and those remaining cases caused by yeasts, mainly of the Candida and various non-dermatophyte molds. Diagnosis is usually confirmed with direct microscopy and fungal culture. Nail dermoscopy is a non-invasive tool to diagnose various nail disorders and also to avoid time-consuming investigations. The aim of the present study was to determine the dermoscoping findings in OM and to correlate this with clinical type, gender, and culture results. Materials and Methods: This was a cross-sectional study of 100 patients diagnosed with OM according to clinical findings and direct microscopic examination. Nail dermoscopy was performed using a FotoFinder Digital Dermoscope, and images were recorded. A part of the samples was cultured in all patients. Results: The most frequent clinical type was distal lateral subungual onychomycosis (80.0%). The culture was negative in 72.0% of the samples. In the positive group, 48% of Trichophyton rubrum was cultured. The most common dermoscopic findings were longitudinal stria, ruin appearance, and longitudinal leukonychia. In culture-negative samples, irregular termination was most commonly seen. Ruin appearance, brown discoloration, hematoma, and transverse leukonychia, such as brushing, were compatible with total dystrophic OM. Conclusion: Determinative dermoscopic findings for OM, clinical types, and fungus forms were identified. These signs can avoid unnecessary mycology in selected cases.
Long-term isotretinoin use does not cause parenchymal liver change: Ultrasonographic study in 50 patients
(WILEY, 2019) Aktas, Habibullah; Ertugrul, Goksen; Parlak, Muharrem; Unal, Mehmet
The effect of isotretinoin on liver enzymes and lipid profile is reported as rare and reversible. However, possible parenchymal liver changes have not been demonstrated so far. The aim of this study was to evaluate the ultrasonography findings of the liver in patients receiving long-term isotretinoin therapy. We examined ultrasonographic findings of the liver together with serum alanin aminotransferase (ALT), aspartate aminotransferase (AST), and total cholesterol and triglyceride levels in 50 consecutive patients who have taken isotretinoin 10-40 mg daily for at least 6 months between January and December 2017. Of 50 patients examined, 40 were female, 10 were male. Mean age of the patients was 24.8 years. Five patients aged between 42 and 62 were found to have Grade 1 hepatosteatosis. Despite a moderate elevation, serum ALT, AST, and total cholesterol and triglyceride levels were in normal range in these five patients. Moreover, one patient had elevated ALT, and one another patient had elevated triglyceride level although both have normal liver ultrasonographic findings. Isotretinoin did not cause parenchymal liver changes as well as serum ALT, AST, and total cholesterol and triglyceride levels in patients who take it 10-40 mg daily for at least 6 months.
Geographic tongue that responds to the treatment of pregabalin: Can it be a new treatment choice?
(WILEY, 2019) Kurtipek, Gulcan S.; Sari, Nihal; Akyurek, Fatma T.
[Abstract not Available]
Experiences of barbed polydioxanone (PDO) cog thread for facial rejuvenation and our technique to prevent thread migration
(TAYLOR & FRANCIS LTD, 2021) Unal, Mehmet.; İslamoğlu, Gizem Kaya.; Unal, Gülbahar Ürün.; Köylü, Nihal.
Background: One of the most common nonsurgical options for facial rejuvenation is lifting using threads. Application of polydioxanone (PDO) threads is generally secure and effective procedure, but complications on the involved regions can occur. Objective: In this study, we shared our experiences of efficacy and safety of PDO thread lifting for facial rejuvenation and presented our technique to prevent the migration of threads. Materials and methods: Thirty-eight patients who underwent PDO cog treatment for facial rejuvenation were evaluated. Via 23 G/90 mm sharp needle, bidirectional barbed PDO cog thread was inserted into subcutaneous tissue. The outcomes of procedure were assessed by Global Aesthetic Improvement Scale (GAIS) and patient satisfaction. Results: Thirty-eight patients were included in this study. Mean age of participants was 39.6 +/- 7.5 years. The GAIS score showed satisfactory results (very much improved: 78.9%; much improved: 18.4%; improved: 2.6%). According to patient satisfaction, all patients were satisfied with the clinical outcomes of procedure (excellent: 76.3%; very good: 21.0%; good: 2.6%). No patient reported 'fair' or 'poor' result. Conclusions: Our results revealed barbed PDO cog thread is highly effective in facial rejuvenation. Also, tying the PDO threads in same entry point to each other seems to be an effective technique to prevent thread migration.
Evaluation of complete blood cell and inflammatory parameters in patients with alopecia areata: Their association with disease severity
(WILEY, 2019) Kaya İslamoğlu, Zeynep Gizem.; Demirbaş, Abdullah.
Background Alopecia areata (AA) is a chronic inflammatory disease characterized by non-cicatricial hair loss. The cause of the disease is still unknown. It can appear at any age and occurs in 0.2% of the general population. Red cell distribution width (RDW), mean platelet volume (MPV), plateletcrit (PCT), the ratio of neutrophils to lymphocytes (NLR), and the ratio of platelets to lymphocytes (PLR) have all been reported as inflammatory markers in recent studies. However, these parameters have not been investigated in AA patients. Aim We investigated the haematological and inflammatory parameters of AA and considered their association with disease severity. Patients/Methods One hundred and five patients with AA and 108 healthy controls were enrolled in the study. RDW, MPV, PCT, NLR, PLR, erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) were studied retrospectively. Disease severity was evaluated by using the Severity of Alopecia Tool (SALT) score. Results There were no statistically significant differences between RDW, MPV, PCT, NLR, and PLR levels in AA patients and in healthy controls. Only the CRP values were significantly higher in the AA group. Conclusion Complete blood count (CBC) parameters are low-cost tests that can be used to define inflammation levels in inflammatory diseases. Our study shows that CRP can be used as a marker in diagnosing AA.
Effects of isotretinoin on the hair cycle
(WILEY, 2019) Kaya İslamoğlu, Zeynep Gizem.; Altınyazar, Hilmi Cevdet.
Background/ ObjectivesIsotretinoin is a synthetic vitamin A agent that affects all of the pathogenic factors that suppress sebum production and play a role in the formation of acne. It is frequently used in the treatment of moderate-severe acne vulgaris. However, there are some mucocutaneous and systemic side effects that limit the use of isotretinoin. In this study, we aimed to determine the effect of isotretinoin on hair growth parameters. Material and MethodsIsotretinoin treatment at 0.5mg/kg per day dose was started to patients with moderate-severe acne vulgaris, and hair growth parameters were evaluated before treatment and after 3months of treatment. Parameters were measured by Fotofinder dermatoscopy device using the TrichoScan Professional program. ResultsIn the TrichoScan analysis, the total hair count, hair density, percentage of anagen and telogen hair, density, count, and ratio of vellus and terminal hairs in the 0.73 area were calculated. As a result, there were differences in some values between the first analysis and the second analysis. However, these differences were not statistically significant. ConclusionOur study was based on the mucocutaneous side effects of isotretinoin which are telogen effluvium and thinning hair. Our results support that the drug does not alter hair growth parameters in the short term and when very high doses are not used.
Atopic dermatitis in adults and irritable bowel syndrome: a cross-sectional study
(WOLTERS KLUWER MEDKNOW PUBLICATIONS, 2019) Kaya İslamoğlu, Z. Gizem.; Unal, Mehmet.; Küçük, Adem.
Background: Irritable bowel syndrome (IBS) is a chronic functional gastrointestinal disorder affecting a large number of people in the world. Atopic dermatitis (AD) is a common inflammatory skin condition characterized by relapsing eczematous lesions in a typical distribution. It was first described in 1933 but exists since antiquity. Aim and Objectives: To determine the relationship between AD and IBS. Materials and Methods: A total of 109 patients with AD and 100 healthy controls were included in the study. They were defined for diagnosis of IBS according to ROME-III diagnostic criteria. Supporting findings, Bristol stool scale, frequency of defecation and history of AD and IBS were also evaluated. AD severity was assessed using Severity Scoring of Atopic Dermatitis index. Results: A total of 62 patients (56.9%) in the AD group and 28 patients (28%) in the control group were diagnosed with IBS (P<0.001). Supportive findings excluding abnormal stool frequency and passage of mucus were more frequent in AD patients. There was no significant relationship between disease severity according to SCORAD index and variables in AD patients. Conclusions: This is a rather uncultivated area in the field of AD. We observed that IBS was more common in AD group. Also, supporting findings like abnormal stool form, abdominal distension, feeling of incomplete evacuation, and straining were found more frequently in AD patients. These results may indicate the association between AD and IBS. In our opinion, patients with atopic dermatitis should be questioned in terms of IBS.
Tıp Fakültesi Öğrencilerinin Melanositik Nevusler, Dermoskopi ve Güneşten Korunma İle İlgili Bilgi, Tutum ve Görüşlerinin Değerlendirilmesi
(2019) İslamoğlu, Zeynep Gizem Kaya; Demirbaş, Abdullah
Amaç: Bu çalışmayla klinik branşlara geçiş yapmış Tıp Fakültesi öğrencilerinin melanositik nevuslar, dermoskopi ve güneşten korunma ile ilgili bilgi ve görüşlerinin değerlendirilmesi, bu bilincin tıp eğitimi sırasında kazanılıp kazanılmadığının belirlenmesi amaçlanmıştır.Gereç ve Yöntemler: Çalışmamız Haziran-2018 tarihinde Tıp Fakültesi Dönem-3, 4, 5 ve 6 öğrencilerine tarafımızca hazırlanan demografik verileri, nevuslar, dermoskopi, güneş ve güneşten korunma ile ilgili bilgileri ölçmeye yönelik 30 sorudan oluşan anket çalışması olarak planlandı. Veriler SPSS 22.0 programı kullanılarak, istatistiksel anlamlılık düzeyi p0,05 olacak şekilde değerlendirildi.Bulgular: Çalışmamıza 187 öğrenci katıldı. %46,5’i erkek, %53,5’i kadın idi. Yaş ortalaması 23,0751,795 olarak bulundu. Öğrencilerin büyük çoğunluğu melanositik nevus denilince ilk akla edinsel melanositik nevus geldiğini, atipik nevusların malign melanom riski taşıdığını, her benin kansere dönüşmeyeceğini ve benlerin alınmasının tehlikeli olmadığını bildirdiler. Büyük çoğunluğu dermoskopi kelimesini duymuştu, ancak ne işe yaradığını bilmiyordu. Yine büyük çoğunluğu ben ve dermoskopi muayenesi kendine ve yakınlarına hiç yaptırmamıştı. Büyük oranda güneşten korunuyorlardı, ancak güneşten koruyucu krem kullanım oranı ve kullanma sıklığı düşüktü. Güneşten koruyucu kremler hakkındaki bilgi düzeyleri de düşük –orta düzeydeydi. Genel olarak dönem arttıkça, özellikle dermatoloji stajının alındığı Dönem-5 öğrencilerinde soruların doğru cevaplanma oranı daha yüksekti.Sonuç: Öğrencilerimizin nevuslar, deri kanserleri ve kanser gelişimi için risk faktörleri, güneşten korunma konusundaki bilgilerinin orta-iyi düzeyde, dermoskopi ile ilgili bilgilerinin zayıf olduğu görüldü. Tıp eğitimi sırasında bu konuların sadece dermatoloji stajında değil de, diğer dönemlerde de ara ara işlenmesi bu konudaki eksikliği azaltmakta ve öğrencilerimizin daha iyi bilinçlenmesinde faydalı olabilir görüşündeyiz.
Leukonychia is the Most Common Nail Change in Alopecia Areata Patients: A Retrospective Study in 207 Patients
(2019) Aktaş, Habibullah; Ünal, Mehmet
Aim: Alopecia areata is an auto-immune skin disease characterized by non-scarring hair loss. Nail changes are strongly associatedwith prognosis. In patients with Alopecia areata, the nail examination should not be neglected for an optimal follow-up.Material and Methods: A retrospective study involving 207 patients with Alopecia areata was undertaken in a tertiary hospitalbetween April 2016 and May 2017. Patients whose nail changes were registered in the database were included in the study. Gender,age, disease severity, sites affected, and nail changes of those patients were noted.Results: 114 patients (55%) had nail involvement. The most common nail finding was leukonychia (n 84). Nail pitting was detectedin 29 patients.11 patients had both leukonychia and nail pitting. The mean age of the patients with leukonychia was 23.3, while themean age of nail pitting patients was 31.7 and the mean age of the patients without nail change was 34.1.Conclusion: Leukonychia is the most common nail change in this study, as a different finding from all previous studies
Cutenous sarcoidosis, mimicking acne in a patient and the importance of dermoscopy in different diagnosis
(Yuzuncu Yil Universitesi Tip Fakultesi, 2018) İslamoğlu, Zeynep Gizem Kaya; Demirbaş, Abdullah
Sarcoidosis is a multi-systemic granulomatous disease of unknown aetiology. After the lungs, the skin is the second most common organ involved. Cutaneous involvement occurs in up to 30% of patients and skin findings are often the initial presenting symptom. Plaques and papules are the most commonly observed cutaneous lesions. Sarcoidosis can be mimicing other diseases. Dermoscopy is a non-invasive method that allows skin lesions to be visualized. In recent years, it is used for increasing diagnostic accuracy in many skin diseases. Sarcoidosis is one of these diseases. We present a case of 50 year old man, with erythematous maculopapules over the front of chest for about two years. He was treated like acne but had no benefit from therapies. Cutaneus sarcoidosis was diagnosed at the end of t he dermoscopic, clinical and histopatological examination of patient. Here, we emphasized that, sarcoidosis can interfere with many skin diseases and dermoscopy is a non-invasive method that can be used before biopsy in the differential diagnosis. © 2018, Yuzuncu Yil Universitesi Tip Fakultesi. All rights reserved.
The association of abo blood groups and serum ferritin levels with telogen effluvium in women
(2018) Kaya, Zeynep Gizem İslamoğlu
Aim: Telogen effluvium(TE) in women is a common problem in dermatology and has multiple etiologic causes. Low iron storescan be a possible contributing factor in TE. Although etiopathogenesis is not fully understood, many studies show remarkableassociations between various diseases and ABO blood groups. Genomewide association studies have reported alleles in the ABO locus to be associated with ferritin levels. We had done this study with TE patients to detect serum ferritin levels and to find this relation between blood groups.Material and Methods: Healthy people and patients with TE were included in this study. A total of 103 females who have telogen effluvium and 125 controls were included.Results: ABO blood group and Rhesus factor distribution in patients with TE and distribution of healthy donors were similar. There haven’t any significant association between ferritin levels and blood groups in TE patients.Conclusion: There are many different causes in TE etiology, for this reason in our opinion, ferritin levels and other laboratory tests must be done. We conclude that there was no evocation between ABO blood groups, Rhesus factor and ferritin levels in TE, but this is the first study that can show this relationship and can be important for new studies which will be carried out in other centers with wider series.
Hiperhidrozis tedavisi
(2014) Apilioğulları, Burhan; Bilgiç, Özlem
Hiperhidrozis, patolojik kabul edilebilecek kadar ciddi, lokalize veya genel, aşırı terleme ile karakterize bir durumdur. Bu durum ha- yatın sosyal ve mesleki kalitesi üzerinde olumsuz etki eden önemli bir stres kaynağı olabilir. Eller, koltuk altı, ayaklar ve yüzü etkileyen primer hiperhidrozisin tedavisi hakkında tartışmalar mevcuttur. Cerrahi olmayan tedavi, topikal ilaçlar, iyontoforez ve sistemik anti- kolinerjikleri içerir. Son zamanlarda, intradermal botulinum toksini kullanımı popülarite kazanmıştır. Günümüzde, torasik sempatik cerrahi uygulaması primer hiperhidrozisli hastalar için altın standarttır.

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