Session Title: Section Info: Annual Assembly Posters (Non Presentations)
Session Time: 11:15am-12:45pm
Location: Research Hub - Kiosk 8
Disclosures: Krystal N. Yankowski, DO: Nothing to disclose
Case Description: A 59-year-old male veteran who sustained a traumatic left transfemoral amputation secondary to an IED blast in Iraq in 2005, presented with hyperhidrosis of his left residual limb. Due to hyperhidrosis, he developed skin breakdown, decreased prosthetic wear time, impaired function and decreased quality of life. Though not FDA approved, he underwent chemodenervation of the eccrine glands of his residual limb with botulinum toxin type A. He was injected with 100 units of botulinum toxin type A into the subcutaneous tissue of the residual limb. He continued to return at 4-5 month intervals for repeat therapy which he reported a 100% reduction in perspiration from the limb 5 months after the initial injection therapy. He noted that with the reduction in perspiration, he had an increase in prosthetic wear time which allowed him to perform recreational activities without issue and overall improved his quality of life.
Setting: Outpatient botulinum toxin injection clinic
Patient: A 59-year-old male veteran who sustained a traumatic left transfemoral amputation secondary to an IED blast in Iraq in 2005.
Assessment/Results: Assessment on hyperhidrosis improvement was measured with the hyperhidrosis disease severity scale (HDSS), which was completed before the botulinum toxin injections and was also assessed at follow up appointments.
Discussion: Botulinum toxin type A is currently FDA approved for the treatment of severe hyperhidrosis only in the axillary region. This case illustrates the benefit of using botulinum toxin type A to treat hyperhidrosis of residual limbs of amputees.
Conclusion: Botulinum toxin type A was successfully used to perform chemodenervation of eccrine glands in the residual limb of this amputee to treat hyperhidrosis. HDSS went from a 3 to a 1 and prosthetic wear time increased by 2-4 hours. This procedure successfully increased wear time of his prosthetic, improved patient’s function and lead to an overall increased quality of life of this amputee.
Level of Evidence: Level V
To cite this abstract in AMA style:Yankowski KN, Mortazavi E, Mccarthy M. Eccrine Gland Chemodenervation of Hyperhidrosis Management of an Amputee’s Residual Limb [abstract]. PM R. 2019; 11(S2)(suppl 2). https://pmrjabstracts.org/abstract/eccrine-gland-chemodenervation-of-hyperhidrosis-management-of-an-amputees-residual-limb/. Accessed September 24, 2023.
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PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/eccrine-gland-chemodenervation-of-hyperhidrosis-management-of-an-amputees-residual-limb/