Thesis (M.Sc.) -Cairo University, 2024.

Bibliography: pages 61-72.

Primary palmar hyperhidrosis (PH) tends to arise in childhood or adolescence and
usually persists throughout life. Despite its unknown origin, it is attributed to localized
sympathetic hyperactivity on otherwise normal eccrine sweat glands, mainly triggered by
emotional or thermal stimuli.
Objective: To evaluate the therapeutic efficacy, tolerability and side effects of the low
concentration (1%) versus high concentration of aluminium chloride hexahydrate (20%)
iontophoresis for primary palmar hyperhidrosis.
Patients and Methods: Thirty patients of both genders who established diagnosis of primary
palmar hyperhidrosis with age ranged 10-30 years were selected randomly from dermatology
outpatient clinic of Ain Shams General Hospital, Cairo, Egypt. The included patients were
randomly distributed into two equal groups in number; Group (A) consisted of 15 patients (6
males and 9 females) with palmar hyperhidrosis were treated with iontophoresis of low
concentration 1% aluminum chloride for 3 days per week for 4 weeks. Group (B) consisted of 15
patients (7 males and 8 females) were treated with iontophoresis of high concentration 20% of
aluminium chloride hexahydrate at the same time.
Outcomes: The primary outcome was reduction of sweating rate in palmar hyperhidrosis using
low concentration 1% of aluminum chloride hexahydrate with longer endurance and no skin
irritation compared to high concentration 20%, which was measured by using gravimetric test,
iodine- starch test and hyperhidrosis disease severity scale (HDSS).
Results: Both groups of the study showed a significant decrease in hyperhidrosis from the
3rd day until the 4th week post-treatment (p < 0.05) throughout the follow-up period. The result
revealed percentage of improvement in group (A) was 1.1% while group (B) was 1.3% for
gravimetric measure. Also, percentage of improvement in group (A) was 1.4% while group (B)
was 1.6% for HDSS measure but with more side effects like dermatitis and low endurance, some
patients might stop the treatment sessions.
Conclusion: Iontophoretic application of low concentration 1% of aluminum chloride
hexahydrate is shown to considerably reduce the palmar sweating rate with long endurance and
no skin irritation compared to high concentration method (20%)

تم اختيار ثلاثين مريضا من كلا الجنسين ممن تم تشخيص اصابتهم بفرط تعرق راحة اليد الأولى تتراوح اعمارهم بين10و30 عاما بشكل عشوائي من العيادة الخارجية للامراض الجلدية بمستشفى عين شمس العام، القاهرة، مصر، تم توزيع الموضوعات المشمولة بشكل عشوائى الى مجموعتين متساويتين فى العدد،المجموعة(أ) تتكون من 15 مريضا (6ذكورو9إناث) يعانون من فرط تعرق راحة اليد وتم علاجهم بانتقال الأيونات بالكهرباء بتركيز منخفض 1% كلوريد الألومنيوم لمدة 3 ايام فى الاسبوع لمدة 4 اسابيع المجموعة (ب) تتكون من 15 مريضا (7ذكور و8 إناث) تم علاجهم بإنتقال الايونات بالكهرباء بتركيز عال 20% من كلوريد الالومنيوم سداسى هيدرات فى نفس الوقت. الخلاصة إن التطبيق الايونى للتركيز المنخفض 1% من سداسى هيدرات كلوريد الالومنيوم يقلل بشكل كبير من معدل تعرق راحة اليد مع التحمل الطويل وعدم تهيج الجلد مقارنة بطريقة التركيز العالى (20%).

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