| Background and Objective:The axillary bromhidrosis(AB),commonly known as “body odor”,is characterized by bilateral underarm sweating and an unpleasant odor.It is believed that the unpleasant odor is related to unsaturated fatty acid which is secreted by the secretion of apocrine glands via surface bacterial decomposition in local microenvironment in the armpit.It has severely affects the professional,academic,and social aspects of the patient,leading to his work deficits,delirium,and depressive symptoms.Studies have shown that the odor is familial and occurs mostly in young people,with a male to female ratio of 1:1.4.In China,the incidence rate is as high as 6.41% according to the survey.The usual treatment methods for underarm odor include topical drugs,local injections of drugs,local botulinum toxin treatment,laser therapy,high-frequency microneedle electrolysis and other non-surgical methods and subcutaneous pruning,subcutaneous pruning,suction and curettagewith tumescent anaesthesia,intermediate-thickness skin grafting and other surgical methods.These treatments have limited efficacy and obviousside effects.This study used BTX-A to treat AB and observed its efficacy and side effects in order to provide more clinical reference for BTX-A as a treatment method and therapeutic dose for the treatment of AB.Methods:Twelve patients with AB were selected from our clinic.Patients were asked to remove their armpit hair and to wear a thin cotton shirt at the time of treatment one week before treatment.The room temperature is adjusted to about 25°C.After the patient sat down without activity for15 minutes,the degree of odor was subjectively assessed by the same two individuals according to the score criteria and scored.We selected 9points in a 9-point method in the sweat gland secretion zone of the patient’s axilla,and gave 2.5 U/point to the 8 patients in the A group and5 U/point to the 9 patients in the group B.Before treatment,patients were scored at 2 weeks,2 months,and 6 months after treatment.Efficacy evaluation criteria:(1)Recovery: odor symptom disappear entirely(x→0);(2)Significantly effective: Significant reduction in odor(3→1);(3)Effective: Slight reduction in odor(3→2 or 2→1);(4)Invalid: The odor is not reduced(x→x).Total effective rate =[(Recovery + Significantly effective)cases/total number of cases].SPSS22.0 statistical software was used for analysis.The measurement data were compared by rank test and expressed in medians and quartiles.The difference was statistically significant when lower 0.05.Result:1.Clinical efficacyCompared with baseline values before treatment,17 cases of AB patients treated with BTX-A had reduced the severity of stench during the follow-up period.At the follow-up period of 6 months,37.5% of subjects were responders,of which 12.5% were cured,25% showed significantly effective,and 25% showed effective in group A.88.89% of subjects were responders,of which 55.56% were cured,33.33% showed significantly effective in group B.The score was 2.63(2.00-3.00)before treatment,and the score was0.88(0.00-1.75),1.50(1.00-2.75),1.63(1.00-2.75)at two weeks,two months and six months after BTX-A treatment in group A.The effects of two weeks and two months had statistically difference compared with that before treatment(P<0.05).After 6 months,the curative effect still existed,but there was a obviously decrease compared with the previous.The score before treatment was 2.67(2.00-3.00)in group B,and the score at 2 weeks,2 months after BTX-A treatment was 0.44(0.00-1.00).The score was 0.56(0.00-1.00)after six months after BTX-A treatment.The difference was statistically significant before treatment(P< 0.05).Before and after treatment in groups A and B,scores of 2 weeks,2months and 6 months were compared,P values were <0.05,and the differences were significant;P(group A and B)<0.05 at 2 months and 6months after treatment.The results showed that there was a significant difference in the results after treatment between group A and B.The treatment effect of group B was significantly better than that of group A.2.Side effectsLocal pain during treatment was a common side effect of all patients with AB.One patient(2.5 U per point)was fatigued and dizzy during treatment.After BTX-A treatment,there were no adverse reactions during follow-up.Conclusion:1.It is confirmed that BTX-A is effective in the treatment of AB.2.The effect of injection dose 5U per point is better than 2.5U per point.3.The effect of BTX-A can last 6 months.4.BTX-A was safe in the treatment of AB,and the side effects of5 U per point did not increase than 2.5U per point. |
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