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Botulinum toxin in the management of focal hyperhidrosis
Published in Anthony V. Benedetto, Botulinum Toxins in Clinical Aesthetic Practice, 2017
David M. Pariser, DeeAnna Glaser
To optimize treatment, the area of axillary involvement should be identified before treatment by a Minor's iodine-starch test (as previously described) so that the BoNT can be concentrated into the affected area. Although it is true that the majority of the eccrine glands in the axilla are located in the hair-bearing area of skin, often the problematic areas extend beyond the visible hair-bearing area and if these ectopic areas of eccrine glands are missed, the results of treatment may be suboptimal. The key to performing a high-quality iodine-starch test is to thoroughly dry the region before beginning the test (see Figures 9.1 and 9.2). The axilla does not need to be shaved prior to performing an iodine-starch test or to injecting BoNT.
Correlation of neurological level and sweating level of injury in persons with spinal cord injury
Published in The Journal of Spinal Cord Medicine, 2021
Michelle Trbovich, Ashley Ford, Yubo Wu, Wouter Koek, Jill Wecht, Dean Kellogg
Participants fasted for at least 3 h prior to participation. To minimize risk of nor-adrenergic sweating from AD,26 participants with SCI were: (1) asked to perform a bowel program at least 24 h prior to testing and (2) emptied their bladder within 15 min of initiating study procedures. The AB participants were also asked to empty their bladder to be sure the heat stress protocol would not be interrupted. Participants were then placed in the supine position in a hospital bed wearing a minimum of clothing (shorts only for men; shorts and bra for women) in a 35°C room. While acclimating to the environment, the iodine starch test was set up to measure SR.27,28 Based on Normell’s finding that sweating persisted a few centimeters below the NLOI in most cases of PP (no SR seen in the 6 persons with TP),12 iodine was applied over the skin 3–5 dermatomes above and 5–10 dermatomes below the NLOI (to be more thorough in looking below NLOI) for all persons with SCI. AB persons had iodine applied over the exact same skin surface as their SCI pair. After 3–5 min, which allowed for the iodine to fully dry, starch powder was evenly distributed over the surface using a previously published method.27 This starch-iodine sweat test method relies on a chemical reaction that occurs between iodinated starch powder and sweat, that turns the powder a purple color. After acclimatizing to the room for at least 15 min, a thermocouple was placed sublingually to measure baseline core temperature (Tc), while baseline blood pressure and pulse rate, were measured by Portapres. (Finipres; Enschede, Netherlands). Rate of perceived thermal strain (RPTS) was recorded using a 9-point (0–8) Likert scale at baseline and at end of heat stress protocol.29–31
Iodine–Starch test for assessment of hyperhidrosis in amputees, evaluation of different methods of application*
Published in Disability and Rehabilitation, 2018
Colby Hansen, Ben Wayment, Stephanie Klein, Bradeigh Godfrey
The iodine–starch test consists of an application of iodine, which is allowed to dry and then dusted with cornstarch. Sweat will react with the iodine and starch and produce a black/purple colour. While this test is primarily used to identify the areas of hyperhidrosis, a grading scale has been proposed for test interpretation and monitoring response to treatments [9].