Inguinal hyperhidrosis misdiagnosed as urinary incontinence: treatment with botulinum toxin A

Hyperhidrosis is a psychosocially embarrassing condition with a treatment history of varied success, including topical application of antiperspirants with aluminum salts (e.g., Drysol), oral anticholinergics, iontophoresis, and endoscopic transthoracic sympathectomy. The use of botulinum toxin type A (Botox) in humans for the treatment of hyperhidrosis didn't emerge until 1996. Botulinum toxin A is a safe and effective treatment for hyperhidrosis, and it has been shown to improve the quality of life in affected patients. The toxin works by inhibiting the release of acetylcholine at the neuromuscular junction, and affecting the postganglionic sympathetic innervation of sweat glands. The authors report a case of inguinal hyperhidrosis treated with botulinum toxin A. Very few cases with similar treatments have been found in the medical literature. More work should be done to find the optimal dose for treating this area, and affected patients should be informed of the potential benefits of botulinum toxin therapy.