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Intradermal botulinum toxin a for peristomal hyperhidrosis: a case study.

Kristen Kalkbrenner¹, Kyle Sanniec, Lyndsey Bryant

¹Kristen Kalkbrenner, PA-C, Department of Surgery, Mayo Clinic Arizona, Phoenix. Kyle Sanniec, MHA, MA, Department of Surgery, Mayo Clinic Arizona, Phoenix. Lyndsey Bryant, PA-C, Department of Surgery, Mayo Clinic Arizona, Phoenix. Jacques Heppell, MD, Department of Surgery, Mayo Clinic Arizona, Phoenix. Heather McEntarffer, RN, WOCN, Department of Nursing, Mayo Clinic Arizona, Phoenix. Alanna Rebecca, MD, Department of Surgery, Mayo Clinic Arizona, Phoenix.

Journal of Wound, Ostomy, and Continence Nursing : Official Publication of the Wound, Ostomy and Continence Nurses Society

|September 5, 2014

Summary

Botulinum toxin A (BTX-A) injections effectively treated peristomal hyperhidrosis in an ileostomy patient. This improved pouch adherence and resolved skin damage, offering a new therapeutic option.

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Area of Science:

Dermatology
Gastroenterology
Wound Care

Background:

Peristomal hyperhidrosis presents challenges for ileostomy patients, impacting pouch adherence and leading to skin damage.
Excessive sweating around the stoma can compromise the integrity of the pouching system.

Observation:

A case study involved a patient with autonomic dysregulation causing severe hyperhidrosis, leading to ileostomy appliance adherence issues.
Intradermal injections of 200 units of botulinum toxin A (BTX-A) were administered to the peristomal skin.

Findings:

BTX-A treatment significantly improved ileostomy pouch wear time from under 24 hours to 120 hours.
Peristomal moisture-associated skin damage resolved almost completely following BTX-A injections.
The positive effects of BTX-A lasted for 3 months, with repeat injections yielding similar benefits.

Implications:

Intradermal BTX-A injections represent a promising therapeutic strategy for managing peristomal hyperhidrosis.
This treatment can enhance pouch adherence and improve the quality of life for individuals with ileostomies.
BTX-A offers a potential solution for reducing peristomal skin complications associated with excessive sweating.