[Use of oral oxybutynin at 7.5 mg per day in primary hyperhidrosis]. / Utilisation de l'oxybutynine a la posologie de 7.5 mg par jour dans le traitement des hyperhidroses primitives.

Oxybutynin is being increasingly being prescribed in the treatment of hyperhidrosis but currently, there is no precise dosage for this treatment. Nine patients were treated for primary hyperhidrosis resistant to conventional therapies with oxybutynin between January to May 2010. The treatment was progressively increased at 7.5 mg per day. Oxybutynin efficacy was evaluated by iodine starch test and biometrological measurements at 2 and 4 weeks of treatment. Hyperhidrosis Disease Severity Scale (HDSS) and Dermatology Life Quality Index (DLQI) were obtained for each patient. The means of HDSS and DLQI were respectively 3.2 +/- 0.7 and 17.0 +/- 5.1 before treatment and were 1.8 +/- 0.4 and 4.6 +/- 4.4 at 4 weeks of treatment. Oxybutynin at 7.5 mg per day significantly decreased intensity and area of sweat for palms but not for soles. Trans Epidermal Water Loss, conductance, pH and Skin temperature were modified with treatment. Oxybutynin at 7.5 mg per day has improved patient's quality of life. Efficiency of oxybutynin in primary palmar hyperhidrosis was proved by biometrological measurements and iodine starch test.

[Efficacy of diuretics in the treatment of Morbihan's disease: three cases]. / Efficacité des diurétiques dans la prise en charge thérapeutique de la maladie de Morbihan: trois cas.

BACKGROUND: Morbihan's disease (MD), also known as 'persistent facial oedema' or 'rosaceous lymphoedema', is an uncommon facial condition that is difficult to treat. Its cause remains unclear. AIM: We report three new cases of solid persistent facial oedema, which, after treatment with furosemide, showed dramatic improvement. PATIENTS AND METHODS: Three men (respectively aged 38, 66 and 76 years) presented Morbihan's disease progressing respectively for 2, 5 and 8 years. These patients presented with facial oedema, mainly affecting the eyelids. The diagnosis of MD was based on clinical and laboratory criteria (after exclusion of other aetiologies such as sarcoidosis, lupus erythematosus, facial demodicidosis and rosacea). After several unsuccessful treatments (tetracyclines, synthetic antimalarials, danazol, systemic steroids and isotretinoin), the patients received diuretics: furosemide (60 mg/d) in two cases and spironolactone 75 mg twice daily for the third patient. The patients were evaluated after 1 month, then every 3 months. RESULTS: Regression of oedema was complete or almost complete with follow-up of between 1 and 16 years. No adverse effects were reported. DISCUSSION: Treatment of Morbihan's disease remains difficult and empirical. Diuretics may be of value since they help significantly reduce swelling even if they do not definitely cure patients.