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Zakażenia i maceracja skóry możliwymi powikłaniami nadpotliwości

Karolina2 273 komentarze
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Infekcje grzybicze i bakteryjne, maceracja skóry – to niektóre powikłania mogące dotykać osoby z nadpotliwością. W przypadku szczególnie nasilonych objawów nadpotliwości konieczne jest leczenie chirurgiczne polegające na wycięciu gruczołów potowych lub przerwaniu ciągłości włókien nerwowych.

Pacjenci, którzy cierpią na nadpotliwość doświadczają nadmiernej produkcji potu, wykraczającej poza potrzeby fizjologiczne, która nasila się w sytuacjach stresowych i przy wysokiej temperaturze otoczenia. Pot występuje na skórze w okolicach pach, dłoni, stóp i twarzy lub na owłosionej skórze głowy.

Objawy i powikłania nadpotliwości

Chorzy na nadpotliwość pocą się często i obficie, a pot niejednokrotnie przesiąka przez ubranie.

Nadpotliwość może prowadzić do:

  • maceracji skóry spowodowanej utrzymującym się zawilgoceniem – największe ryzyko powstania maceracji obserwuje się u pacjentów z nadpotliwością stóp, mniejsze w przypadku pach i dłoni;
  • grzybicy stóp z towarzyszącym brzydkim zapachem;
  • infekcji paznokci;
  • brodawki HPV, które rozwijają się w środowisku wilgotnym;
  • infekcji bakteryjnych;
  • infekcji grzybiczych;
  • wysypki skórnej, która powstaje wskutek zablokowania przewodów potowych;
  • zaostrzenia innych chorób skórnych, np. łuszczycy.

Leczenie nadpotliwości

Nadpotliwość w praktyce klinicznej leczy się ogólnoustrojowo, np. z zastosowaniem preparatów hamujących czynność układu przywspółczulnego, takich jak leki parasympatykolityczne, albo środków neurotropowych, np. hydroksyzyny.

Terapię przeprowadza się również miejscowo – podając zasypki zawierające kwas borowy, sole metali lub roztworów formaliny. W praktyce klinicznej stosuje się także miejscowe leki antycholinergiczne, np. glikopirolan, który ogranicza potliwość.

Leczenie laserem, radiofrekwencją, mikrofalami i botoksem

Gabinety medycyny estetycznej oferują szeroką ofertę nowoczesnego leczenia nadpotliwości.

Pacjenci mogą zdecydować się m.in. na leczenie laserowe, które polega na wykonaniu niewielkiego nacięcia na skórze i wprowadzeniu cienkiej głowicy ze światłowodem. Laseroterapia prowadzi do nieodwracalnego zniszczenia gruczołów łojowych i potowych. Zabieg laserowego leczenia nadpotliwości wykonywany jest w znieczuleniu miejscowym. Możliwe powikłania po zabiegu to oparzenia i powstawanie blizn.

Kolejnym rozwiązaniem jest zabieg z wykorzystaniem fal radiowych, które kierowane są na gruczoły potowe. Lekarz wprowadza pod skórę kaniulę, która emituje radiofrekwencję. Dochodzi do podgrzania tkanki, a w efekcie do trwałego zablokowania gruczołów potowych.

Inne dostępne metody leczenia to promieniowanie elektromagnetyczne, które trwale uszkadza gruczoły potowe i hamuje wydzielanie potu, a także iniekcje z botoksu, który redukuje wydzielanie potu na około 6 miesięcy.

Operacyjne leczenie nadpotliwości

Sympatektomia to zabieg chirurgiczny polegający na przerwaniu ciągłości włókien nerwowych leżących wzdłuż rdzenia kręgowego, w klatce piersiowej lub w odcinku lędźwiowym. Operację wykonuje się u pacjentów, u których objawy są szczególnie nasilone. Zabieg wykonuje się metodą endoskopową pod kontrolą wideo. Chirurg za pomocą nożyc połączonych z endoskopem przecina zwoje nerwowe. Efekt sympatektomii to rozszerzenie naczyń krwionośnych i zmniejszenie wydzielania potu. Operacja obarczona jest ryzykiem wystąpienia powikłań takich jak:

  • nadmierna potliwość w innych częściach ciała;
  • pocenie po spożyciu pikantnych potraw;
  • pocenie fantomowe;
  • zakażenie rany pooperacyjnej w miejscu wprowadzenia endoskopu;
  • martwica tkanek;
  • blizny.

W praktyce klinicznej stosuje się również usuwanie gruczołów potowych za pomocą zabiegu curettage, liposukcji i chirurgicznego wycięcia. W przypadku każdej z tych metod wystąpić mogą powikłania w postaci: pocenia kompensacyjnego w innym miejscu, zespołu Hornera, odmy opłucnej, zapalenia płuc, ograniczenia ruchów, bólu i bliznowacenia.

Przyczyny nadpotliwości

Nadpotliwość może mieć charakter pierwotny o nieznanej etiologii bądź wtórny.

Jedną z przyczyn schorzenia są choroby współistniejące, takie jak reumatoidalne zapalenie stawów, gruźlica, cukrzyca, choroba Raynauda, choroba Prakinsona, a także nadczynność tarczycy, menopauza, dna moczanowa. Nadpotliwość może być też objawem choroby nowotworowej – chłoniaka lub karcynoidu. Niewydolność serca również może mieć związek z nadmierną produkcją potu. Nadpotliwość może też zostać wywołana przez przyjmowanie niektórych leków – przeciwbólowych, przeciwdepresyjnych czy antybiotyków.

Źródła:

Dr n. med. D. Kupczyńska, Nadpotliwość – przyczyny i metody leczenia, Arsestetica, 2019

R. Piotrkowska, P. Jarzynkowski, J. Książek, T. Stefaniak, M. Leyk, Leczenie chirurgiczne nadmiernej potliwości kończyn górnych – implikacje dla pielęgniarstwa, Medycyna Rodzinna 3/2016, s. 122-126

D. M. Wydro, Leczenie nadpotliwości dłoni i pach toksyną botulinową typu A metodą mezoporacji, Academy of Cosmetics and Health Care, 2015, str. 11

interna.com.pl

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Karolina

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