Clinics in dermatology
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Clinics in dermatology · Jan 2004
ReviewAnatomy of the sweat glands, pharmacology of botulinum toxin, and distinctive syndromes associated with hyperhidrosis.
For a long period the therapeutic modalities to treat focal hyperhidrosis (HH) were very limited. Due to this the problem of focal HH was delt with stepmotherly. Nowadays we can consider BTX as the therapy of choice for axillary HH after topical treatment with aluminium salts have failed. ⋯ The structural architecture of BTX comprises three domains-L, H(N) and H(C)-each with a specific function in the mechanism of cell intoxication. The heavy chain is responsible for binding to the nerve cell, whereas the light chain catalyzes the proteolysis of one of the three SNARE proteins (Snap-25, Vamp or Syntaxin) depending to the serotype of BTX (7 serotypes A-G). Once cleaved by BTX, the SNARE proteins cannot become part of the complex capable of mediating the vesicle membrane fusion and therefore prevents the release of ACh and hence transmission of the nerve impulse.