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Leitungswasseriontophorese

Tap water iontophoresis

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Zusammenfassung

Die Leitungswasseriontophorese ist seit 1968 eine Standardtherapie zur Behandlung der palmoplantaren Hyperhidrose. Mithilfe spezieller Elektroden kann auch die Hyperhidrosis axillaris behandelt werden. Die Leitungswasseriontophorese eignet sich auch zur unterstützenden Erhaltungstherapie bei dyshidrosiformen Ekzemen. Der Wirkungsmechanismus beruht auf einer funktionellen Hemmung des Sekretionsmechanismus in den ekkrinen Azini. Die Behandlung in der Induktionsphase erfolgt 1-mal täglich, die Dauer einer Behandlungssitzung beträgt 10–15 min. Die Stromrichtung wird vor jeder Behandlungssitzung umgepolt oder nur 1-malig während der Induktionsphase, sobald auf der mit der Anode behandelten Seite Euhidrosis eingetreten ist. Zur Erhaltungstherapie sind Behandlungen etwa 1-mal pro Woche erforderlich, vor jeder Sitzung wird die Stromrichtung umgepolt. Ein hochfrequent pulsierender Gleichstrom wird besser als kontinuierlicher Gleichstrom vertragen und ist leichter zu handhaben, sodass diese Geräte auch zur Behandlung von Kindern geeignet sind. Nebenwirkungen umfassen leichte Dysästhesien oder Kribbeln. Kontraindikationen umfassen Defekte in der Hornschichtbarriere wie Erosionen oder Risse, die nicht abgedeckt werden können, sowie elektronische Implantate oder metallische Implantate anderer Art, die im Stromkreis liegen. Erfahrungen zur Behandlung während der Schwangerschaft liegen nicht vor, sie wird deshalb nicht empfohlen.

Abstract

Since 1968, tap water iontophoresis has been employed as the method of choice for treating palmoplantar hyperhidrosis. Special electrodes also allow treatment of axillary hyperhidrosis. Tap water iontophoresis also can extend symptom -free intervals in dyshidrotic palmar eczema. The mechanism action is most likely a functional disturbance of the secretory mechanism of eccrine acini. During the induction phase, treatments are carried out once daily. Current direction may be switched before each treatment or, even better, kept constant until one side, preferably the dominant hand on the anode, is sweating normally. Then polarity is switched until both hands are adequately treated. During the weekly maintenance therapy, current direction is switched before each treatment. The most comfortable means of iontophoretic treatment employs pulsed direct current of high frequency (5–10 kHz) which is better tolerated than continuous direct current and also suitable for children. Side effects are minimal and transient. Only slight skin irritation or sensations of discomfort may occur during treatment. Electric burns and shocks can be avoided by following routine precautions. Contraindications for tap water iontophoresis are metallic implants, such as cardiac pacemakers, or orthopaedic joint or bone implants, if they are within the electric circuit. Defects in the skin barrier, which can not be protected by petrolatum or insulating tape, also represent a temporary contraindication. Treatment in pregnancy is contraindicated, since experience is lacking.

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Literatur

  1. Abell E, Morgan K (1974) The treatment of idiopathic hyperhidrosis by glycopyrronium bromide and tap water iontophoresis. Br J Dermatol 91:87–91

    Article  PubMed  CAS  Google Scholar 

  2. Bouman HD, Grunewald Lentzer M (1952) The treatment of hyperhidrosis of hands and feet with constant current. Am J Phys Med 31:158–169

    PubMed  CAS  Google Scholar 

  3. Dolianitis C, Scarff CE, Kelly J, Sinclair R (2004) Iontophortesis with glycopyrrolate for the treatment of palmoplantar hyperhidrosis. Australas J Dermatol 45:208–212

    Article  PubMed  Google Scholar 

  4. Freis ED (1946) Treatment of dermatophytosis and hyperhidrosis with formaldehyde and cupric sulfate iontophoresis. Arch Dermatol Syph 53:34–38

    Article  CAS  Google Scholar 

  5. Gibinski K, Giec L, Zmudzinski J et al (1973) Transcutaneous inhibition of sweat gland function by atropine. J Appl Physiol 34:850–852

    PubMed  CAS  Google Scholar 

  6. Grice K, Sattar H, Baker H (1972) Treatment of idiopathic hyperhidrosis with iontophoresis of tap water and poldine methosulfate. Br J Dermatol 86:72–78

    Article  PubMed  CAS  Google Scholar 

  7. Grimnes S (1984) Pathways of ionic flow through human skin in vivo. Acta Derm Venereol 64:93–98

    PubMed  CAS  Google Scholar 

  8. Hill AC, Baker GF, Jansen GT (1981) Mechanism of action of iontophoresis in the treatment of palmar hyperhidrosis. Cutis 28:69–72

    PubMed  CAS  Google Scholar 

  9. Hill BHR (1976) Poldine iontophoresis in the treatment of palmar and plantar hyperhidrosis. Australas J Dermatol 17:92–93

    Article  PubMed  CAS  Google Scholar 

  10. Hölzle E (1984) Die essentielle Hyperhidrose. Habilitationsschrift, Düsseldorf

  11. Hölzle E, Alberti N (1987) Long-term efficacy and side effects of tap water iontophoresis of palmoplantar hyperhidrosis – the usefulness of home therapy. Dermatologica 175:126–136

    Article  PubMed  Google Scholar 

  12. Hölzle E, Hund M, Lommel K, Melnik B (2009) Qualitätssicherung der Leitungswasser-Iontophorese. In: Korting HC et al (Hrsg) Dermatologische Qualitätssicherung. ABW Wissenschaftsverlag, Berlin

  13. Hölzle E, Pauli M, Braun-Falco O (1984) Leitungswasser-Iontophorese zur Behandlung von Hyperhidrosis manuum et pedum. Hautarzt 35:142–147

    PubMed  Google Scholar 

  14. Ichihashi T (1936) Effect of drugs on the sweat glands by cataphoresis, and an effective method for suprression of local sweating. Observation on the effect of diaphoretics and anaphoretics. J Orient Med 25:101–102

    Google Scholar 

  15. Levit F (1968) Simple device for treatment of hyperhidrosis by iontophoresis. Arch Dermatol 98:505–507

    Article  PubMed  CAS  Google Scholar 

  16. Levit F (1980) Treatment of hyperhidrosis by tap water iontophoresis. Cutis 26:192–196

    PubMed  CAS  Google Scholar 

  17. Morgan K (1980) The technique of treating hyperhidrosis by iontophoresis. Physiotherapy 66:45–48

    PubMed  CAS  Google Scholar 

  18. Odia S, Vocks E, Rakoski J, Ring J (1996) Successful treatment of dyshidrotic hand eczema using tap water iontophoresis with pulsed direct current. Acta Derm Venereol 76:472–474

    PubMed  CAS  Google Scholar 

  19. Oesterle IS, Owen T, Rustin MH (1995) Neuropeptides in the skin of patients with atopic dermatitis. Clin Exp Dermatol 20:462–467

    Article  Google Scholar 

  20. Ohshima Y, Shimizu H, Yanagishita T et al (2008) Changes in Na+, K+ concentrations in perspiration and perspiration volume with alternating current iontophoresis in palmoplantar hyperhidrosis patients. Arch Dermatol Res 300:595–600

    Article  PubMed  CAS  Google Scholar 

  21. Raulin C, Rösing S, Petzoldt D (1988) Heimbehandlung der Hyperhidrosis manuum et pedum durch Leitungswasser-Iontophorese. Hautarzt 39:504–508

    PubMed  CAS  Google Scholar 

  22. Reinauer S, Neußer A, Schauf G, Hölzle E (1993) Iontophoresis with alternating current and direct current offset (AC-DC iontophoresis): a new approach for the treatment of hyperhidrosis. Br J Dermatol 129:166–169

    Article  PubMed  CAS  Google Scholar 

  23. Reinauer S, Neußer A, Schauf G, Hölzle E (1995) Die gepulste Gleichstrom-Iontophorese als neue Behandlungsmöglichkeit der Hyperhidrosis. Hautarzt 46:543–547

    Article  PubMed  CAS  Google Scholar 

  24. Reinauer S, Schauf G, Hölzle E (1993) Ross syndrome: treatment of segmental compensatory hyperhidrosis by a modified iontophoretic device. J Am Acad Dermatol 28:308–312

    Article  PubMed  CAS  Google Scholar 

  25. Reinauer S, Schauf G, Hubert M, Hölzle E (1992) Mechanism of action of tap water iontophoresis: functional disturbance of the secretory epithelium. Z Hautkr 67:622–626

    Google Scholar 

  26. Sato K, Timm DE, Sato F et al (1993) Generation and transit pathway of H+ is critical for inhibition of palmar sweating by iontophoresis in water. J Appl Physiol 75:2258–2264

    PubMed  CAS  Google Scholar 

  27. Schaar WW van der (1974) Die Behandlung der Hyperhidrosis mit Iontophorese. Hautarzt 25:504–506

    PubMed  Google Scholar 

  28. Schauf G, Hubert M, Reinauer S, Hölzle E (1994) Modifikation und Optimierung der Leitungswasser-Iontophorese. Hautarzt 45:756–761

    Article  PubMed  CAS  Google Scholar 

  29. Schempp CM, Czech W, Schöpf E, Simon JC (1996) Leitungswasser-Iontophorese bei der Behandlung dyshidrotischer mit Hyperhidrosis assoziierter Palmoplantarekzeme. Akt Dermatol 22:198–201

    Google Scholar 

  30. Shelley W, Horvath P, Weidman F et al (1948) Experimental miliaria in man. I. Production of sweat retention anhidrosis and vesicles by means of iotnophoresis. J Invest Dermatol 11:275

    PubMed  CAS  Google Scholar 

  31. Shrivastava SN, Singh G (1977) Tap water iontophoresis in palmoplantar hyperhidrosis. Br J Dermatol 96:189–195

    Article  PubMed  CAS  Google Scholar 

  32. Sloan JB, Soltani K (1986) Iontophoresis in dermatology. J Am Acad Dermatol 15:671–684

    Article  PubMed  CAS  Google Scholar 

  33. Turnell WJ (1921) Therapeutic action of constant current. Proc R Soc Med 14:41–52

    Google Scholar 

  34. Wang L, Hilliges M, Gajecki M et al (1994) No change in skin innervation in patients with palmar hyperhidrosis treated with tap-water iontophoresis. Br J Dermatol 13:742

    Article  Google Scholar 

  35. Wollina U, Karamfilov T (2002) Adjuvant botulinum toxin A in dyshidrotic hand eczema: a controlled prospective pilot study with left-right comparison. J Eur Acad Dermatol Venereol 1:40–42

    Article  Google Scholar 

  36. Wollina U, Uhlemann C, Elstermann D et al (1998) Therapie der Hyperhidrosis mittels Leitungswasseriontophorese. Hautarzt 49:109–113

    Article  PubMed  CAS  Google Scholar 

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Hölzle, E. Leitungswasseriontophorese. Hautarzt 63, 462–468 (2012). https://doi.org/10.1007/s00105-012-2332-0

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