Endoscopic surgical treatment of bromhidrosis: a report of 18 consecutive patients from 2010 to 2013.

Background: The current treatments available for bromhidrosis, such as subdermal excision of the apocrine glands, liposuction-curettage, and laser therapy, have certain drawbacks, for example, requirement of repeated treatments, high recurrence rate, and induration, pain, and scarring in the armpits. In this study we aimed to investigate the clinical efficacy and complications of endoscopic surgery for treatment of bromhidrosis. Patients and Methods: From August 2010 to June 2013, 18 patients (15 women and 3 men; mean age, 31 years old; age range, 19-40 years) with axillary bromhidrosis underwent endoscopic resection of the apocrine glands. The clinical efficiency and patient satisfaction were investigated by the Dermatology Quality Life Index scoring system, and complications of the surgery were assessed. Results: The mean operative time was 128 minutes (range, 92-164 minutes). Subcutaneous fluid drainage occurred in 5 of the 18 patients. Skin necrosis, upper limb edema, and bleeding did not occur in any patient. In 2 patients, subcutaneous fluid accumulation recurred after discharge. Numbness of the inside of the upper arm occurred in 3 patients. After approximately 0.5-2 years of follow-up, all patients had considerably reduced axillary sweating. The Dermatology Quality Life Index assessment indicated that the influence of bromhidrosis on the patients' life quality was greatly reduced. Conclusions: Our endoscopic surgical technique for the treatment of axillary bromhidrosis causes minimal tissue damage, allows full exposure, and is associated with few complications and a low recurrence rate.