A RETROSPECTIVE STUDY ON THE LONG-TERM FOLLOW-UP ASSESSMENT AFTER TREATMENT OF THE AXILLARY BROMHIDROSIS: COMPARISON OF 1444 nm Nd:YAG LASER VERSUS SURGERY

초록

Background: Axillary bromhidrosis is a diseasecharacterized by malodor caused by the interactionbetween apocrine gland secretions and bacteria. Current treatment modalities include topical treatment, lipo-suction curettage, microwave therapy, and surgical intervention. This retrospective study aimed to evaluate the clinical outcome assessment through a long‐term follow‐up period of up to 3 years by comparison of the long‐pulse (LP) 1444 nm Nd:YAG laser with interstitial internal fiber technique and minimal incision with subcutaneous shaving surgery (modified Inaba's method, MIS). Study Design/Materials and Method: Total 20 patients received laser treatment to destroy apocrine glands in the dermal and subcutaneous layer (Accusculpt™; LutronicCorp.) by irradiating from 1706 to 2267 J at LP 1444 nm with 175 mJ of pulse energy (pulse rate of 40 Hz).Twenty‐five patients with axillary bromhidrosis received minimally invasive surgery (MIS). The patient characteristics of age, sex, duration, and underlying disease were similar between two groups. Results: On posttreatment Days 7, 1 month, 2 months, 6 months, 1 year, and 3 years remaining odor and overall satisfaction score showed no significant difference between laser‐treated group and surgical treatment group. However, on posttreatment Days 7, pain score was significantly severe in surgical treated group. Also, the degree of reduced mobility was significantly higher in surgery on postoperative Days 7 and 1 month. The adverse events such as hypertrophic scar, recurrence, postinflammatory hyperpigmentation,wound infection had no significant differences. Conclusion: In our study, LP 1444 nm Nd:YAG laser for axillary bromhidrosis showed effectiveness comparable to MIS. Moreover, postprocedure complications were much less in laser treated group. Surgical intervention might have higher risk of other complications such as axillary nerve damage, scar contracture, and so forth. In conclusion, subdermal and subcutaneous coagulation treatment with LP 1444 nm Nd:YAG laser may be least invasive and compatible effective therapy for bromhidrosis.