ミラドライⓇを用いた腋窩多汗症・腋臭症治療（1）—施術時の工夫と治療成績—

The Treatment of Axillary Hyperhidrosis and Hircismus Using the MiraDry Ⓡ

はじめに

　日常診療で腋窩多汗症や腋臭症に悩む患者は多く見られる。腋窩多汗症は薬剤による治療も行われているが，腋臭症は効果的な薬剤はなく，アポクリン汗腺を物理的に除去しなければならない。従来の汗腺摘出手術は，腋窩切開部の瘢痕や拘縮が目立つことがあり問題となっていた。近年，腋窩多汗症治療機であるmiraDry Ⓡシステム（以下，ミラドライ Ⓡ：ジェイメック社）が，切開瘢痕を残さずエクリン汗腺と同時にアポクリン汗腺を熱変性させ除去できるため，腋臭症に対しても用いられるようになってきた 1）。本稿では，ミラドライ Ⓡの原理と，施術方法，著者の施術時の工夫，治療成績について述べる。

　The miraDry Ⓡ is a therapeutic device that uses microwave thermal energy for the treatment of axillary hyperhidrosis. One-pass irradiation is usually applied. Although two-pass irradiation delivers energy to deeper sites and provides a greater therapeutic effect, it is also associated with an increased risk of complications. We have achieved sufficient therapeutic effects together with a low complication rate by customizing the positions of the miraDry Ⓡ device. For the validation of the miraDry Ⓡ treatment outcomes at our clinic, we evaluated the results of both the sweat test （using gauze and filter paper） and the numerical rating scale scores reported by the patients. The evaluation demonstrated that the miraDry Ⓡ device was highly effective for the treatment of not only axillary hyperhidrosis, for which it has already been approved under the Pharmaceutical Affairs Law, but also hircismus. The use of the miraDry Ⓡ also enables the treatment of hircismus without leaving an incision scar, and the miraDry Ⓡ thus appears to be a potential first-line treatment of hircismus and axillary hyperhidrosis in patients who emphasize esthetic outcomes.