The place of botulinum toxin type A in the treatment of focal hyperhidrosis
Bibliographic record
Abstract
Conflicts of interest: none declared. Sir, I read with great interest the paper by Lowe et al.1 in which they discuss the place of botulinum toxin type A (BTX‐A) in the treatment of focal hyperhidrosis (HH) and propose, based on published data, an algorithm for axillary HH and a second for palmar HH. I agree with the authors that topical medications should be used as first‐line therapy where practical. In that sense I would like to indicate that treatment with supersaturated concentrations of aluminium chloride (AlCl3) ranging from 25% to 50% in a 4–6% salicylic acid (SA) gel should be considered, particularly on the palms and soles,2 alone or in combination with other therapeutic modalities such as iontophoresis and BTX‐A, before resorting to surgery. Even patients with axillary HH, who failed to respond to AlCl3 in alcohol or did not tolerate it, found AlCl3 in the gel formulation3 more effective and better tolerated. The details of this extemporaneous formulation have already been published.4
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.006 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.002 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.010 | 0.008 |
| Insufficient payload (model declined to judge) | 0.002 | 0.002 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".