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 distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
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 teacher head, 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".