Oxybutynin and propranolol combo successfully resolves symptoms in Harlequin syndrome: Case report
Source- Naharro-Fernández C, de Quintana-Sancho A, López-Sundh AE, Reguero-Del Cura L, Gónzalez-López MA. Successful treatment of idiopathic Harlequin Syndrome with oxybutynin and propranolol. Australas J Dermatol. 2021 Nov;62(4):504-505. doi: 10.1111/ajd.13665. Epub 2021 Jul 27. PMID: 34314021.a
Oxybutynin and propranolol combination successful in Harlequin syndrome- 1st case report- Harlequin syndrome (HS) is a rare disorder characterised by unilateral facial flushing and sweating induced by exercise, heat and emotion. It is mostly idiopathic. In some cases, it can lead to social embarrassment. It is difficult to treat and can have a significant impact on quality of life.
Recently a case describing successful treatment of idiopathic HS with a combined therapy of oxybutynin and propranolol was published in Australasian Journal of Dermatology.
A 47-year-old woman presented with hyperhidrosis and erythema episodes limited to the right side of the face, triggered by physical exercise. She was receiving prophylactic metoprolol with suboptimal control of her migraine episodes. Magnetic resonance imaging of brain and cervical spine and chest radiograph were normal. Treatment with oxybutynin (5 mg/daily orally) resulted in optimal control of hyperhidrosis but facial flushing persisted so she was switched over from metoprolol to propranolol (10 mg/8 h orally). The patient experienced a marked improvement in frequency, intensity and duration of the facial flushing, and better control of her migraine episodes.
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