Botulinum toxin in the treatment of sweat-worsened foot problems in patients with epidermolysis bullosa simplex and pachyonychia congenita.
Br J Dermatol
; 163(5): 1072-6, 2010 Nov.
Article
em En
| MEDLINE
| ID: mdl-20618323
ABSTRACT
BACKGROUND:
Painful foot blistering is a common problem in patients with epidermolysis bullosa simplex (EBS) and pachyonychia congenita (PC). Hyperhidrosis, a condition which can be effectively blocked by plantar injections of botulinum toxin (Btx), often exacerbates the blistering.OBJECTIVES:
A retrospective evaluation of the effects of Btx injections in 14 patients with EBS and PC with foot blisters and painful callosities.METHODS:
After informed consent, patients with EBS (n = 6) and PC (n = 8), aged 7-66 years, who had received Btx therapy at our centre since 2003, were included. The treatment consisted of multiple plantar injections of Btx A or Btx B after prior regional or general anaesthesia. Patients were interviewed about the treatment effect and were asked to score the improvement from 0 to 5, where 5 is 'excellent'. One patient with PC with painful callosities was studied by magnetic resonance (MR) spectroscopic microimaging before and after Btx injections to disclose any underlying blisters.RESULTS:
In total, 76 treatments were evaluated (one to 19 sessions per patient). Thirteen patients (93%) reported reduced plantar blistering and pain; the improvement score was ≥ 4 in four of six patients with EBS and six of eight patients with PC. The mean effect duration was 3 months. No adverse events, apart from mild anticholinergic side-effects in two patients, were noted. MR spectroscopic microimaging showed disappearance of intraepidermal blistering after Btx therapy.CONCLUSIONS:
Plantar injection of Btx is an efficient, long-lasting and safe treatment of painful blistering and callosities in EBS and PC that can be given repeatedly without loss of efficacy.
Texto completo:
1
Bases de dados:
MEDLINE
Assunto principal:
Toxinas Botulínicas
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Epidermólise Bolhosa Simples
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Paquioníquia Congênita
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Doenças do Pé
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Fármacos Neuromusculares
Tipo de estudo:
Observational_studies
Limite:
Adolescent
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Adult
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Aged
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Child
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Br J Dermatol
Ano de publicação:
2010
Tipo de documento:
Article
País de afiliação:
Suécia