Format

Send to

Choose Destination
J Eur Acad Dermatol Venereol. 2008 Apr;22(4):431-6. doi: 10.1111/j.1468-3083.2007.02457.x.

Botulinum toxin type-A for the treatment of inverse psoriasis.

Author information

1
Department of Dermatology, SS Giovanni E Paolo Civil Hospital, Venice, Italy. malvina_zanchi@yahoo.it

Abstract

OBJECTIVE:

To evaluate the efficacy of botulinum toxin type-A (BoNTA) for the treatment of inverse psoriasis.

BACKGROUND:

The use of BoNTA in inverse psoriasis would be a novel approach compared with conventional treatments and may act at the neuroglandular junction level to reduce local sweating with its consequent skin maceration and secondary infection and at the extra-junction level to inhibit the liberation of neuropeptides and other pro-algogenic substances responsible for inflammation, hyperkeratosis and pain transmission.

PATIENTS:

Fifteen patients with a confirmed diagnosis of inverse psoriasis were enrolled into the study. The psoriasis was located in several areas: armpits (7 patients), submammary sulcus (6 patients), intergluteal folds (7 patients), inguinal folds (5 patients) and umbilicus (1 patient).

METHODS:

BoNTA treatment comprised individual injections 2.8 cm apart of 2.4 U BoNTA, with a total dosage between 50 and 100 U per patient depending on the extent and severity of the psoriasis. Patient assessments were done pre-treatment and at 2, 4 and 12 weeks post-treatment. The erythematous area was defined using objective photographic evidence, and subjective patient assessment of pain and itch was assessed using a 10-point visual analogue scale scale.

RESULTS:

Subjective symptomatology improved in all patients and erythema extension, intensity and infiltration improved in 13 of 15 patients (87%). Treatment was well tolerated with no reported adverse events.

CONCLUSIONS:

BoNTA therapy resulted in improvements in subjective patient symptomatology and objective reductions in erythema and maceration in the treated areas according to photographic evidence. Further large-scale methodologically rigorous studies are required to investigate the safety and efficacy of BoNTA in this indication.

Comment in

[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Wiley
Loading ...
Support Center