Hailey-Hailey disease: Botulinum toxin treatment

Abstract

Hailey-Hailey disease, also known as familial chronic benign pemphigus, is characterized by flaccid blisters and erosions, especially in the axillary and inguinal areas. Friction associated with local factors such as heat, moisture, microbial colonization, and secondary infections induce the typical appearance of the lesions, especially in intertriginous areas. Traditionally, the treatment is done with corticosteroids associated with topical or systemic antibiotics. We report the case of a patient with the disease presenting in the inguinal region, which has made use of different conventional drug treatments for 20 years without results. Treatment with application of botulinum toxin type A showed a significant improvement after about 20 days. The satisfactory response has been linked to decreased local sweating caused by botulinum toxin. which would lead to a less local irritation factors and lower colonization of microrganisms.