Abstract
Botulinum toxin is a superfamily of neurotoxins produced by the bacterium Clostridium Botulinum with well-established efficacy and safety profile in focal idiopathic hyperhidrosis. Recently, botulinum toxins have also been used in many other skin diseases, in off label regimen. The objective of this manuscript is to review and analyze the main therapeutic applications of botulinum toxins in skin diseases. A systematic review of the published data was conducted, following Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. Botulinum toxins present several label and off-label indications of interest for dermatologists. The best-reported evidence concerns focal idiopathic hyperhidrosis, Raynaud phenomenon, suppurative hidradenitis, Hailey–Hailey disease, epidermolysis bullosa simplex Weber–Cockayne type, Darier’s disease, pachyonychia congenita, aquagenic keratoderma, alopecia, psoriasis, notalgia paresthetica, facial erythema and flushing, and oily skin. Further clinical trials are still needed to better understand the real efficacy and safety of these applications and to standardize injection and doses protocols for off label applications.
Highlights
Botulinum toxin (BoNT) is a superfamily of neurotoxins able to block the release of acetylcholine and many other neurotransmitters from presynaptic vesicles by cleavage of target proteins of the SNARE.Botulinum neurotoxin type A (BoNT-A) has a long history of therapeutic application in idiopathic focal hyperhidrosis, and aesthetic medicine with a strong efficacy and safety profile [1,2,3,4,5,6,7,8]
This review emphasizes the great potential of the use of BoNT in a large number of heterogeneous skin diseases
It can be inferred that many of the diseases that affect the folds can improve after injection of botulinum toxin probably owing to its anhidrotic effect reducing bacterial contamination and maceration
Summary
Botulinum toxin (BoNT) is a superfamily of neurotoxins able to block the release of acetylcholine and many other neurotransmitters from presynaptic vesicles by cleavage of target proteins of the SNARE. BoNT-A has a long history of therapeutic application in idiopathic focal hyperhidrosis, and aesthetic medicine with a strong efficacy and safety profile [1,2,3,4,5,6,7,8]. The great potential therapeutic application of BoNT-A has driven clinicians to evaluate its therapeutic potentiality in many other cutaneous diseases. The aim of this review is to collect and analyze the published data concerning the most relevant label and off-label indications of botulinum toxin in dermatology
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