Botulinum toxin and skin rash reaction

Serious and Long-Term Adverse Events Associated with the Therapeutic and Cosmetic Use of Botulinum Toxin

“…The serious adverse events identified in case reports varied from idiosyncratic adverse reactions like anaphylactic shock to dose-dependent adverse reactions like cervical kyphosis and botulism [7,8,9,10,11,12,13,14,15,16,17,18,19,20,21,22,23,24,25,26,27,28,29,30,31,32,33,34,35,36,37,38]. They were attributed to various types and preparations of botulinum toxin.…”

“…In addition, botulism-like generalized weakness has been reported in a patient treated for axillary and palmar hyperhidrosis [12]. Serious adverse events related to the therapeutic use of botulinum toxin include severe velopharyngeal insufficiency, brachial plexopathy, remote muscle weakness, botulism-like generalized muscle weakness, necrotizing fasciitis, crisis of myasthenia, generalized paralysis, marked bilateral blepharoptosis, impairment of speech and chewing, Guillain-Barré syndrome, severe dysphagia, iatrogenic botulism, generalized skin rash, aspiration pneumonia, unilateral facial madarosis and alopecia, and palatal palsy [13,14,15,16,17,18,19,20,21,22,23,24,25,26,27,28,29,30,31,32,33,34,35,36,37,38]. It is interesting that one of the patients presented with generalized weakness 5 years after continued use of botulinum toxin [19].…”

An Overview of Botulinum Toxins: Past, Present, and Future

“…There has been one report of postinjection nodules diagnosed as sarcoidosis 50 and one report of a fixed drug eruption elicited by the lactose included with AboA. 48 Three of the documented BTX-related eruptions previously mentioned had a morbilliform character comparable to a classic drug exanthem 45,47 (although 2 of these did not recur on rechallenge). BTX, in sufficient doses and durations, will, however, engender significant humoral immunity, including neutralizing antibodies.…”

“…There were only a handful of reports of cutaneous eruptions or potential hypersensitivity reactions that could be reasonably attributed to BTX-A or an associated excipient. [44][45][46][47][48] A 2005 comprehensive review of FDA AE reporting revealed 47 cases of unspecified "nonserious rash" and 13 "serious" cases of "allergic reactions/rash" out of millions of exposures, with 85% of the latter serious reactions following noncosmetic usage. 49 Similarly, BTX does not appear to provoke significant cell-mediated immunity with few, if any, well-established reactions consistent with a delayed type hypersensitivity.…”

Skin reactions after intramuscular injection of Botulinum toxin A: A rare side effect

“…The reasons for skin rash currently remain unknown 1 5 6. Based on available data, no conclusion can be drawn concerning the risk of skin reactions between different preparations.…”