Botulinum Toxin: Beyond Cosmesis

Klein, Arnold William; Glogau, Richard G.

doi:10.1001/archderm.136.4.539

Cited by 32 publications

(18 citation statements)

References 37 publications

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“…[1][2][3][4][5][6][7][8][9][10][11][13][14][15] However, one of the main disadvantages of this treatment is the degree of pain experienced during injections, which is related to the abundance of free nerve endings located in the papillary dermis of the palms. 3,5,9 A subcutaneous injection of BTX-A would be more comfortable 2,9 ; however, intracutaneous administration is the most appropriate procedure for palmar hyperhidrosis to deliver the toxin as close to the sweat glands as possible and to reduce the risk of causing muscular weakness and weakening of the grip.…”

Section: Discussionmentioning

confidence: 99%

“…Thus, there is a need to find an appropriate method of anesthesia for repeated treatment sessions in palmar hyperhidrosis. 5,13,14 Owing to the anatomic structure of the wrist, the use of a shorter 30-G 3 0.40 3 6 mm gauge needle to administer the anesthetic in proximity of the median and ulnar nerve reduces the potential risk of injecting directly into the nerves and the associated risk of mechanical and chemical neural damage.…”

Section: Discussionmentioning

confidence: 99%

“…[1][2][3]6,8,9 For this reason the use of locoregional anesthesia of the median and ulnar nerves before the treatment is often used. 1,[6][7][8][10][11][12] However, blockage of the ulnar and median nerves at the wrist can be associated with a risk of mechanical and chemical neural damage 13,14 as a result of the deep injections of anesthetic. However, if direct injection into the nerve can be avoided then this risk would be greatly reduced.…”

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confidence: 99%

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Local neural block at the wrist for treatment of palmar hyperhidrosis with botulinum toxin: Technical improvements

Campanati

Lagalla

Penna

et al. 2004

Journal of the American Academy of Dermatology

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Local neural block at the wrist for treatment of palmar hyperhidrosis with botulinum toxin: Technical improvements

Campanati

Lagalla

Penna

et al. 2004

Journal of the American Academy of Dermatology

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“…Botulinum toxin A has been used to treat headache. 28,29 Headache after cosmetic injection of botulinum toxin A usually occurs immediately after injection and lasts about half a day. 30 Its cause is presumed to be toxin-related stimulation of muscles immediately after injection, with a subsequent toxin-mediated relaxation coinciding with headache resolution.…”

Section: Fig 3 Adverse Effects After 18-point Abobotulinum Toxin a mentioning

confidence: 99%

Eighteen-Point Abobotulinum Toxin A Upper Face Rejuvenation

Kashkouli

Amani

Jamshidian-Tehrani

et al. 2014

Ophthalmic Plastic &Amp; Reconstructive Surgery

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“…23 Today, botulinum toxin is used in dermatology for the treatment of vertical glabellar frown and horizontal forehead lines, wrinkles from actinic damage, lateral canthal lines (crow's feet), nasal flare, eyebrow elevation or shaping, facial asymmetry, upper lip creases and chin dimpling. Reports since the mid-1990s have also described Botox as highly effective for hyperhidrosis of the axilla, palms of the hands and soles of the feet, 24 and a useful adjunctive medication with laser resurfacing and other cosmetic procedures. 25 Doses range from 3 U for small muscles of the face and up to 300 U for larger treatment areas, such as those of hyperhidrosis.…”

Section: Dermatologymentioning

confidence: 99%

The story of Clostridium botulinum: from food poisoning to Botox

2004

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-In the last fifty years, Clostridium botulinum has become notorious for its ability to produce the deadly botulinum neurotoxins. While botulinum toxin A, better known as Botox™, is universally recognised by the public as a cosmetic enhancement tool, the botulinum neurotoxins are commonly used off-label for many medical conditions in ophthalmology, neurology and dermatology. The versatility of these botulinum toxins has made Clostridium botulinum one of the most widely known bacterial pathogens in medical history. This article outlines the discovery of botulinum toxins through to their present day applications in medicine.KEY WORDS: botulinum toxin, dermatology, food poisoning, human disease, neurology, ophthalmology The botulinum toxinsClostridium botulinum is a rod-shaped, gram-positive anaerobic bacterium. Each of the seven serotypes of this bacterium (A, B, C, D, E, F and G) produce a unique form of botulinum neurotoxin (also designated A to G). 1,2 Types A, B and E are commonly involved in human botulism 3 and found in terrestrial, marine and fresh water environments.Botulinum toxin A, produced by the high yield Hall strain of C botulinum, is the most potent form of botulinum neurotoxin. 4 Botulinum toxin is a high molecular weight protein of 150,000 daltons with noncovalent proteins that protect it from digestive enzymes, thereby making it a highly dangerous food poison. The toxin is destroyed by heating at 80°C for at least one minute.Botulinum toxin A is widely distributed and commercially available as Botox™ (Allergen, Inc) in North America while Dysport™ (Speywood, UK) dominates the European markets. Botulinum toxin B is marketed as Myobloc (Elan Pharmaceuticals) in the USA and Neurobloc (Elan Pharmaceuticals) in Europe; both are currently under review by the US Food and Drug Administration (FDA). 5,6 The FDA specify that Botox™ be distributed in vials of 100±30 mouse units (U) with 1 U equal to the median amount necessary to kill half the sample of mice (LD 50 ). 2,4 Of further note, 1 U of Botox™ is equivalent to 3 ng of botulinum toxin A or 2-5 U Dysport™ (the latter will not be further discussed in this essay). 2 Depending on the medical condition, 30-300 U (1-10 ng) Botox™ injections are required two to six times per year, and administration of the toxin at higher concentrations or too frequently creates the risk of developing antibodies that nullify any beneficial effects. 2 As a pharmaceutical, botulinum toxin A has a large margin of safety with an LD 50 of 3,000 U (100 ng) in humans and side effects from treatment are minimal.All botulinum toxins have a similar mode of action whereby they interfere with the transmission of nerve impulses by inhibiting the release of the acetylcholine neurotransmitter from nerve terminals at the neuromuscular junction. The effect is long lasting but also reversible, as new nerve terminals sprout to replace the formerly inhibited ones. 7,8 Food poisoning from botulinum toxinsIn the late 1700s, botulism, a disease caused by human ingestion of botulinum t...

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Botulinum Toxin: Beyond Cosmesis

Cited by 32 publications

References 37 publications

Local neural block at the wrist for treatment of palmar hyperhidrosis with botulinum toxin: Technical improvements

Local neural block at the wrist for treatment of palmar hyperhidrosis with botulinum toxin: Technical improvements

Eighteen-Point Abobotulinum Toxin A Upper Face Rejuvenation

The story of Clostridium botulinum: from food poisoning to Botox

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