Botulinum toxin type‐A for the treatment of inverse psoriasis

Zanchi, M; Favot, Francesca; Bizzarini, Massimo; Piai, M; Donini, Massimo; Sedona, P

doi:10.1111/j.1468-3083.2007.02457.x

Cited by 66 publications

(49 citation statements)

References 15 publications

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“…4-6 In one study, all 15 patients with a confirmed diagnosis of inverse psoriasis showed improvements in subjective symptoms, and 13 patients showed improvements in erythema extension, intensity, and infiltration. Treatment was well tolerated.…”

Section: Future Developmentsmentioning

confidence: 98%

“…2 BoNT is also a therapeutic mainstay for other conditions, such as axillary hyperhidrosis, chronic migraine, and neurogenic detrusor over-activity. 3 The range of potential therapeutic uses continues to expand, with recent clinical studies suggesting that BoNT may be effective for some cases of psoriasis, 4-6 acne, 7,8 and lateral patellofemoral overload syndrome, 9 although these are currently investigative clinical studies and BoNT is unlicensed for these indications.…”

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confidence: 99%

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AbobotulinumtoxinA: A 25-Year History

Monheit

Pickett

2017

Aesthetic Surgery Journal

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During the late 1960s and early 1970s, Alan Scott showed that intramuscular injections of botulinum toxin (BoNT) corrected nonaccommodative strabismus without resorting to surgery. The UK doctors who trained with Scott soon realized the significant potential offered by BoNT type A as a therapeutic option for several difficult-to-treat diseases. This led to a collaboration between these pioneering clinicians and the Centre for Applied Microbiology and Research at Porton Down, United Kingdom, and, in turn, to the development and commercialization of abobotulinumtoxinA as Dysport (Dystonia/Porton Down; Ipsen Biopharm Ltd., Wrexham, UK). Dysport was approved in Europe for the treatment of specific dystonias in December 1990 and now has marketing authorizations in 75 countries. Since then, the use of BoNT in therapeutic and aesthetic indications has grown year-on-year, and continues to expand well beyond Scott’s initial aim. For example, ongoing trials are assessing potential new indications for BoNT-A, including acne and psoriasis. Furthermore, a growing number of other BoNT products, often termed “biosimilars,” together with innovative formulations of well-established BoNT types, are likely to reach the market over the next few years. This review focuses on the history of Dysport to mark the 25th anniversary of its first launch in the United Kingdom.

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Section: Future Developmentsmentioning

confidence: 98%

mentioning

confidence: 99%

AbobotulinumtoxinA: A 25-Year History

Monheit

Pickett

2017

Aesthetic Surgery Journal

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“…21 More resistant cases, like the one described herein, may require combination therapy. Other therapeutic options include botulinum toxin 22,23 and efalizumab, 24 although evidence of their effectiveness is limited to case reports.…”

Section: Discussionmentioning

confidence: 99%

Resistant "Candidal Intertrigo": Could Inverse Psoriasis Be the True Culprit?

Wilmer

Hatch

2013

The Journal of the American Board of Family Medicine

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Inverse psoriasis is a disorder of intertriginous areas of the skin that can easily masquerade as candidal intertrigo. Candidal rashes are commonly encountered in primary care and typically respond promptly to therapy. When treatment fails, nonadherence to treatment and medication resistance often are suspected; however, the possibility of an incorrect diagnosis should also be entertained. This article presents the case of a patient with inverse psoriasis who was misdiagnosed with recurrent candidal intertrigo multiple times. The diagnosis and treatment of inverse psoriasis is reviewed, and other conditions that may be confused with Candida and inverse psoriasis, including bacterial intertrigo, tinea, and seborrheic dermatitis, are discussed. When confronted with a case of "resistant Candida," consideration of inverse psoriasis and other Candida mimics can allow physicians to diagnose and treat these conditions more effectively, avoiding the frustration experienced by our patient. A 68-year old woman with a history of poorly controlled type 2 diabetes mellitus presented as a new patient with exacerbation of chronic obstructive pulmonary disease (COPD) and a rash. The rash consisted of chronic, recurrent, erythematous patches in the inframammary and inguinal folds (Figure 1). The patches were mildly macerated. Scanty satellite lesions were observed near the inframammary but not the inguinal patches; scales were absent in these locations. There was scaling and tenderness in both auditory canals, with mild scaling of each pinna. Over the past week, the patient had applied multiple topical medications to the rash, including clotrimazole, moisturizer, and bacitracin/neomycin/polymyxin. She reported a 10-year history of similar rash affecting the axillae, groin, inframammary folds, retroauricular area, and gluteal cleft. The skin lesions had been diagnosed previously as candidiasis, but the patient was adamant that multiple trials with topical and oral antifungals did not help the rash. It is interesting that she noted that the skin lesions always improved when she was taking prednisone for the treatment of COPD exacerbations.The patient was prescribed prednisone for her COPD exacerbation and neomycin-polymyxin Bhydrocortisone otic solution for presumed otitis externa. Antifungal cream was offered but the patient was certain it would not help and insisted the prednisone would resolve the rash. She was instructed to discontinue all topical products for the rash and to return for follow-up. She presented 1 week later with a dramatic improvement in her rash. However, within 2 weeks of terminating oral prednisone, the erythematous patches recurred in the inframammary folds and gluteal cleft. The differential diagnosis included intertrigo, erythrasma, seborrheic dermatitis, inverse psoriasis, and resistant Candida secondary to poorly controlled diabetes. The affected areas were examined with a Wood's lamp and demonstrated no signs of fluorescence that would suggest erythrasma. A fungal culture was obtained, and clotrimazol...

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“…Therefore, the clinical observation that psoriasis undergoes remission following loss of innervation, nerve function or nervous system injury, supports this hypothesis [69] . BoNT-A inhibits nerve-derived release of CGRP and SP, and this probably explains the subjective clinical observation of disease improvement in inverse psoriasis following BoNT-A administration by Zanchi et al [70] . Ward et al [69] demonstrated, using adult KC-Tie2 mouse (a murine model of psoriasiform dermatitis) that the intradermal injections of BoNT-A lead to a significant improvement versus placebo in acanthosis and a reduction of cutaneous lymphocyte infiltration.…”

Section: Psoriasismentioning

confidence: 99%

“…However, clinical reports and observational study published are few and not placebo-controlled. Zanchi et al [70] reported a good response to the BoNT-A treatment in 15 patients with inverse psoriasis, but the outcomes were evaluated with patient self-assessment (VAS scale for itch and pain) and a photographic evaluation of erythema and infiltration. For this reason, Chroni et al [71] raised several criticism in the study such as the absence of a quantitative measure in order to estimate the improvement (PASI score, for example) or a histological evaluation prior and post treatment.…”

Section: Psoriasismentioning

confidence: 99%

Botulinum Toxin Off-Label Use in Dermatology: A Review

Campanati

Martina

Giuliodori

et al. 2017

Skin Appendage Disord

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focal hyperhidrosis, aesthetic medicine and neurological conditions with a strong efficacy and safety profile [1][2][3][4][5][6][7] . The enormous therapeutic potential of this drug contributed to a number of broad applications, especially in dermatological diseases. A large number of these indications are still lacking shared, approved protocols for dilution, doses, and timing of follow-up and retreatment. Also the injection techniques are still debated, depending on the operator's experience, angle of injection and depth. We have previously published a novel injection approach consisting in a needle adaptor that ensures a uniform administration of the toxin [3] . The aim of this review was to collect and analyze the published data concerning the most relevant off-label indications of BoNT-A. MethodsA PubMed search from 1950 to July 2016 was performed to identify any reports on the use of botulinum toxin in off-label indications concerning dermatology. We detected these articles using the terms "botulinum toxin dermatology," "botulinum toxin treatment," "botulinum toxin off-label," and meshed with a secondary search of studies pertaining to each indication. Only studies in English were reviewed. All studies that met the criteria were included and summarized in this review. KeywordsBotulinum toxin · Off-label therapy · Keloids · Hidradenitis suppurativa · Folds dermatitis Abstract Background: Botulinum toxin is a neurotoxin produced by the bacterium Clostridium botulinum which causes a flaccid muscle paralysis. It is currently used for aesthetic treatments and in the focal hyperhidrosis. Recently, botulinum toxin has also been used experimentally in many other dermatological conditions with good results. Objective: To review and analyze the possible botulinum toxin off-label applications published. Methods: A retrospective review of the published data was conducted. Conclusions: this potent drug can lead to several off-label indications of interest for dermatologists. Further clinical trials are still needed to better understand the real efficacy and safety of these applications and to standardize injection and dose protocols.

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Botulinum toxin type‐A for the treatment of inverse psoriasis

Cited by 66 publications

References 15 publications

AbobotulinumtoxinA: A 25-Year History

AbobotulinumtoxinA: A 25-Year History

Resistant "Candidal Intertrigo": Could Inverse Psoriasis Be the True Culprit?

Botulinum Toxin Off-Label Use in Dermatology: A Review

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