肉毒毒素在皮肤科的超适应证临床应用

doi:10.35541/cjd.20210389

Abstract

Abstract: 【Abstract】 In recent years, botulinum toxin has been used in many skin diseases and related problems. This review summarizes and analyzes the off-label clinical application of botulinum toxin in dermatology, including facial flushing, Raynaud phenomenon, postherpetic neuralgia, psoriasis, etc., in order to provide new means and ideas for the management of these skin conditions.

Key words: Botulinum toxin, Dermatology, Flushing, Erythema, Raynaud phenomenon, Postherpetic neuralgia, Psoriasis

Zhang Yuanwen, Sun Congqian, Pan Wendong. Off-label clinical application of botulinum toxin in dermatology[J]. Chinese Journal of Dermatology, 2024, 57(5): 471-475.doi:10.35541/cjd.20210389

References ［61］

［1］	Rossetto O, Pirazzini M, Fabris F, et al. Botulinum neurotoxins: mechanism of action［J］. Handb Exp Pharmacol, 2021,263:35⁃47. doi: 10.1007/164_2020_355.
［2］	Bellows S, Jankovic J. Immunogenicity associated with botulinum toxin treatment［J］. Toxins （Basel）, 2019,11（9）:491. doi: 10. 3390/toxins11090491.
［3］	Kattimani V, Tiwari R, Gufran K, et al. Botulinum toxin application in facial esthetics and recent treatment indications （2013-2018）［J］. J Int Soc Prev Community Dent, 2019,9（2）:99⁃105. doi: 10.4103/jispcd.JISPCD_430_18.
［4］	Matak I, Bölcskei K, Bach⁃Rojecky L, et al. Mechanisms of botulinum toxin type A action on pain［J］. Toxins （Basel）, 2019,11（8）:459. doi: 10.3390/toxins11080459.
［5］	Ramachandran R, Marino MJ, Paul S, et al. A study and review of effects of botulinum toxins on mast cell dependent and independent pruritus［J］. Toxins （Basel）, 2018,10（4）:134. doi: 10.3390/toxins10040134.
［6］	List EK, Pascual JC, Zarchi K, et al. Mast cells in hidradenitis suppurativa: a clinicopathological study［J］. Arch Dermatol Res, 2019,311（4）:331⁃335. doi: 10.1007/s00403⁃019⁃01910⁃3.
［7］	Martina E, Diotallevi F, Radi G, et al. Therapeutic use of botulinum neurotoxins in dermatology: systematic review［J］. Toxins （Basel）, 2021, 13（2）:120. doi: 10.3390/toxins13020120.
［8］	李健, 宋志强. 玫瑰痤疮面部潮红与红斑新认识［J］. 中华皮肤科杂志, 2021,54（4）:360⁃363. doi: 10.35541/cjd.20190920.
［9］	Scala J, Vojvodic A, Vojvodic P, et al. Botulin toxin use in rosacea and facial flushing treatment［J］. Open Access Maced J Med Sci, 2019,7（18）:2985⁃2987. doi: 10.3889/oamjms.2019. 784.
［10］	Bharti J, Sonthalia S, Jakhar D. Mesotherapy with Botulinum toxin for the treatment of refractory vascular and papulopustular rosacea［J］. J Am Acad Dermatol, 2018,19:S0190⁃9622（18）30808⁃30809. doi: 10.1016/j.jaad.2018.05.014.
［11］	Choi JE, Werbel T, Wang Z, et al. Botulinum toxin blocks mast cells and prevents rosacea like inflammation［J］. J Dermatol Sci, 2019,93（1）:58⁃64. doi: 10.1016/j.jdermsci.2018.12.004.
［12］	刘乙萱, 姜沛彧, 刘韵祎, 等. 玫瑰痤疮神经源性炎症及肉毒毒素治疗相关机制的研究进展［J］. 中华皮肤科杂志, 2022,55（6）:552⁃554. doi: 10.35541/cjd.20200266.
［13］	Eshghi G, Khezrian L, Alirezaei P. Botulinum toxin A in treatment of facial flushing［J］. Acta Med Iran, 2016,54（7）:454⁃457.
［14］	Oh YJ, Lee NY, Suh DH, et al. A split⁃face study using botulinum toxin type B to decrease facial erythema index［J］. J Cosmet Laser Ther, 2011,13（5）:243⁃248. doi: 10.3109/14764172. 2011.613479.
［15］	Bloom BS, Payongayong L, Mourin A, et al. Impact of intradermal abobotulinumtoxinA on facial erythema of rosacea［J］. Dermatol Surg, 2015,41 Suppl 1:S9⁃S16. doi: 10.1097/DSS.000000000000 0277.
［16］	Dayan SH, Ashourian N, Cho K. A pilot, double⁃blind, placebo⁃controlled study to assess the efficacy and safety of incobotulinumtoxinA injections in the treatment of rosacea［J］. J Drugs Dermatol, 2017,16（6）:549⁃554.
［17］	Kim MJ, Kim JH, Cheon HI, et al. Assessment of skin physiology change and safety after intradermal injections with botulinum toxin: a randomized, double⁃blind, placebo⁃controlled, split⁃face pilot study in rosacea patients with facial erythema［J］. Dermatol Surg, 2019,45（9）:1155⁃1162. doi: 10.1097/DSS.000000000000 1819.
［18］	Al⁃Niaimi F, Glagoleva E, Araviiskaia E. Pulsed dye laser followed by intradermal botulinum toxin type⁃A in the treatment of rosacea⁃associated erythema and flushing［J］. Dermatol Ther, 2020,33（6）:e13976. doi: 10.1111/dth.13976.
［19］	Dhaliwal K, Griffin MF, Salinas S, et al. Optimisation of botulinum toxin type a treatment for the management of Raynaud′s phenomenon using a dorsal approach: a prospective case series［J］. Clin Rheumatol, 2019,38（12）:3669⁃3676. doi: 10.1007/s10067⁃019⁃04762⁃4.
［20］	Winter AR, Camargo Macias K, Kim S, et al. The effect of abobotulinum toxin A on the symptoms of Raynaud′s phenomenon: a case series［J］. Cureus, 2020,12（5）:e8235. doi: 10.7759/cureus.8235.
［21］	Quintana Castanedo L, Feito Rodríguez M, Nieto Rodríguez D, et al. Botulinum toxin A treatment for primary and secondary Raynaud′s phenomenon in teenagers［J］. Dermatol Surg, 2021,47（1）:61⁃64. doi: 10.1097/DSS.0000000000002397.
［22］	Zhou Y, Liu Y, Hao Y, et al. The mechanism of botulinum A on Raynaud syndrome［J］. Drug Des Devel Ther, 2018,12:1905⁃1915. doi: 10.2147/DDDT.S161113.
［23］	Jenkins SN, Neyman KM, Veledar E, et al. A pilot study evaluating the efficacy of botulinum toxin A in the treatment of Raynaud phenomenon［J］. J Am Acad Dermatol, 2013,69（5）:834⁃835. doi: 10.1016/j.jaad.2013.06.029.
［24］	Bello RJ, Cooney CM, Melamed E, et al. The therapeutic efficacy of botulinum toxin in treating scleroderma⁃associated Raynaud′s phenomenon: a randomized, double⁃blind, placebo⁃controlled clinical trial［J］. Arthritis Rheumatol, 2017,69（8）:1661⁃1669. doi: 10.1002/art.40123.
［25］	Motegi SI, Uehara A, Yamada K, et al. Efficacy of botulinum toxin B injection for Raynaud′s phenomenon and digital ulcers in patients with systemic sclerosis［J］. Acta Derm Venereol, 2017,97（7）:843⁃850. doi: 10.2340/00015555⁃2665.
［26］	周末. A型肉毒毒素治疗系统性硬化症继发雷诺现象的疗效及皮肤镜评估［D］. 北京: 北京协和医学院中国医学科学院, 2017. doi: 10.7666/d.Y3277591.
［27］	Medina S, Gómez⁃Zubiaur A, Valdeolivas⁃Casillas N, et al. Botulinum toxin type A in the treatment of Raynaud′s phenomenon: a three⁃year follow⁃up study［J］. Eur J Rheumatol, 2018,5（4）:224⁃229. doi: 10.5152/eurjrheum.2018.18013.
［28］	Dhaliwal K, Griffin MF, Salinas S, et al. Optimisation of botulinum toxin type a treatment for the management of Raynaud′s phenomenon using a dorsal approach: a prospective case series［J］. Clin Rheumatol, 2019,38（12）:3669⁃3676. doi: 10.1007/s10067⁃019⁃04762⁃4.
［29］	Ennis D, Ahmad Z, Anderson MA, et al. Botulinum toxin in the management of primary and secondary Raynaud′s phenomenon［J］. Best Pract Res Clin Rheumatol, 2021,35（3）:101684. doi: 10.1016/j.berh.2021.101684.
［30］	Park J, Park HJ. Botulinum toxin for the treatment of neuropathic pain［J］. Toxins （Basel）, 2017,9（9）:260. doi: 10. 3390/toxins 9090260.
［31］	Xiao L, Mackey S, Hui H, et al. Subcutaneous injection of botulinum toxin a is beneficial in postherpetic neuralgia［J］. Pain Med, 2010,11（12）:1827⁃1833. doi: 10.1111/j.1526⁃4637. 2010.01003.x.
［32］	Apalla Z, Sotiriou E, Lallas A, et al. Botulinum toxin A in postherpetic neuralgia: a parallel, randomized, double⁃blind, single⁃dose, placebo⁃controlled trial［J］. Clin J Pain, 2013,29（10）:857⁃864. doi: 10.1097/AJP.0b013e31827a72d2.
［33］	原永康, 王红斌, 贾博, 等. 局部注射A型肉毒毒素治疗带状疱疹后遗神经痛的疗效观察［J］. 中华物理医学与康复杂志, 2015,37（9）:694⁃695. doi: 10.3760/cma.j.issn.0254⁃1424.2015. 09.014.
［34］	Ding XD, Zhong J, Liu YP, et al. Botulinum as a toxin for treating post⁃herpetic neuralgia［J］. Iran J Public Health, 2017,46（5）:608⁃611.
［35］	Hu Y, Zou L, Qi X, et al. Subcutaneous botulinum toxin⁃A injection for treating postherpetic neuralgia［J］. Dermatol Ther, 2020,33（1）:e13181. doi: 10.1111/dth.13181.
［36］	Li XL, Zeng X, Zeng S, et al. Botulinum toxin A treatment for post⁃herpetic neuralgia: a systematic review and meta⁃analysis［J］. Exp Ther Med, 2020,19（2）:1058⁃1064. doi: 10.3892/etm. 2019.8301.
［37］	Ayasse MT, Buddenkotte J, Alam M, et al. Role of neuroimmune circuits and pruritus in psoriasis［J］. Exp Dermatol, 2020,29（4）:414⁃426. doi: 10.1111/exd.14071.
［38］	Qin B, Sun C, Chen L, et al. The nerve injuries attenuate the persistence of psoriatic lesions［J］. J Dermatol Sci, 2021,102（2）:85⁃93. doi: 10.1016/j.jdermsci.2021.02.006.
［39］	Popescu MN, Beiu C, Iliescu MG, et al. Botulinum toxin use for modulating neuroimmune cutaneous activity in psoriasis［J］. Medicina （Kaunas）, 2022,58（6）:813. doi: 10.3390/medicina580 60813.
［40］	Zanchi M, Favot F, Bizzarini M, et al. Botulinum toxin type⁃A for the treatment of inverse psoriasis［J］. J Eur Acad Dermatol Venereol, 2008,22（4）:431⁃436. doi: 10.1111/j.1468⁃3083.2007. 02457.x.
［41］	Todberg T, Zachariae C, Bregnhøj A, et al. The effect of botulinum neurotoxin A in patients with plaque psoriasis ⁃ an exploratory trial［J］. J Eur Acad Dermatol Venereol, 2018,32（2）:e81⁃e82. doi: 10.1111/jdv.14536.
［42］	Aschenbeck KA, Hordinsky MK, Kennedy WR, et al. Neuromodulatory treatment of recalcitrant plaque psoriasis with onabotulinumtoxinA［J］. J Am Acad Dermatol, 2018,79（6）:1156⁃1159. doi: 10.1016/j.jaad.2018.07.058.
［43］	González C, Franco M, Londoño A, et al. Breaking paradigms in the treatment of psoriasis: Use of botulinum toxin for the treatment of plaque psoriasis［J］. Dermatol Ther, 2020,33（6）:e14319. doi: 10.1111/dth.14319.
［44］	Khattab FM, Samir MA. Botulinum toxin type⁃A versus 5⁃fluorouracil in the treatment of plaque psoriasis: Comparative study［J］. J Cosmet Dermatol, 2021,20（10）:3128⁃3132. doi: 10. 1111/jocd.14306.
［45］	Agamia NF, Sobhy N, Abd⁃Elraouf A, et al. Fractional CO2 laser for transcutaneous drug delivery of onabotulinum toxin in palmar hyperhidrosis［J］. Dermatol Surg, 2021,47（5）:678⁃683. doi: 10.1097/DSS.0000000000002901.
［46］	Wu CJ, Chang CK, Wang CY, et al. Efficacy and safety of botulinum toxin A in axillary bromhidrosis and associated histological changes in sweat glands: a prospective randomized double⁃blind side⁃by⁃side comparison clinical study［J］. Dermatol Surg, 2019,45（12）:1605⁃1609. doi: 10.1097/ DSS.000 0000000001906.
［47］	Qiao Z, Yang H, Jin L, et al. The efficacy and safety of botulinum toxin injections in preventing postoperative scars and improving scar quality: a systematic review and meta⁃analysis［J］. Aesthetic Plast Surg, 2021,45（5）:2350⁃2362. doi: 10.1007/s00266⁃021⁃02196⁃5.
［48］	Sun P, Lu X, Zhang H, et al. The efficacy of drug injection in the treatment of pathological scar: a network meta⁃analysis［J］. Aesthetic Plast Surg, 2021,45（2）:791⁃805. doi: 10.1007/s00266⁃019⁃01570⁃8.
［49］	Grimstad Ø, Kvammen BØ, Swartling C. Botulinum toxin type B for hidradenitis suppurativa: a randomised, double⁃blind, placebo⁃controlled pilot study［J］. Am J Clin Dermatol, 2020,21（5）:741⁃748. doi: 10.1007/s40257⁃020⁃00537⁃9.
［50］	Vachiramon V, Kositkuljorn C, Leerunyakul K, et al. A study of botulinum toxin A for ultraviolet⁃induced hyperpigmentation: a randomized controlled trial［J］. Dermatol Surg, 2021,47（5）:e174⁃e178. doi: 10.1097/DSS.0000000000002943.
［51］	Sayed KS, Hegazy R, Gawdat HI, et al. The efficacy of intradermal injections of botulinum toxin in the management of enlarged facial pores and seborrhea: a split face⁃controlled study［J］. J Dermatolog Treat, 2021,32（7）:771⁃777. doi: 10.1080/09546634.2019.1708241.
［52］	Shirshakova M, Morozova E, Sokolova D, et al. The effectiveness of botulinum toxin type A （BTX⁃A） in the treatment of facial skin oily seborrhea, enlarged pores, and symptom complex of post⁃acne［J］. Int J Dermatol, 2021,60（10）:1232⁃1241. doi: 10.1111/ijd.15574.
［53］	Zhang L, Yu Q, Wang Y, et al. A small dose of botulinum toxin A is effective for treating androgenetic alopecia in Chinese patients［J］. Dermatol Ther, 2019,32（4）:e12785. doi: 10.1111/dth.12785.
［54］	Zhou Y, Yu S, Zhao J, et al. Effectiveness and safety of botulinum toxin type A in the treatment of androgenetic alopecia［J］. Biomed Res Int, 2020,2020:1501893. doi: 10.1155/2020/1501893.
［55］	Zhang H, Tang K, Wang Y, et al. Botulinum toxin in treating Hailey⁃Hailey disease: a systematic review［J］. J Cosmet Dermatol, 2021,20（5）:1396⁃1402. doi: 10.1111/jocd.13963.
［56］	Rodríguez⁃Villa Lario A, Vega⁃Díez D, González⁃Cañete M, et al. Aquagenic keratoderma with dorsal involvement treated with botulinum toxin. Case report and review of literature［J］. Dermatol Ther, 2020,33（6）:e14347. doi: 10.1111/dth.14347.
［57］	Wen X, Li Y, Hamblin MR, et al. Facial manifestations of pachydermoperiostosis treated with botulinum toxin type⁃A: report of 3 cases［J］. Acta Derm Venereol, 2017,97（6）:761⁃762. doi: 10.2340/00015555⁃2645.
［58］	Lu Y, Qi X, Zhou X, et al. Intralesional botulinum toxin A injection for treating nodular scabies［J］. Dermatol Ther, 2020,33（6）:e14163. doi: 10.1111/dth.14163.
［59］	Turkmani MG, Alnomair N. Enhancement of the aesthetic outcome of scleroderma en coup de sabre with botulinum toxin injection［J］. JAAD Case Rep, 2018,4（6）:579⁃581. doi: 10. 1016/j.jdcr.2018.03.023.
［60］	Koren A, Sprecher E, Reider E, et al. A treatment protocol for botulinum toxin injections in the treatment of pachyonychia congenita⁃associated keratoderma［J］. Br J Dermatol, 2020,182（3）:671⁃677. doi: 10.1111/bjd.18169.
［61］	Zhong J, Lan Y, Fu S, et al. Botulinum toxin A injection for treatment of chronic skin ulcer: a case series and literature review［J］. Int J Low Extrem Wounds, 2019,18（1）:97⁃103. doi: 10.1177/1534734618816589.

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Off-label clinical application of botulinum toxin in dermatology

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