Botulinum Toxin Type B for Hidradenitis Suppurativa: A Randomised, Double-Blind, Placebo-Controlled Pilot Study

Abstract

Background Botulinum toxin (BTX) is a potent neurotoxin with a long history of therapeutic application in neurological and dermatological conditions, with a strong efficacy and safety profile. Objective Our aim was to assess whether intradermal injection with BTX-B is an effective treatment for hidradenitis suppurativa (HS). Methods Twenty patients with HS stage I-III disease, according to Hurley's classification, were consecutively included for treatment with either a placebo or BTX-B. At the next intervention after 3 months, all participants received the active substance and another follow-up at 6 months. The primary outcome was quality of life, measured using the Dermatology Life Quality Index (DLQI), while secondary outcomes were the visual analogue scale (VAS) for pain in the worst boil and HS-related impairment of general health (VAS), as well as changes in physician-reported disease activity assessed as the number of total lesions, and reported adverse effects of treatment. Results The DLQI improved from a median of 17 at baseline to 8 at 3 months in the BTX-B group, compared with a reduction from 13.5 to 11 in the placebo group (p <0.05). Improvement of the patients' own ratings of symptoms and a reduction in total lesions supplemented the primary outcome. Fifty-five percent of the study population reported some degree of hyperhidrosis. Conclusion BTX-B improves the quality of life in patients with HS. Furthermore, comorbidity between HS and hyperhidrosis is suggested. Trial Registration ClinicalTrials.gov identifier: NCT03103074.

Quality of Life in Hidradenitis Suppurativa: An Update

“…Botulinum toxin type B was compared with placebo in the treatment of HS [ 50 ]. The DLQI improved from a median of 17 at baseline to 8 at 3 months in the botulinum toxin group, compared with an improvement from 13.5 to 11 in the placebo group ( p < 0.05).…”

Hyperhidrosis treatments in hidradenitis suppurativa: A systematic review

“…Hurley stage was reported in seven studies (37% Hurley I, 43% Hurley II, 21% Hurley III). [1][2][3][7][8][9][10] Study locations include the United States for hyperhidrosis. HS disease activity was evaluated by clinician assessment of disease (such as change in drainage and total number of lesions), 1,[7][8][9][10][11][12][13][14] the pain visual analog score (VAS), 9,12 dermatology life quality index (DLQI), 1,9 patient-reported subjective improvement, 7,9 and HS clinical response (HiSCR).…”

“…Mean age at time of study ranged from 7 to 68 years. Hurley stage was reported in seven studies (37% Hurley I, 43% Hurley II, 21% Hurley III) 1–3,7–10 . Study locations include the United States ( n = 5), United Kingdom ( n = 4), Italy ( n = 1), Spain ( n = 1), Norway ( n = 1), Singapore ( n = 1), Netherlands ( n = 1), Canada ( n = 1), and Poland ( n = 1).…”

Botulinum toxin beyond aesthetics in dermatology

“…Hyperhidrosis [7] Eccrine hydrocystomas Eccrine angiomatous hamartoma Pitted keratolysis Chromhidrosis Hailey-Hailey disease [8] Dyshidrotic eczema [9] Disorders of apocrine glands Hidradenitis suppurativa [10] Bromhidrosis Disorders of striated muscles For unopposed muscle action in facial palsy [11] Disorders associated with pain Post-herpetic neuralgia [12] Leiomyoma associated pain Notalgia paresthetica…”