A型肉毒素治疗银屑病一例并文献复习

有文献报道A型肉毒素治疗顽固性斑块型银屑病和反转型银屑病效果较好。本文报道A型肉毒素治疗斑块型银屑病患者一例并对相关文献进行复习。患者右小腿外侧皮损作为靶皮损（PASI=7分）,注射A型肉毒素,臀部皮损（PASI=6分）为对照靶皮损,无特殊治疗。A型肉毒素注射1个月后回访,右小腿皮疹明显好转,PASI=1分;臀部对照皮损,无明显好转,PASI=5分。     

A型肉毒素治疗额横纹剂量探讨

目的观察A型肉毒素(BTX-A)治疗额横纹的注射点数的设计和使用剂量与治疗效果的关系。方法回顾性研究了42例先后两次采用不同剂量BTXA接受去除额横纹治疗者,比较两次治疗后额横纹的评分、患者满意度评分及疗效持续时间。第1次平均注射点数为10.44±1.27,平均注射剂量为(26.10±3.16)U;第2次平均注射点数为4.88±0.81,平均注射剂量为(12.20±2.03)U。结果两次治疗后的额纹评分差异无统计学意义(P>0.05),而第2次治疗后患者满意度评分高于第1次,差异有统计学意义(P<0.05),两次治疗后疗效维持时间差异无统计学意义(P>0.05)。结论低剂量注射BTX-A(衡力)治疗额横皱可取得与高剂量注射基本相同的效果,并且使患者治疗后的满意度增加。     

A型肉毒毒素在美容皮肤科的应用

介绍A型肉毒毒素在美容皮肤科除皱、止汗的功效和方法。A型肉毒毒素局部注射除皱、止汗疗效肯定,而且安全性好,注射1次A型肉毒毒素可维持除皱约4个月,止汗效果可维持12个月。A型肉毒毒素局部注射是美容皮肤科用于除皱、止汗的新方法。     

A型肉毒杆菌毒素在皮肤科临床上的应用

治疗用A型肉毒杆菌毒素是从A型肉毒杆菌中提取的一种神经毒素。它能使肌肉麻痹。1989年美国食品与药品管理局首先批准用于治疗神经肌肉疾病。1992年Carruthers等把这一新技术引进到皮肤科，用于治疗各种面部皱纹和各种多汗症。应用10余年来其疗效与安全性得到了肯定。2002年4月15日美国食品与药品管理局批准用于皮肤除皱的适证。肉毒杆菌毒素注射技术要求很高。为掌握这一技术并正确使用该毒素，医生在使用前应经过严格的正规培训。如果使用不当会出现一些不必要的并发症。有的并发症还较严重，应尽量作好预防。     

A型肉毒素对兔耳增生性瘢痕的抑制作用及机制

目的 探讨A型肉毒素对兔耳增生性瘢痕的抑制作用及可能的机制。方法 SPF级大耳兔建立增生性瘢痕动物模型,随机分成3组：A型肉毒素组(A组)、复方倍他米松组(B组)和对照组(C组)。A、B两组待瘢痕增生达到高峰即伤后第30天,均瘢痕内注入药物,每个创面0.1 mL/次,2周/次,共注射2次,而C组不做任何治疗。于伤后第58天切取兔耳创面作为标本,对比3组瘢痕增生指数、胶原容积分数、血管内皮细胞生长因子(vascular endothelial growth factor, VEGF)、转化生长因子-β1(transforming growth factor beta 1,TGF-β1)及神经肽P物质(neuropeptide substance P,SP)表达的差异。结果 A、B、C三组的瘢痕增生指数分别为(1.20±0.15)mm、(1.17±0.10)mm和(2.64±0.34)mm;胶原容积分数为(63.67±2.25)%、(62.08±2.19)%和(79.08±4.80)%;VEGF的表达分别为(24.44±2.62)%、(23.75±2.58)%和(34.39±2.49)%;...     

异维A酸在皮肤科的应用

自1986年以来异维A酸就有效地治疗严重痤疮.异维A酸影响表皮细胞生长和分化以及皮脂腺活性,并具有免疫调节和抗炎作用,可治疗一系列皮肤病.本文温习了异维A酸在皮肤科的应用及副反应和药物相互作用,现综述如下.     

外用维生素A在皮肤科的重新应用

皮肤科对全反式维生素A的研究始于60年代,因其不稳定和不良反应,研究转向了其代谢产物-全反式维A酸。随着化妆品工业的发展,目前生产出了稳定的外用维生素A。临床实验证实,它可诱导表皮产生与维A酸类似的有益作用而刺激性却明显下降。     

A型肉毒杆菌毒素在皮肤科临床上的应用

治疗用A型肉毒杆菌毒素是从A型肉毒杆菌中提取的一种神经毒素。它能使肌肉麻痹。 1989年美国食品与药品管理局首先批准用于治疗神经肌肉疾病。 1992年Carruthers等把这一新技术引进到皮肤科 ,用于治疗各种面部皱纹和各种多汗症。应用 10余年来其疗效与安全性得到了肯定。 2 0 0 2年 4月 15日美国食品与药品管理局批准用于皮肤除皱的适应证。肉毒杆菌毒素注射技术要求很高。为掌握这一技术并正确使用该毒素 ,医生在使用前应经过严格的正规培训。如果使用不当会出现一些不必要的并发症。有的并发症还较严重 ,应尽量作好预防。     

异维A酸在皮肤科的应用

异维A酸 (Isotretinoin)即 1 3 -顺维A酸 ,其商品名为泰尔丝 ,化学结构式如下 :　　异维A酸是继全反式维A酸之后的又一种第一代维A酸 ,可影响上皮细胞的生长、分化及皮脂腺的活性 ,并具有调节免疫和抗炎的特性 ,1 973年开始用于临床 ,1 982年经美国FDA认证 ,它治疗角化性和增殖性皮病等有较高的疗效 ,且其适应证正在不断扩大中 ,故在皮肤科的治疗领域中有着广阔的前景。1　在皮肤科的应用1 1　痤疮及与其相关疾病1 1 1　痤疮 :本病极为常见 ,到 1 6岁时发病率高达 83～95 % ,2 0岁时下降至 3 5岁时则很低 ,病因和病机为 1 ,皮脂腺分…     

维A酸类药物在皮肤科的应用

维Ａ酸类药 (维生素Ａ酸 ,视黄酸 ,Ｖｉ ｔａｍｉｎ Ａａｃｉｄ ,ｒｅｔｉｎｏｉｃａｃｉｄ)是食物中的维生素和类胡萝卜素在体内代谢后形成的一种形态发生性激素 (ｍｏｒｐｈｏｇｅｎｅｔｉｃｈｏｒｍｏｎｅ) ,在多种组织的形态发生和分化过程中发挥重要作用1 。由于维Ａ酸类药的多种生物学活性 ,临床上被广泛用于银屑病、角化性皮肤病、光老化皮肤、痤疮及部分肿瘤和癌前病变的治疗。现将有关维Ａ酸类药治疗皮肤病的情况介绍如下。1　维Ａ酸类药物的分类维Ａ酸基本结构由环已烯环、侧链和极性终末基团 3部分组成。维Ａ酸的衍生物很多 ,大…     

Botulinum toxin type A in chronic non-dyshidrotic palmar eczema: A side-by-side comparative study

New indications are being reported for intradermal botulinum toxin type A (BTX-A) owing to its anti-inflammatory and antipruritic actions. Its successful use for dyshidrotic hand eczema and lichen simplex has been reported in a few cases, while its utility in dry palmar eczema not associated with hyperhidrosis has not yet been investigated. The aim of this study was the assessment of the additive efficacy and tolerability of BTX-A in chronic dry palmar eczema. This prospective non-randomized side-by-side comparative study included 30 cases of chronic bilateral dry palmar eczema with no associated hyperhidrosis. Combined emollients and topical mid-potency steroid on one side were compared with an additive 100 units of intradermal BTX-A on the other side for efficacy and tolerability using both patient- and physician-oriented scores over a period of 6 months. Timing and extent of improvement and relapse were recorded on both sides, together with the frequency of development of side-effects. Both lines were effective and well tolerated, with significantly greater reduction of symptom and sign scores and higher overall patient satisfaction on the side receiving BTX-A, an effect which lasted for a significantly longer duration on this side (4 months) as compared with the other side (1 month). In conclusion, intradermal BTX-A at a dose of 100 units/palm is beneficial and well tolerated in chronic dry palmar eczema. Compared with topical steroid and emollients alone, its addition yielded superior efficacy that was longer lasting and more satisfactory to the patients, while exerting a steroid-sparing effect.     

Intralesional triamcinolone alone or in combination with botulinium toxin A is ineffective for the treatment of formed keloid scar: A double blind controlled pilot study

Cutaneous injury can ignite excessive fibroproliferative growth that results in keloid formation. Keloids are associated with significant morbidity related to disfigurement and/or symptoms (e.g., pain and pruritus). First‐line treatment of formed keloids involves topical or intralesional steroids. Recurrent or resistant keloids are managed by surgical excision or cryotherapy, followed by steroidal application or adjuvant irradiation. Although adjuvant irradiation appears to be most efficacious, alternative therapeutic options are needed for patients without access to radiation centers. Botulinum Toxin A (BTA) appears to have similar inhibitory effects to irradiation on the cell cycle via downregulation of pathogenic cytokines. Herein, we conducted a study to compare the efficacy of intralesional triamcinolone used alone, or in combination with BTA, in the treatment of formed keloid scars. Twenty patients with a cumulative of 40 keloids completed the study. There was no significant difference between treatment arms with respect to height vascularization, pliability, and pigmentation scores. The addition of BTA resulted in significant symptomatic improvement of pain and pruritus as compared to intralesional triamcinolone alone (p < 0.001). Irradiation is only effective when administered in the adjuvant setting where inhibitory effects on cell cycle and migration are optimized. Future studies with intralesional triamcinolone and BTA should be performed adjuvantly.     

A型肉毒毒素在几种皮肤病的应用进展

近年来,随着A型肉毒毒素作用机制和临床研究的不断深入,其在皮肤病的应用范围日渐增多.A型肉毒毒素的植物神经系统效应可治疗腋部多汗症和手部多汗症,其镇痛效应可治疗带状疱疹后遗神经痛,因其抑制增生性瘢痕成纤维细胞增殖和胶原蛋白的合成,可治疗瘢痕疙瘩及瘢痕.A型肉毒毒素可短暂麻痹骨骼肌,达到延缓皱纹深化的作用.A型肉毒毒素注射的最大弊端就是只能暂时缓解或消除症状,若想长期控制就必须反复注射,许多报道表明,A型肉毒毒素注射最多只能维持12个月.     

A succinct review of botulinum toxin in dermatology; update of cosmetic and noncosmetic use

Botulinum toxin A has a wide variety of clinical applications in medical and dermatologic sciences. Nowadays, researchers introduce some other indications for botulinum toxin in cosmetic and especially noncosmetic aspects of dermatology such as medical rhinoplasty, hypertrophic scar, chemical brow lift, supraciliary wrinkles, pompholix, eccrine angiomatosis, Hailey-Hailey, dermatochalasis, lichen simplex, nosthalgia parestetica, and granulosis rubra nasi. In this general overview of the use of botulinum toxin in dermatology, an extensive literature search was carried out to updates of all dermatology-oriented experiments and clinical trials on the mentioned aspect of botulinum toxin.     

Botulinum toxin type A for the treatment and prevention of hypertrophic scars and keloids: Updated review

Botulinum Toxin Type A is a potent neurotoxin that is produced by a gram‐positive bacteria clostridium botulinum. Its utilization in the treatment of various medical condition has expanded over the years in both medical and esthetic uses. It is being preferred by most physicians due to its efficacy and lack of side effects. It can be used as monotherapy or combined therapy. The aim of this review study was to show the role and mechanism of action of Botulinum toxin type A in the treatment and prevention of hypertrophic scars and keloids. The clear mechanisms underlying hypertrophic scars and keloids are still not clearly understood; however, the mechanism of action of Botulinum toxin type A has been shown to include action on wound tension, action on collagen, and action on fibroblasts. Different randomized controlled trials, double‐blind, and placebo‐controlled studies have been conducted to investigate its use in treatment and prevention of hypertrophic scars and keloids, and it still is one of the active areas of research in Dermatology and related fields. Method: In March 2018, we performed a literature search in PubMed for clinical studies, clinical trials, case reports, controlled trials, randomized controlled trials, and systemic reviews. The search terms we used were “BOTULINUM TOXIN” AND “HYPERTROPHIC SCARS” OR “KELOIDS” (from 1980). The search resulted in 1000 articles, out of these 35 articles met our inclusion exclusion criteria. Our inclusion criteria included relevant original articles relevant, critical systemic reviews, and crucial referenced articles, exclusion criteria included duplicates and articles not published in English language. We have reviewed these papers to show the role and mechanism of action of Botulinum toxin type A in the treatment and prevention of hypertrophic scars and keloids.     

Intracutaneous botulinum toxin A versus ablative therapy of Hailey-Hailey disease - a case report

BACKGROUND: Hailey-Hailey disease is an autosomal-dominant blistering disease affecting the intertriginous skin. Dermabrasion and ablative laser treatment are known to be curative. Sweating is a common aggravating factor. Botulinum toxin A (BTXA) has been shown to inhibit sudoriferic nerves. OBJECTIVE: To evaluate whether a treatment with BTXA induces remissions and can compete with ablative therapy. To compare dermabrasion with erbium:YAG laser therapy. METHOD: Case report with side-by-side comparison. We used intracutaneous BTXA on both sides of the submammary region. Four days later a limited area of 25 cm 2 on each side was treated with either dermabrasion or erbium:YAG laser. The follow-up was 12 months. RESULTS: Wound healing was complete within 7 days after erbium:YAG laser and two weeks after dermabrasion. Areas treated with BTXA alone also showed complete remission within two weeks. During a follow-up, no relapse occurred with either treatment. CONCLUSION: BTXA is capable of inducing remissions of Hailey-Hailey disease without abrasion for at least 12 months. Among ablative treatments, erbium: YAG laser therapy leads to a more rapid wound closure than dermabrasion, with both causing complete remissions.