Botulinum toxin type A for the treatment of axillary Hailey-Hailey disease.
BACKGROUND
Hailey-Hailey disease is an inherited acantholytic disorder affecting the intertriginous areas of the body which is exacerbated by sweat, moisture, and friction. The disease is frequently resistant to conventional nonsurgical treatment.


OBJECTIVE
To evaluate whether chemodenervation of sweat glands would improve the course of the disease in a patient with Hailey-Hailey.


METHODS
We used low-dose treatment of the left axilla with botulinum toxin type A, the right axilla being used as a control, followed by treatment of both axillae with the optimal dose routinely used for the treatment of axillary hyperhidrosis.


RESULTS
After one treatment with a low dose of botulinum toxin type A, we observed partial improvement of the treated axilla. With subsequent treatment of both axillae with the recommended dose for axillary hyperhidrosis, we observed a sustained complete remission of the disease in the treated axillae.


CONCLUSIONS
Botulinum toxin type A may be an effective and safe nonsurgical alternative for the treatment of benign familial pemphigus in intertriginous areas such as the axillae.
Lapiere
J C
JC
Department of Dermatology, Northwestern University Medical School, Chicago, Illinois, USA. j.lapiere@nwu.edu
Hirsh
A
A
Gordon
K B
KB
Cook
B
B
Montalvo
A
A
D001365:Axilla; D019274:Botulinum Toxins, Type A / Q000008:administration & dosage*; D006801:Humans; D007267:Injections; D008297:Male; D008875:Middle Aged; D016506:Pemphigus, Benign Familial / Q000473:pathology / Q000628:therapy*; D012867:Skin / Q000473:pathology; D013545:Sweat Glands / Q000187:drug effects / Q000294:innervation
D019274:Botulinum Toxins, Type A