title: Treatment of dyshidrotic hand dermatitis with intradermal botulinum toxin.
abstract: BACKGROUND
  Botulinum toxin (Btx A) has recently been used in the treatment of focal hyperhidrosis. Hyperhidrosis is also an aggravating factor in nearly 40% of patients with dyshidrotic hand eczema.
  
  
  OBJECTIVE
  The objective of this study was to evaluate the effect of intradermal injections of Btx A on dermatitis in patients with vesicular hand dermatitis.
  
  
  METHODS
  Ten patients with vesicular dermatitis were treated on one hand with intradermal Btx A (mean, 162 U BOTOX, Allergan Pharmaceuticals, Irvine, Calif) with the untreated side as a control.
  
  
  RESULTS
  Self-assessment at follow-up 5 to 6 weeks after injection on a 5-point scale (none, slight, moderate, good, or very good effect) showed that 7 of 10 patients experienced good or very good effect. A decrease in itching was shown with a visual linear analogue scale (VAS) for itching, with mean 39% on the treated side compared with an increase by 52% on the untreated side. These findings were supported by the evaluation of clinical signs. Six of 7 patients who experienced good or very good effect also had aggravating hand sweating or worsening during the summer.
  
  
  CONCLUSIONS
  Btx A can be a valuable alternative for patients with treatment-refractory hand eczema of the vesicular type, especially with hyperhidrosis or worsening during the summer.
authors.affiliation: Department of Medical Sciences, Uppsala University, Uppsala, Sweden.
authors.forename: Carl
authors.initials: C
authors.lastname: Swartling
authors.forename: Hans
authors.initials: H
authors.lastname: Naver
authors.forename: Magnus
authors.initials: M
authors.lastname: Lindberg
authors.forename: Ingegard
authors.initials: I
authors.lastname: Anveden
mesh_terms: D000328:Adult; D019274:Botulinum Toxins, Type A / Q000008:administration & dosage*; D011146:Eczema, Dyshidrotic / Q000188:drug therapy*; D005260:Female; D006225:Hand; D006801:Humans; D007271:Injections, Intradermal; D008297:Male; D008875:Middle Aged; D009465:Neuromuscular Agents / Q000008:administration & dosage*; D011446:Prospective Studies; D016896:Treatment Outcome
chemical_list: D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A