title: Intracutaneous botulinum toxin A versus ablative therapy of Hailey-Hailey disease--a case report.
abstract: 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.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Dermatology and Allergology, University of Jena, Germany.
authors.forename: H
authors.initials: H
authors.lastname: Konrad
authors.forename: T
authors.initials: T
authors.lastname: Karamfilov
authors.forename: U
authors.initials: U
authors.lastname: Wollina
mesh_terms: D019274:Botulinum Toxins, Type A / Q000627:therapeutic use*; D003869:Dermabrasion / Q000379:methods*; D005260:Female; D006801:Humans; D007271:Injections, Intradermal; D053685:Laser Therapy; D008875:Middle Aged; D009465:Neuromuscular Agents / Q000627:therapeutic use*; D016506:Pemphigus, Benign Familial / Q000628:therapy*; D016896:Treatment Outcome
chemical_list: D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A