title: Failure of botulinum toxin treatment for localized vitiligo.
abstract: BACKGROUND
  It was found that acetylcholine concentration increased with a significantly reduced expression of acetylcholinesterase in vitiliginous patches that return to normal upon repigmentation.
  
  
  OBJECTIVE
  To evaluate the efficacy and safety of botulinum toxin A in patients with localized vitiligo.
  
  
  METHODS
  Ten patients were recruited. Eight patients had two or more focal vitiliginous patches. Two had segmental vitiligo. For each patient with focal vitiligo, one or two vitiliginous patches were treated. For each patient with segmental vitiligo, half of the lesion was treated. The untreated parts were used as a control. Botulinum toxin was injected. The response was analyzed at the initial visit, and then two weeks, two months and six months after therapy.
  
  
  RESULTS
  Thirteen vitiliginous patches were treated. Reassessment showed no evidence of repigmentation. Comparing treated versus untreated sides, no differences were found. No adverse effects were reported.
  
  
  CONCLUSIONS
  Botulinum toxin is not effective in the treatment of localized vitiligo.
authors.affiliation: Department of Dermatology, College of Medicine, King Saud University-Riyadh, Kingdom of Saudi Arabia. gbinsaif@ksu.edu.sa
authors.forename: Ghada A
authors.initials: GA
authors.lastname: BinSaif
authors.forename: Abdullah
authors.initials: A
authors.lastname: Al Samary
authors.forename: Saad
authors.initials: S
authors.lastname: Al Mohizea
mesh_terms: D000109:Acetylcholine / Q000378:metabolism; D000110:Acetylcholinesterase / Q000378:metabolism; D000293:Adolescent; D019274:Botulinum Toxins, Type A / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D009465:Neuromuscular Agents / Q000009:adverse effects / Q000627:therapeutic use*; D010858:Pigmentation / Q000187:drug effects; D010865:Pilot Projects; D011446:Prospective Studies; D017211:Treatment Failure; D016896:Treatment Outcome; D014820:Vitiligo / Q000188:drug therapy* / Q000473:pathology; D055815:Young Adult
chemical_list: D009465:Neuromuscular Agents; D000110:Acetylcholinesterase; D019274:Botulinum Toxins, Type A; D000109:Acetylcholine