The use of botulinum toxin in the management of burns itching: preliminary results.
Itching is a common and well recognised problem following burns. As the underlying pathways involved in burns itch have been identified, different pharmacological agents have been introduced to improve the effectiveness of management regimes. We present preliminary data from an on-going study in the use of botulinum toxin as a novel agent in the treatment of this problem.


METHODS
Patients with recalcitrant itching secondary to burns treated with Botox(©) were identified. Data pertaining to burn size, depth and management were recorded. The delay in the onset of the itch, its severity and the speed and duration of any improvement in symptoms were also noted.


RESULTS
10 patients were identified. 1 patient was excluded. Average follow-up was 11.3 months. All patients had deep partial thickness to full thickness burns. Eight patients underwent grafting. The average burn was 24% TBSA. 87.5% of patients rated their burns itch as being severe (>7 on the pain scale). Following the administration of Botox(©) this fell to 0 out of 10 at 4 weeks. The average duration of the symptom free period was nine months (range 3-18 months).


CONCLUSIONS
Botox(©) can successfully be used to treat burns itch that are resistant to conventional therapies.
Department of Burns and Plastic Surgery, Nottingham City Hospital, Herries Road, Nottingham, United Kingdom. nadeem_akhtar_3@hotmail.com
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Akhtar
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Brooks
D000293:Adolescent; D000328:Adult; D000368:Aged; D001905:Botulinum Toxins / Q000627:therapeutic use*; D002056:Burns / Q000150:complications*; D002648:Child; D002675:Child, Preschool; D003879:Dermatologic Agents / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007223:Infant; D007271:Injections, Intradermal; D008297:Male; D008875:Middle Aged; D011042:Poisons / Q000627:therapeutic use*; D011446:Prospective Studies; D011537:Pruritus / Q000188:drug therapy* / Q000209:etiology; D012720:Severity of Illness Index; D055815:Young Adult
D003879:Dermatologic Agents; D011042:Poisons; D001905:Botulinum Toxins