title: Effectiveness of botulinum toxin A in treatment of refractory erythromelalgia.
abstract: Erythromelalgia is characterized by intense burning pain, erythema, and heat in affected areas after precipitating factors such as warm temperature or stress. It is refractory to treatment in some situations. We describe a woman with adenosquamous cell carcinoma of the lung and medically refractory erythromelalgia. The symptoms of erythromelalgia presented as refractory to any medical treatment. Due to the unresponsive nature of her condition, botulinum toxin type A (onabotulinumtoxin A) was injected over both of her cheeks, periodically for six cycles. Her symptoms responded dramatically to subcutaneous and intradermal injection of botulinum toxin type A. Repetitive injection demonstrated consistent and reproducible responses, and the efficacy was maintained for approximately 1 month. No adverse effects or complications were noted. Botulinum toxin type A might be safe and effective as an alternative treatment for refractory erythromelalgia, but further large-scale studies are required.
authors.affiliation: Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan, ROC. siriuson1202@gmail.com
authors.forename: Kuan-Hsiang
authors.initials: KH
authors.lastname: Lin
authors.forename: Shuu-Jiun
authors.initials: SJ
authors.lastname: Wang
authors.forename: Jong-Ling
authors.initials: JL
authors.lastname: Fuh
authors.forename: Shih-Pin
authors.initials: SP
authors.lastname: Chen
mesh_terms: D019274:Botulinum Toxins, Type A / Q000627:therapeutic use*; D004916:Erythromelalgia / Q000188:drug therapy*; D005260:Female; D006801:Humans; D008875:Middle Aged
chemical_list: D019274:Botulinum Toxins, Type A