title: The use of botulinum toxin-A in the management of neck and anterior chest wall flushing: pilot study.
abstract: Idiopathic neck and chest wall flushing could cause disabling effects on patients' quality of life. We aimed to evaluate the effectiveness of botulinum toxin-A (BTA) in the management of idiopathic neck and chest wall flushing. This was a pilot prospective clinical study of patients with severe idiopathic neck and anterior chest wall flushing. Two mouse units of BTA were injected intracutaneously with a maximum dose of 100 units per patient per session. The dermatology life quality index is used as the primary outcome measure. Twenty-two patients were included in the study (18 women, four men) with an average age of 26 years (range 18-48). Twenty patients (90.9%) had immediate improvement with almost complete resolution of their flushing. At four weeks follow-up, 18 of 22 patients were included in the final analysis, significant improvement in quality of life was achieved, and mean baseline dermatology life quality index score 7.78 (SD 3.25) improved significantly to 4.23 (SD 3.44) with a mean difference of 3.56 (SD 4.6; 95%, confidence interval 1.27, 5.84) with paired samples t-test 3.29 (d.f. 17) P < 0.004. BTA may provide an effective treatment in the management of idiopathic neck and chest wall flushing.
authors: Department of Vascular and General Surgery, The Hillingdon Hospitals NHS Foundation Trust, Mount Vernon Hospital, Northwood, UK.
authors: Emad
authors: E
authors: Geddoa
authors: Hosam E
authors: HE
authors: Matar
authors: Trevor Rudrah Franco
authors: TR
authors: Paes
mesh_terms: D000293:Adolescent; D000328:Adult; D019274:Botulinum Toxins, Type A / Q000627:therapeutic use*; D004890:Erythema / Q000188:drug therapy* / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009333:Neck; D009465:Neuromuscular Agents / Q000627:therapeutic use*; D010865:Pilot Projects; D011446:Prospective Studies; D011788:Quality of Life; D013909:Thorax; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A