The use of botulinum toxin in the management of hidradenitis suppurativa: a systematic review
File(s)
Published version
Author(s)
Geoghegan, Luke
Harrison, Conrad
Rodrigues, Raina
Rodrigues, Jeremy
Type
Journal Article
Abstract
Background
Hidradenitis suppurativa (HS) is a chronic inflammatory skin condition characterised by suppurative infection, sinus tract and abscess formation. International guidelines on the management of HS are largely consensus based. Botulinum toxin (BTX) has been widely used in the treatment of other disorders of apocrine and eccrine gland disorders such as hyperhidrosis, although the effectiveness of BTX in the treatment of HS remains unknown. The aim of this systematic review was to determine the safety and effectiveness of BTX in the treatment of HS.
Methods
We conducted a PRISMA-compliant, prospectively registered (PROSPERO, CRD42021228732), systematic review. We devised bespoke search strategy and applied it to the Cochrane Central Register of Controlled Trials, Medline, EMBASE and OpenGrey to identify relevant publications up until March 2022. We included all clinical studies that reported outcomes following BTX treatment in patients diagnosed with HS (both adult and paediatric).
Results
A total of 4658 studies were identified, of which 6 met full inclusion criteria reporting data on 26 patients. The six identified studies included one randomised control trial, one case series and four case studies. Subjective assessments of intervention effect were used in five out of six included studies. The one included randomised control trial demonstrated a significant reduction in the Dermatology Life Quality Index (DLQI) score at 3 months following treatment with BTX.
Conclusions
The effectiveness and safety of BTX in the treatment of HS remains unknown. This systematic review identified a paucity of high-quality clinical data. Evidence of treatment effectiveness is likely to come from registry-based cohort studies using established core outcome sets in the first instance.
Hidradenitis suppurativa (HS) is a chronic inflammatory skin condition characterised by suppurative infection, sinus tract and abscess formation. International guidelines on the management of HS are largely consensus based. Botulinum toxin (BTX) has been widely used in the treatment of other disorders of apocrine and eccrine gland disorders such as hyperhidrosis, although the effectiveness of BTX in the treatment of HS remains unknown. The aim of this systematic review was to determine the safety and effectiveness of BTX in the treatment of HS.
Methods
We conducted a PRISMA-compliant, prospectively registered (PROSPERO, CRD42021228732), systematic review. We devised bespoke search strategy and applied it to the Cochrane Central Register of Controlled Trials, Medline, EMBASE and OpenGrey to identify relevant publications up until March 2022. We included all clinical studies that reported outcomes following BTX treatment in patients diagnosed with HS (both adult and paediatric).
Results
A total of 4658 studies were identified, of which 6 met full inclusion criteria reporting data on 26 patients. The six identified studies included one randomised control trial, one case series and four case studies. Subjective assessments of intervention effect were used in five out of six included studies. The one included randomised control trial demonstrated a significant reduction in the Dermatology Life Quality Index (DLQI) score at 3 months following treatment with BTX.
Conclusions
The effectiveness and safety of BTX in the treatment of HS remains unknown. This systematic review identified a paucity of high-quality clinical data. Evidence of treatment effectiveness is likely to come from registry-based cohort studies using established core outcome sets in the first instance.
Date Issued
2022-11
Date Acceptance
2022-09-21
Citation
Plastic and Reconstructive Surgery Global Open, 2022, 10 (11), pp.1-6
ISSN
2169-7574
Publisher
Lippincott, Williams & Wilkins
Start Page
1
End Page
6
Journal / Book Title
Plastic and Reconstructive Surgery Global Open
Volume
10
Issue
11
Copyright Statement
Copyright © 2022 The Authors. Published by Wolters Kluwer Health,
Inc. on behalf of The American Society of Plastic Surgeons. This
is an open-access article distributed under the terms of the Creative
Commons Attribution-Non Commercial-No Derivatives License 4.0
(CCBY-NC-ND), where it is permissible to download and share the
work provided it is properly cited. The work cannot be changed in
any way or used commercially without permission from the journal.
DOI: 10.1097/GOX.0000000000004660
Inc. on behalf of The American Society of Plastic Surgeons. This
is an open-access article distributed under the terms of the Creative
Commons Attribution-Non Commercial-No Derivatives License 4.0
(CCBY-NC-ND), where it is permissible to download and share the
work provided it is properly cited. The work cannot be changed in
any way or used commercially without permission from the journal.
DOI: 10.1097/GOX.0000000000004660
Identifier
https://journals.lww.com/prsgo/Fulltext/2022/11000/The_Use_of_Botulinum_Toxin_in_the_Management_of.39.aspx?context=LatestArticles
Publication Status
Published
Date Publish Online
2022-11