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Botulinophilia: contraindication for therapy with botulinum toxin.
International Journal of Clinical Pharmacology and Therapeutics
|October 30, 2001
Summary
Botulinum toxin is increasingly sought for cosmetic and therapeutic uses. However, a significant percentage of patients seeking treatment may have body dysmorphic disorder, a condition for which botulinum toxin is contraindicated.
Area of Science:
- Neurology
- Dermatology
- Psychiatry
Background:
- Botulinum toxin is a potent neurotoxin that inhibits neuromuscular transmission.
- It is widely used therapeutically for conditions like hyperhidrosis.
- Botulinum toxin treatments are increasingly in demand for cosmetic and therapeutic purposes.
Observation:
- Patients with body dysmorphic disorder (BDD) are seeking botulinum toxin treatments.
- BDD involves preoccupation with an imagined or slight defect in appearance, causing significant distress.
- This phenomenon, termed 'botulinophilia,' presents challenges in clinical management.
Findings:
- In a clinical series, 23.1% of patients seeking botulinum toxin treatment screened positive for BDD.
- The Minor sweat test is negative in these patients, ruling out hyperhidrosis as the primary concern.
- Botulinophilia represents a form of venenophilia, a desire for toxic substances.
Implications:
- Botulinophilia is a contraindication for botulinum toxin therapy.
- Patients with BDD seeking botulinum toxin require specialized management, often involving psychotherapy.
- Dermatologists must be vigilant in identifying and appropriately managing patients with BDD to avoid inappropriate treatments.