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Treatment of a painful keloid with botulinum toxin type A

Betty Uyesugi¹, Benjamin Lippincott, Shashank Dave

¹Department of Physical Medicine and Rehabilitation, Indiana University School of Medicine, Indianapolis, Indiana 46202, USA.

American Journal of Physical Medicine & Rehabilitation

|November 4, 2009

Abstract:

Keloids are associated with small-fiber neuropathy and typically present with itching, pain, and allodynia. The following is a case presentation in which painful neuropathic symptoms from a keloid were treated successfully with botulinum toxin type A. To our knowledge, this is the first such case report in the literature. Further research in the use of botulinum toxin to treat keloidal pain is warranted.

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Directly acting muscle relaxants like dantrolene and botulinum toxin (BoNT) have distinct mechanisms and applications. Dantrolene, a hydantoin derivative, acts on the ryanodine receptor (RYR1) in skeletal muscle cells. RYR1 are calcium channels present at the sarcoplasmic reticulum membrane. In response to excitation, they release calcium ions from the sarcoplasmic reticulum to the cytosol. Calcium promotes actin-myosin-mediated contraction of muscles.
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