Botulinum Toxin Type B for Hidradenitis Suppurativa: A Randomised, Double-Blind, Placebo-Controlled Pilot Study

Area of Science:

• Dermatology
• Toxicology
• Clinical Therapeutics

Background:

• Botulinum toxin (BTX) is a neurotoxin with established efficacy and safety in various conditions.
• Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease impacting quality of life.

Purpose of the Study:

• To evaluate the effectiveness of intradermal Botulinum toxin type B (BTX-B) as a treatment for hidradenitis suppurativa (HS).

Main Methods:

• A randomized controlled trial involving 20 patients with HS (stage I-III) comparing BTX-B to placebo.
• Primary outcome: Dermatology Life Quality Index (DLQI). Secondary outcomes: Visual analogue scale (VAS) for pain and general health, lesion count, and adverse effects.
• Patients received placebo or BTX-B, with crossover to active treatment after 3 months, followed by a 6-month follow-up.

Main Results:

• BTX-B treatment led to a significant improvement in DLQI scores from baseline (median 17 to 8) compared to placebo (median 13.5 to 11) at 3 months (p<0.05).
• Patient-reported symptom improvement and a reduction in total lesions were observed.
• Fifty-five percent of participants reported hyperhidrosis, suggesting a potential comorbidity.

Conclusions:

• Intradermal BTX-B is an effective treatment for improving quality of life in patients with hidradenitis suppurativa.
• The findings suggest a potential comorbidity between HS and hyperhidrosis.