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Treatment of pachyonychia congenita with plantar injections of botulinum toxin
Author(s) -
Swartling C.,
Vahlquist A.
Publication year - 2006
Publication title -
british journal of dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.304
H-Index - 179
eISSN - 1365-2133
pISSN - 0007-0963
DOI - 10.1111/j.1365-2133.2005.07115.x
Subject(s) - medicine , prilocaine , botulinum toxin , anesthesia , dermatology , tachyphylaxis , heel , surgery , local anesthetic , anatomy
Summary Pachyonychia congenita (PC) is a rare genodermatosis which may be associated with painful, focal hyperkeratosis on the soles. Plantar sweating at high ambient temperatures increases the blistering of the callosities. We report three patients with PC who had great problems in walking, especially during summer time. They were treated with intracutaneous plantar injections of botulinum toxin type A (Dysport ® , 100 U mL −1 ; Ipsen, Slough, U.K.) after prior intravenous regional anaesthesia of the foot with a low tourniquet and 25 mL prilocaine (5 mg mL −1 ). Within a week all three patients experienced dryness and a remarkable relief of pain from plantar pressure sites. The effect duration was 6 weeks to 6 months. Repeated injections over a 2‐year period confirmed the good results, with no side‐effects or tachyphylaxis noted.