Glogau Richard G
Department of Dermatology, University of California, San Francisco, San Francisco, California 94117, USA.
Clin J Pain. 2002 Nov-Dec;18(6 Suppl):S191-7. doi: 10.1097/00002508-200211001-00012.
This article reviews the current status of dermatological uses for botulinum toxin type A (Botox), recently approved in the United States for treatment of glabellar wrinkles, and type B (Myobloc), approved for cervical dystonia. The respective formulations of Botox and Myobloc are described, and injection techniques and special considerations for administration in the treatment of dermatologic conditions are also discussed. The use of botulinum toxin injections for cosmetic treatment of movement-related facial lines and platysmal bands in the neck is reviewed, including injection procedures, efficacy, and potential complications. Recent developments in the use of botulinum toxins for the treatment of palmar and axillary hyperhidrosis are also described, comparing type A and type B results. Although direct comparisons between botulinum toxins for dermatologic applications are complicated by the lack of functional equivalence of the standard potency assays, appropriate dosing strategies for obtaining satisfactory clinical results using type B are being established, which will add to the experience already gained with type A. The diffusion characteristics of type B appear to show different and potentially advantageous clinical profiles in the treatment of crows' feet and hyperhidrosis compared with type A.
本文综述了A型肉毒毒素（保妥适，最近在美国被批准用于治疗眉间皱纹）和B型肉毒毒素（肌柔，被批准用于治疗颈部肌张力障碍）在皮肤科应用的现状。文中描述了保妥适和肌柔各自的配方，还讨论了在皮肤病治疗中注射技术及给药的特殊注意事项。本文回顾了肉毒毒素注射用于面部运动相关皱纹及颈部颈阔肌带的美容治疗，包括注射程序、疗效和潜在并发症。还描述了肉毒毒素用于治疗手掌和腋窝多汗症的最新进展，并比较了A型和B型的治疗结果。尽管由于标准效价测定缺乏功能等效性，使得用于皮肤科的不同肉毒毒素之间的直接比较变得复杂，但目前正在确立使用B型肉毒毒素获得满意临床效果的适当给药策略，这将丰富我们已经积累的使用A型肉毒毒素的经验。与A型肉毒毒素相比，B型肉毒毒素在治疗鱼尾纹和多汗症方面的扩散特性似乎显示出不同且可能更具优势的临床特征。
