Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran.
Guilan University of Medical Sciences, Rasht, Iran.
BMC Infect Dis. 2023 Oct 2;23(1):647. doi: 10.1186/s12879-023-08514-3.
Botox injections are commonly used for cosmetic and therapeutic purposes because they temporarily paralyze muscles, reduce wrinkles, and alleviate certain medical conditions. Although generally considered safe and effective, Botox injections may cause potential complications. While herpes reactivation is more commonly associated with immunosuppressive therapies, such as chemotherapy or corticosteroid use, its association with Botox injection is poorly documented.
A 33-year-old woman presented with progressive painful rashes and vesicles on her forehead, scalp, and right upper eyelid, accompanied by fever and malaise following a Botox injection to treat wrinkles. A positive Tzanck smear test result confirmed the diagnosis of herpes infection. The patient was treated with antiviral medication, and her symptoms gradually regressed over several days.
Although herpes reactivation is more commonly associated with immunosuppressive therapies, few cases of herpes zoster and herpes simplex following Botox injection have been reported. The pathogenesis of herpes reactivation following Botox injection is unclear; however, it has been hypothesized that the Botox protein is a potent antigen that may activate the cellular immune system, making it easier for the virus to reactivate. Healthcare providers should be aware of this potential complication and consider it when evaluating patients who present with painful rashes following Botox injections. In addition, individuals who want to receive Botox injections should be informed of this complication. The diagnosis of herpetic infection should be made promptly, and antiviral therapy should be initiated to minimize the risk of complications. Further research is needed to better understand the pathogenesis and risk factors for herpes following Botox injection and to develop strategies for preventing and managing this complication.
肉毒杆菌素注射常用于美容和治疗目的，因为它可以暂时使肌肉瘫痪，减少皱纹，并缓解某些医疗状况。尽管肉毒杆菌素注射通常被认为是安全有效的，但它可能会引起潜在的并发症。虽然疱疹再激活更常见于免疫抑制治疗，如化疗或皮质类固醇的使用，但与肉毒杆菌素注射的关联记录很少。
一名 33 岁女性在接受肉毒杆菌素注射以治疗皱纹后，出现额部、头皮和右上眼睑逐渐加重的疼痛性皮疹和水疱，伴有发热和不适。Tzanck 涂片检查阳性结果证实了疱疹感染的诊断。患者接受了抗病毒药物治疗，症状在数天内逐渐消退。
虽然疱疹再激活更常见于免疫抑制治疗，但已有少数报道称在接受肉毒杆菌素注射后出现带状疱疹和单纯疱疹。肉毒杆菌素注射后疱疹再激活的发病机制尚不清楚；然而，有人假设肉毒杆菌素蛋白是一种有效的抗原，可能激活细胞免疫系统，使病毒更容易再激活。医疗保健提供者应注意这种潜在的并发症，并在评估接受肉毒杆菌素注射后出现疼痛性皮疹的患者时考虑到这一点。此外，想要接受肉毒杆菌素注射的个人应该被告知这种并发症。应迅速做出疱疹感染的诊断，并开始抗病毒治疗，以最大限度地降低并发症的风险。需要进一步研究以更好地了解肉毒杆菌素注射后疱疹的发病机制和危险因素，并制定预防和管理这种并发症的策略。
