The use of botulinum toxin-A in the management of neck and anterior chest wall flushing: pilot study

Authors

  • Emad Geddoa MB.ChB, MRCS, MSc, DIC,

    1. Department of Vascular and General Surgery, The Hillingdon Hospitals NHS Foundation Trust, Mount Vernon Hospital, Northwood, UK
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  • Hosam E Matar BSc, MBBS, MRCS,

    Corresponding author
    1. Sheffield Teaching Hospitals, Sheffield, UK
    • Correspondence

      Hosam E. Matar, bsc, mbbs, mrcs

      Core Surgical Trainee

      Sheffield Teaching Hospitals

      Herries Road

      Sheffield S5 7AU

      UK

      E-mail: hematar@doctors.org.uk

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  • Trevor Rudrah Franco Paes BSc (Hons), FRCS, MS

    1. Department of Vascular and General Surgery, The Hillingdon Hospitals NHS Foundation Trust, Mount Vernon Hospital, Northwood, UK
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  • Conflicts of interest: None.
  • Funding: Botulinum Toxin-A injections (Botox®) were provided by Allergan Company. No grants or other funds were provided.

Abstract

Idiopathic neck and chest wall flushing could cause disabling effects on patients' quality of life. We aimed to evaluate the effectiveness of botulinum toxin-A (BTA) in the management of idiopathic neck and chest wall flushing. This was a pilot prospective clinical study of patients with severe idiopathic neck and anterior chest wall flushing. Two mouse units of BTA were injected intracutaneously with a maximum dose of 100 units per patient per session. The dermatology life quality index is used as the primary outcome measure. Twenty-two patients were included in the study (18 women, four men) with an average age of 26 years (range 18–48). Twenty patients (90.9%) had immediate improvement with almost complete resolution of their flushing. At four weeks follow-up, 18 of 22 patients were included in the final analysis, significant improvement in quality of life was achieved, and mean baseline dermatology life quality index score 7.78 (SD 3.25) improved significantly to 4.23 (SD 3.44) with a mean difference of 3.56 (SD 4.6; 95%, confidence interval 1.27, 5.84) with paired samples t-test 3.29 (d.f. 17) < 0.004. BTA may provide an effective treatment in the management of idiopathic neck and chest wall flushing.

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