Ali Ebrahimi1, Mohammad Radmanesh. 1. Department of Dermatology, Kermanshah University of Medical Sciences, Kermanshah, Iran.
Abstract
BACKGROUND: The treatment of multiple eccrine hydrocystomas is challenging. Surgical excision is impractical. The outcomes of CO(2) and pulsed-dye laser therapy are not well studied. Botulinum toxin-A (BT-A) can block the secretions of the sweat glands and prevent dilatation of the cysts. OBJECTIVE: To study the efficacy of BT-A on eccrine hydrocystoma. METHODS: Eighteen patients with multiple facial eccrine hydrocystomas were treated by BT-A. The 500 IU vial of BT-A (Dysport; Ipsen Ltd, UK) was dissolved in 7.5 cc of normal saline to prepare a solution, 0.1 cc of which contains 6 IU of BT-A. Then, 0.1-0.2 ml of diluted BT-A was injected intradermally around the lesions using an insulin syringe with a 30-gauge needle. A second BT-A injection session was carried out 3-4 weeks later for four partially responsive patients. RESULTS: Thirteen patients showed significant flattening of the lesions after the first session. The remaining partially responsive four patients showed considerable flattening after the second boosting session, performed 3-4 weeks later. The side effects were temporary and minimal. The duration of effect for the BT-A injection was 5-7 months. CONCLUSION: Intradermal BT-A injection can be considered as a relatively safe and cost-effective treatment for multiple eccrine hydrocystomas.
BACKGROUND: The treatment of multiple eccrine hydrocystomas is challenging. Surgical excision is impractical. The outcomes of CO(2) and pulsed-dye laser therapy are not well studied. Botulinum toxin-A (BT-A) can block the secretions of the sweat glands and prevent dilatation of the cysts. OBJECTIVE: To study the efficacy of BT-A on eccrine hydrocystoma. METHODS: Eighteen patients with multiple facial eccrine hydrocystomas were treated by BT-A. The 500 IU vial of BT-A (Dysport; Ipsen Ltd, UK) was dissolved in 7.5 cc of normal saline to prepare a solution, 0.1 cc of which contains 6 IU of BT-A. Then, 0.1-0.2 ml of diluted BT-A was injected intradermally around the lesions using an insulin syringe with a 30-gauge needle. A second BT-A injection session was carried out 3-4 weeks later for four partially responsive patients. RESULTS: Thirteen patients showed significant flattening of the lesions after the first session. The remaining partially responsive four patients showed considerable flattening after the second boosting session, performed 3-4 weeks later. The side effects were temporary and minimal. The duration of effect for the BT-A injection was 5-7 months. CONCLUSION: Intradermal BT-A injection can be considered as a relatively safe and cost-effective treatment for multiple eccrine hydrocystomas.