Botulinum Toxin A for Relief of Pain in Cutaneous Leiomyomas

Summary and Comment |
March 17, 2016

Botulinum Toxin A for Relief of Pain in Cutaneous Leiomyomas

  1. Murad Alam, MD, MSCI

Botulinum toxin may be of therapeutic utility in patients with symptomatic and painful leiomyomas

  1. Murad Alam, MD, MSCI

Investigators studied the effect on patient pain of botulinum toxin injections to cutaneous leiomyomas. Eighteen patients who reported pain at least weekly from such lesions at a level of at least 4 on a 0–10-point scale were randomized to receive injections to the affected areas of botulinum toxin at 5 units/cm2 or equal volumes of placebo.

Pain was measured before and after ice provocation at 4 weeks after injection. Nominal, nonsignificant decreases in pain were reported on the visual analog pain scale in botulinum toxin recipients before ice provocation. No significant difference was observed regarding change in pain after ice provocation. Quality of life as assessed by the Dermatology Life Quality Index and its specific pain-related item was significantly improved in the toxin group (toxin: median, −1.00; range, −2.00 to 1.00; placebo: median, 0.00; range, −1.00 to 0.00; P=0.048).

Comment

Botulinum toxin may be of therapeutic utility in patients with symptomatic and painful leiomyomas. It is possible that the lack of between-group differences on the pain visual analog scale was due to the complex nature of leiomyoma-related discomfort, which may not be reducible to pain but may include other elements that are more difficult to describe and quantify.

Editor Disclosures at Time of Publication

  • Disclosures for Murad Alam, MD, MSCI at time of publication Consultant / Advisory board Amway Editorial boards JAMA Dermatology; Dermatologic Surgery; Journal of Cosmetic Dermatology; Lasers in Medical Science; Skin Therapy Letter Leadership positions in professional societies American Academy of Dermatology (Chair, Health Care Finance Committee); American College of Mohs Surgery (Board of Directors); American Society for Dermatologic Surgery (Board of Directors)

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