Hoʻohana i ka botulinum toxin i ka dermatology a me ka cosmetology

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Piyu Parth Naik Dermatology, Saudi German Hospitals and Clinics, Dubai, United Arab Emirates Communications: Piyu Parth Naik Dermatology, Saudi German Hospitals and Clinics, Burj Al Arab, Dubai, United Arab Emirates Opposite phone +971 503725616 leka uila [leka uila i loaʻa Palekana] Abstract : Botulinum toxin (BoNT) he neurotoxin i hanaia e Clostridium botulinum bacteria.Loaʻa iā ia ka maikaʻi a me ka palekana i ka mālama ʻana i ka focal idiopathic hyperhidrosis.Aia ʻo BoNT i ʻehiku mau neurotoxins ʻokoʻa;akā naʻe, hoʻohana wale ʻia nā toxins A a me B ma ke kino.Ua hoʻohana ʻia ʻo BoNT no ka mālama ʻana i nā maʻi ʻili like ʻole.ʻO ka pale ʻana i ka scar, hyperhidrosis, wrinkles, liʻiliʻi sweating moles, lauoho poho, psoriasis, mai Darier, bullous ʻili maʻi, sweat herpes a me Raynaud's phenomenon kekahi o nā hōʻailona hou o BoNT i nā mea hoʻonaninani, ʻoi loa i ka dermatology Non-cosmetic mau mea.I mea e hoʻohana pono ai i ka BoNT i ka hoʻomaʻamaʻa lapaʻau, pono mākou e hoʻomaopopo pono i ke anatomy hana o nā ʻiʻo simulated.Ua hana ʻia kahi ʻimi palapala hohonu no ka hoʻonui ʻana i nā hoʻokolohua dermatological-oriented a me nā hoʻokolohua lapaʻau e pili ana i nā mea o BoNT i mea e hāʻawi ai i kahi ʻike ākea o ka hoʻohana ʻana o BoNT i ka dermatology.Ke manaʻo nei kēia loiloi e nānā i ka hana o ka botulinum toxin i ka dermatology a me ka cosmetology.Hua'ōlelo: botulinum toxin, botulinum toxin, botulinum, dermatology, cosmetology, neurotoxin
Hoʻopuka maoli ʻia ka botulinum neurotoxin (BoNT) e Clostridium botulinum, he mea anaerobic, gram-positive, spore-producing bacteria.1 I kēia lā, ʻehiku BoNT serotypes (A to G) i ʻike ʻia, a ʻo nā ʻano A a me B wale nō ke hoʻohana ʻia no ka hoʻohana ʻana i ka lāʻau lapaʻau.Ua ʻae ʻia ʻo BoNT A (Oculinum) e ka US Food and Drug Administration (FDA) ma 1989 no ka mālama ʻana i ka blepharospasm a me ka strabismus.Ua hoʻoholo ʻia ka waiwai therapeutic o BoNT A no ka manawa mua.ʻAʻole a hiki i ʻApelila 2002 i ʻae ka FDA i ka hoʻohana ʻana i ka BoNT A e mālama i nā laina glabellar.Ua ʻae ka FDA iā BoNT A no ka mālama ʻana i ka laina mua a me ka laina canthal lateral i ʻOkakopa 2017 a me Kepakemapa 2013.Mai ia manawa, ua hoʻolauna ʻia kekahi mau ʻano BoNT i ka mākeke.2 Mai kona kūʻai ʻana, ua hoʻohana ʻia ʻo BoNT e mālama i ka cramps, depression, hyperhidrosis, migraine, a me ka ʻelemakule o ka ʻāʻī, ka maka, a me nā poʻohiwi i ka lāʻau lapaʻau a me ka cosmetic.3,4
Hoʻokuʻu ʻo Clostridium botulinum i kahi paʻakikī ʻekolu-protein e loaʻa ana i ka 150 kDa toxin, non-toxic, non-hemagglutinin protein, a me ka hemagglutinin protein non-toxic.Hoʻohaʻahaʻa nā protease bacteria i ka ʻawaʻawa i loko o kahi huahana hana pālua me kahi kaulahao "māmā" 50 kDa a me kahi kaulahao "kaumaha" 100 kDa.Ma hope o ka lawe ʻia ʻana i ka presynaptic nerve terminal, ua hoʻopaʻa ʻia ke kaulahao koʻikoʻi o ka toxin ikaika i ka synaptic vesicle glycoprotein 2, e hāpai ana i ka endocytosis o ka toxin-glycoprotein complex, a me ka hoʻokuʻu ʻana i ke kaulahao māmā toxin i loko o ka synaptic space.Hoʻokaʻawale ʻia nā kaulahao māmā ʻona i ka vesicle pili i ka membrane protein/synaptoxin (BoNT-B, D, F, G) a i ʻole synaptosome-pili pūmua 25 (BoNT-A, C, E) e pale ai i ka hoʻokuʻu ʻana o nā axons neuron motor peripheral denervation kemika a me ka lolo ʻiʻo.2 Ma ʻAmelika Hui Pū ʻIa, ʻehā mau hoʻomākaukau BoNT-A i kūʻai ʻia ma ke kālepa i ʻāpono ʻia e ka FDA: incobotulinumtoxinA (Frankfurt, Kelemānia), onabotulinumtoxinA (Kaleponi, US), prabotulinumtoxinA-xvfs (Kaleponi, US), a me abobotulinumtoxinA (Arizona, US) ;a me Hoʻokahi ʻano BoNT-B: rimabotulinumtoxinB (Kalepona, USA).5 ʻO Guida et al.Ua ʻōlelo ʻo 6 i ke kuleana o BoNT ma ke kahua o ka dermatology.Eia nō naʻe, ʻaʻohe loiloi hou e pili ana i ka noi ʻana o BoNT ma ke kahua o ka dermatology a me ka nani.No laila, manaʻo kēia loiloi e nānā i ke kuleana o BoNT i ka dermatology a me ka cosmetology.
ʻO nā huaʻōlelo kikoʻī e pili ana i ka botulinum toxin, ka ʻili ʻaila, rosacea, ka ʻili ʻana o ka maka, nā ʻōpala, nā wrinkles, ka poho o ka lauoho, psoriasis, ka maʻi ʻili bullous, ka maʻi ʻo Darier, nā mole exocrine, sweat herpes, Raynaud's phenomenon, hyperhidrosis Ma ka pane, dermatology, a me ka nani, ʻimi ʻatikala. ke alakaʻi ʻia nei ma nā waihona ʻikepili: Google Scholar, PubMed, MEDLINE, Scopus, a me Cochrane.Ke ʻimi nei ka mea kākau i nā ʻatikala e pili ana i ke kuleana o BoNT i ka dermatology a me ka cosmetology.He 3112 mau ʻatikala kahi hulina palapala mua.ʻO nā ʻatikala i paʻi ʻia ma waena o Ianuali 1990 a me Iulai 2021 e wehewehe ana i ka BoNT i ka dermatology a me ka cosmetology, nā ʻatikala i paʻi ʻia ma ka ʻōlelo Pelekania, a ua hoʻokomo ʻia nā hoʻolālā noiʻi āpau i kēia loiloi.
Ua ʻae ʻo Canada i ka hoʻohana ʻana i ka BoNT i ka hoʻomaʻamaʻa ʻana i nā ʻiʻo o ka ʻiʻo kūloko a me nā wrinkles kuʻemaka i ka makahiki 2000. Ua ʻae ka US FDA i ka hoʻohana ʻana i ka BoNT no nā hana hoʻonaninani ma ʻApelila 15, 2002. ʻO nā hōʻailona BoNT-A i hoʻohana hou ʻia i nā noi hoʻonaninani e komo nā laina frown ma waena. nā kuʻemaka, nā kapuaʻi koʻo, nā laina lākeke, nā laina lae ākea, nā laina perioral, nā peʻa noʻonoʻo a me nā ʻauwae, nā kaula platysma, nā maka waha, a me nā laina ʻāʻī.7 ʻO nā hōʻailona no ka botulinum ʻano A i ʻāpono ʻia e ka US FDA, ʻo ia nā laina haʻahaʻa haʻahaʻa e pili ana me ka hana nui o nā ʻiʻo mua a/a i ʻole ʻāʻī ma waena o nā kuʻemaka, a me nā laina canthal ʻaoʻao haʻahaʻa a koʻikoʻi e pili ana i ka hana nui o ka ʻiʻo orbicularis.A ʻo ka laina lae ākea maʻalahi a koʻikoʻi e pili ana me ka hana ʻoi loa o ka ʻiʻo mua.8
Kōkua ʻo Sebum i ka hāʻawi ʻana i nā antioxidants momona momona i ka ʻili o ka ʻili a loaʻa nā waiwai antibacterial;no laila, hana ia ma ke ʻano he pale ʻili.ʻO ka nui o ka sebum hiki ke pani i nā pores, hoʻohua i ka hua bacteria a hiki ke hoʻomake i ka ʻili (e laʻana, seborrheic dermatitis, acne).Ma mua, ua hōʻike ʻia ka ʻike pili e pili ana i ka hopena o BoNT ma ka sebum.Ua hoʻāʻo ʻo 9,10 Rose a me Goldberg10 i ka pono a me ka palekana o BoNT ma 25 poʻe me ka ʻili ʻaila.Hoʻokomo ʻia ʻo BoNT (abo-BNT, ka huina o 30-45 IU) i 10 mau wahi o ka lae, kahi e hoʻomaikaʻi maikaʻi ai i ka maʻi maʻi a hoʻemi i ka hana sebum.Min et al.hāʻawi wale ʻia i nā kumuhana 42 me nā lae wrinkles e loaʻa iā 10 a i ʻole 20 mau ʻāpana o BoNT ma ʻelima mau wahi injection.Ua loaʻa i nā hui ʻelua ka lāʻau lapaʻau BoNT, ʻo ia ka hopena o ka hoʻemi nui ʻana o ka sebum ma ka wahi i hoʻopaʻa ʻia a me kahi gradient sebum a puni ka wahi i hoʻopaʻa ʻia.I ka pule 16th, ua hoʻi ka hana sebum o nā hui lapaʻau ʻelua i nā pae maʻamau, a me ka piʻi ʻana o ka nui o ka injection, ʻaʻole i hoʻomaikaʻi nui ka hopena curative.
ʻAʻole maopopo loa ke ʻano o ka hoʻokele intradermal o ka botulinum toxin i ka hoʻohaʻahaʻa ʻana i ka huna ʻana o ka sebum, no ka mea, ʻaʻole i wehewehe piha ʻia nā hopena o ka ʻōnaehana nerve a me ka acetylcholine ma nā kelepa sebaceous.ʻO nā hopena neuromodulatory o BoNT ka mea e hoʻopaʻa ʻia i nā mea loaʻa muscarinic kūloko i ka ʻiʻo erector pili a me nā kelepa sebaceous.I loko o vivo, hōʻike ʻia ka nicotinic acetylcholine receptor 7 (nAchR7) i loko o nā kelepa sebaceous kanaka, a ʻo ka hōʻailona acetylcholine e hoʻonui i ka synthesis lipid ma ke ʻano pili i ka dose in vitro.11 Pono ka noiʻi hou aʻe no ka hoʻoholo ʻana ʻo wai ka moho koʻikoʻi a me ke kaʻina hana hoʻoheheʻe maikaʻi loa (Figure 1A a me B).
Kiʻi 1 ʻO ke kiʻi kiʻekiʻe (A) o ka mea maʻi me ka ʻili ʻaila maopopo, ʻoiai ma ka pole ʻē aʻe, ʻo ke kiʻi haʻahaʻa (B) o ka mea maʻi hoʻokahi ma hope o ʻelua mau lāʻau BoNT e hōʻike ana i kahi holomua nui.(ʻenehana: 100 units, 2.5 ml o intradermal BoNT-A i hoʻopaʻa ʻia i hoʻokahi manawa i ka lae. Ua hana ʻia ʻelua mau lāʻau like ʻole 30 mau lā.
ʻO Rosacea kahi maʻi ʻili maʻamau i hōʻike ʻia e ka ʻili ʻana o ka maka, telangiectasia, papules, pustules, a me ka erythema.Hoʻohana mau ʻia nā lāʻau lapaʻau waha, laser therapy, a me nā lāʻau lapaʻau no ka mālama ʻana i ka ʻili ʻana o ka maka, ʻoiai ʻaʻole maikaʻi lākou i nā manawa a pau.ʻO kekahi hōʻailona maikaʻi ʻole o ka menopause ʻo ka ʻili ʻana o ka maka.Ua hōʻike ʻia kekahi mau haʻawina e hiki i ka BoNT ke kōkua i ka mālama ʻana i nā wela wela a me ka rosacea menopausal.12-14 E noiʻi ʻia ka hopena o ka BoNT ma ka Dermatological Quality of Life Index (DLQI) o nā maʻi me ka ʻulaʻula o ka maka ma kahi noiʻi pailaka e hiki mai ana.Hoʻokahi manawa i hoʻokomo ʻia ʻo 15 BoNT i ka pāpālina, a hiki i ka huina o 30 mau ʻāpana, e hopena i kahi hāʻule nui o DLQI i ʻelua mahina.Wahi a Odo et al., ua hoʻemi nui ʻo BoNT i ka helu awelika o nā wela wela menopausal i ka lā 60th.12 Ua aʻo pū ʻia ka hopena o ka abo-BoNT i nā maʻi 15 me ka rosacea.ʻEkolu mahina ma hope mai, ua hoʻokomo ʻia ʻo 15-45 IU o BoNT i ka maka, a ua hopena i ka hoʻomaikaʻi nui ʻana i ka erythema.13 Ma ka noiʻi ʻana, ʻaʻole i haʻi pinepine ʻia nā hopena ʻino.
ʻO ka hoʻonui nui ʻana o BoNT kekahi o nā kumu hiki ke pale ikaika i ka hoʻokuʻu ʻana o ka acetylcholine mai nā neuron autonomic peripheral o ka ʻōnaehana vasodilation ʻili.16,17 Ua ʻike maopopo ʻia ʻo nā mea hoʻolaha inflammatory e like me ka calcitonin gene-related peptide (CGRP) a me ka waiwai P (SP) ua kāohi pū ʻia e BoNT.18 Inā hoʻemi ʻia ka ʻili o ka ʻili kūloko a hoʻomalu ʻia, e nalowale paha ka erythema.I mea e loiloi ai i ke kuleana o BoNT i ka rosacea, pono nā haʻawina ākea, hoʻomalu ʻia, randomized.Loaʻa nā pono ʻē aʻe o ka BoNT no ka hoʻoheheʻe ʻana i ka maka no ka mea hiki iā lākou ke hōʻemi i ke koʻikoʻi o nā mea hoʻopau maka, a laila e hoʻomaikaʻi ai i nā laina maikaʻi a me nā wrinkles.
Ua ʻike ka poʻe he nui i kēia manawa i ke koʻikoʻi o ka pale ʻana i nā ʻōpala i ka mālama ʻana i nā ʻōpala postoperative.ʻO ka haʻalulu e hana ana ma ka ʻaoʻao o ka ʻeha i ka wā o ke kaʻina hana ho'ōla he kumu nui ia i ka hoʻoholo ʻana i ka ʻike hope loa o ka ʻili maʻi.19,20 BoNT ke pale aku i ka hoʻokuʻu ʻana o ka acetylcholine neurotransmitter, kokoke loa e hoʻopau i ke koʻikoʻi o ka ʻiʻo ikaika ma ka ʻeha ho'ōla mai ke aʻalolo peripheral.ʻO nā waiwai hoʻoluʻu hoʻoluhi o BoNT, a me kona pale pololei ʻana i ka fibroblast a me ka hōʻike TGF-1, e hōʻike ana hiki ke hoʻohana ʻia e pale i nā ʻōpala ʻoki.21-23 ʻO ka hopena anti-inflammatory o BoNT a me kona hopena i ka ʻili o ka ʻili e hiki ke hōʻemi i ke ʻano o ke kaʻina hana ho'ōla ʻeha ʻeha (mai 2 a 5 mau lā), hiki ke kōkua i ka pale ʻana i ka hoʻokumu ʻia ʻana o ka ʻili.
Ma nā haʻawina like ʻole, hiki ke hoʻohana ʻia ʻo BoNT e pale i nā ʻōpala.24-27 I loko o kahi RCT, ua loiloi ʻia ka palekana a me ka maikaʻi o ka hoʻokomo ʻana i ka BoNT postoperative mua i nā maʻi 15 me nā ʻōpala mai ka thyroidectomy.24 Hāʻawi ʻia nā ʻōpala hou (i loko o 10 mau lā o ka thyroidectomy) i ka BoNT (20-65 IU) a i ʻole 0.9% saline maʻamau (mana) hoʻokahi.ʻO ka hapalua o ka lāʻau BoNT i hōʻike i ka ʻoi aku ka maikaʻi o ka ʻili a me ka ʻoluʻolu o ka poʻe maʻi ma mua o ka mālama paʻakai maʻamau.Ua noiʻi ʻo Gassner et al.25 inā hiki ke hoʻoheheʻe ʻia ʻo BoNT i ka maka ma hope o ka ʻoki ʻana o ka lae a me ka wehe ʻana i ka maka.Hoʻohālikelike ʻia me ka placebo (maʻamau saline), ua hoʻokomo ʻia ʻo BoNT (15-45 IU) i loko o ka ʻōpala postoperative ma hope o ka pani ʻana i ka ʻeha i loko o 24 mau hola e hoʻomaikaʻi ai i ka hopena cosmetic a me ka ho'ōla ʻana.
Hoʻokumu ʻia nā wrinkles dynamic a me static e ka ʻiʻo ʻiʻo overactive, ka pōʻino māmā a me ka ʻelemakule, a manaʻo nā poʻe maʻi e hana lākou i ka luhi a huhū paha.Hiki iā ia ke mālama i nā wrinkles maka a hāʻawi i ka poʻe i kahi hiʻohiʻona hoʻomaha a hōʻoluʻolu.Loaʻa i ka FDA i kēia manawa ka mana kūʻokoʻa no BoNT e mālama i ka laina periorbital a me interbrow.Hoʻohana ʻia ʻo BoNT no ka mālama ʻana i ka masseter hypertrophy, gingival minoʻaka, platysma band, mandibular margin, chin depression, horizontal line lae, curved smile, perioral line, horizontal nasal line and sagging eyebrows.ʻO ka hopena maʻi no kahi o ʻekolu mahina.28,29 (Kiʻi 2A a me B).
Kiʻi 2 ʻO ke kiʻi kiʻekiʻe (A) ma mua o ka hoʻokomo ʻia ʻana o Botox o kahi hihia e hōʻike ana i ka laina lae ākea a me ka laina glabellar i mea e huhū ai ke kumuhana.Ma kekahiʻaoʻao,ʻo ke kiʻi haʻahaʻa o ka hihia hoʻokahi (B) ma hope o nāʻiʻoʻelua Ma hope o ka hoʻokuʻuʻana i nā toxin, ua weheʻia kēia mau laina me kaʻoluʻolu.(ʻenehana: 36 units, 0.9 mL o intradermal BoNT-A i hoʻokomo ʻia i ka lae i ka manawa. Ua kaha ʻia ka wahi i hoʻopaʻa ʻia me kahi penikala ʻili ma mua o ka hoʻomaʻamaʻa ʻana. Ua hana ʻia ʻelua mau lāʻau like, 30 mau lā ke kaʻawale).
Hiki i ka BoNT ke hoʻonui i ka manaʻo o ka mea maʻi a me ka hilinaʻi i ʻike ʻia ke hoʻohana ʻia me ka hōʻemi ʻana o ka puʻupuʻu.Ua ʻike ʻia ka hoʻomaikaʻi ʻana i ka helu FACE-Q ma hope o ka mālama ʻana i nā laina glabellar haʻahaʻa a koʻikoʻi.ʻOiai ma hope o 120 mau lā, i ka wā i emi ai nā hopena lapaʻau o BoNT, hōʻike nā mea maʻi i ka hoʻomaikaʻi ʻana i ke olakino noʻonoʻo a hoʻomaikaʻi i ka nani o ka helehelena.
ʻAʻole like me ka hoʻihoʻi hou ʻana o BoNT i kēlā me kēia mahina ʻekolu e loaʻa ai ka pane maikaʻi loa a me ka noʻonoʻo, pono e kūkākūkā ke kauka me ka mea maʻi i ka wā e pono ai ka hoʻihoʻi ʻana.30,31 Eia kekahi, ua hoʻohana maikaʻi ʻia ʻo BoNT e pale a mālama i ka migraine ma ka neurology, hoʻomaikaʻi i ka maikaʻi o ke ola a me ka maikaʻi o nā maʻi32 (Figure 3A a me B).
Kiʻi 3 ʻO ke kiʻi luna (A) o ke kumuhana e hōʻike ana i nā laina lateral periorbital e hāʻawi i ka manaʻo o ka ʻelemakule a me ka luhi.Ma kekahiʻaoʻao,ʻo ke kiʻi haʻahaʻa (B) o ka hihia hoʻokahi e hoʻopau i kēia mau laina a hoʻokiʻekiʻe iā lākou ma hope o ka hoʻokomoʻana o Botox Uaʻike maopopoʻia nā kuʻemakaʻaoʻao.Ma hope o ka noho ʻana i kēia manawa, hōʻike pū kēia kumumanaʻo i ka waiwai o ke ola kino.(ʻenehana: 16 mau ʻāpana, 0.4 ml intradermal BoNT-A i hoʻopaʻa ʻia i hoʻokahi manawa, hoʻokahi ma kēlā me kēia wahi periorbital lateral.
Alopecia areata, androgenetic alopecia, headache alopecia a me radiation-induced alopecia ua mālama ʻia me BoNT-A.ʻOiai ʻaʻole maopopo ka mīkini pololei e kōkua ai ʻo BoNT i ka ulu hou ʻana o ka lauoho, ua manaʻo ʻia ma ka hoʻomaha ʻana i nā ʻiʻo e hōʻemi i ke kaomi microvascular, hiki iā ia ke hoʻomaikaʻi i ka hāʻawi ʻana i ka oxygen i nā follicles lauoho.I loko o 1-12 papa, 30-150 U i injected i loko o ka frontal lobe, periauricular, kino a me occipital muscles (Figure 4A a me B).
Kiʻi 4 ʻO ka hapa hema (A) o ke kiʻi lapaʻau e hōʻike ana i ke ʻano ʻano ʻōhule kāne kāne 6 o kahi kanaka 34 makahiki e like me ka hoʻohālikelike ʻia ʻo Norwood-Hamilton.I ka hoʻohālikelike ʻana, ua hōʻike ka mea maʻi like i ka hoʻohaʻahaʻa ʻana i ke ʻano 3V ma hope o 12 botulinum injections (B).(ʻenehana: 100 mau ʻāpana, 2.5 mL o intradermal BoNT-A i hoʻopaʻa ʻia i ka ʻaoʻao o luna o ke poʻo i hoʻokahi manawa. ʻO ka huina o 12 mau lapaʻau like i hoʻokaʻawale ʻia e 15 mau lā i hopena i kahi pane lapaʻau ʻae ʻia, ʻo 4 mau mahina).
ʻOiai ʻo ka hapa nui o nā haʻawina e hōʻike ana i ka hoʻomaikaʻi ʻana i ka lāʻau lapaʻau i ka nui o ka lauoho a i ʻole ka ulu ʻana a me ka ʻoluʻolu o ka poʻe maʻi, pono hou nā RCTs e hoʻoholo i ka hopena maoli o BoNT i ka ulu ʻana o ka lauoho.33-35 Ma ka ʻaoʻao ʻē aʻe, ua hōʻoia ʻia ka nui o nā injections BoNT no nā wrinkle lae e pili ana i ka loaʻa ʻana o ka lauoho lauoho mua.36
Ua hōʻike ʻia kekahi mau haʻawina e pili ana ka ʻōnaehana nerve i ka psoriasis.He kiʻekiʻe ka paʻa ʻana o nā aʻalolo aʻalolo i ka ʻili o psoriasis, a he kiʻekiʻe nā pae o CGRP a me SP i loaʻa mai nā aʻalolo sensory.No laila, ʻo nā hōʻike lapaʻau e hōʻike ana i ke kala ʻana o ka psoriasis ma hope o ka nalo ʻana o ka innervation e piʻi aʻe ana, a ʻo ka pōʻino o ka ʻōnaehana nerve a i ʻole ka hana nerve ke kākoʻo nei i kēia kuhiakau.37 Hoʻemi ʻo BoNT-A i ka neurogenic CGRP a me ka hoʻokuʻu ʻana SP, hiki ke wehewehe i ka nānā ʻana o ka maʻi maʻi.38 I nā ʻiole KC-Tie2 makua, hiki ke hoʻemi nui ʻia nā ʻiole intradermal o BoNT-A i nā lymphocytes ʻili i hoʻohālikelike ʻia me ka placebo Infiltrate a hoʻomaikaʻi nui i ka acanthosis.37 Eia naʻe, he kakaikahi wale nō nā hōʻike lapaʻau i paʻi ʻia a me nā noiʻi nānā ʻana, a ʻaʻohe o lākou i hoʻopaʻa ʻia i kahi placebo.Ma waena o nā maʻi 15 me ka psoriasis inverse, ua hōʻike ʻo Zanchi et al.38 i kahi pane maikaʻi i ka mālama ʻana iā BoNT-A;akā, ua hoʻohana ʻia nā hopena o ka loiloi pilikino a me ka loiloi kiʻi infiltration a me ka loiloi erythema.No laila, ua kuhikuhi ʻo Chroni et al39 i nā manaʻo hopohopo like ʻole e pili ana i ke aʻo ʻana, me ka nele o nā hōʻailona quantitative e koho i nā hoʻomaikaʻi (e like me nā helu PA).Ua manaʻo ka mea kākau i ka hopena maikaʻi o BoNT-A i ka hoʻohaʻahaʻa ʻana i ka sweating kūloko i loko o nā pā, e like me ka maʻi Hailey-Hailey, kahi o ka hopena o BoNT-A ma muli o ka emi ʻana o ka sweating.40-42 ʻO ka hiki o BoNT-A ke pale i ka hyperalgesia Eia naʻe, ʻo ka hoʻokuʻu ʻana o nā neuropeptides e alakaʻi i ka liʻiliʻi o ka ʻeha a me ka ʻeha i nā maʻi.43
Off-label, ua hoʻohana ʻia ʻo BoNT e mālama i nā maʻi ʻili bullous like ʻole, e like me ka linear IgA bullous skin maʻi, Weber-Cockayne maʻi a me Hailey-Hailey maʻi.Ua hoʻohana ʻia ʻo BoNT-A injections, oral tacrolimus, yttrium aluminum garnet ablation laser, a me ka BoNT-A i loaʻa i ka erbium no ka mālama ʻana i ka maʻi Hailey-Hailey ma ka ʻaoʻao o ka umauma, axillary, inguinal a me nā ʻāpana intergluteal cleft.Ma hope o ka hoʻomaʻamaʻa ʻana, ua hoʻomaikaʻi nā hōʻailona lapaʻau, a he 25 a 200 U i kēlā me kēia 3 a 6 mau mahina.42,44 Ma ka hihia i hōʻike ʻia, ua hoʻokomo ʻia kahi wahine waena me ka epidermolysis bullosa āpana 50 U i kēlā me kēia armpit i kona wāwae, a ua hoʻokomo ʻia ʻo 100 U i ka mea maʻi me ka linear IgA bullosa Foot o ka maʻi ʻōpio me ka maʻi ʻili.45,46
I ka makahiki 2007, ua mālama pono ʻo Kontochristopoulos et al47 i ka ʻāpana submammary o kahi mea maʻi 59 makahiki, me ka hoʻohana ʻana iā BoNT-A ma ke ʻano he lāʻau kōkua no ka maʻi o Darier no ka manawa mua.I kekahi hihia ma 2008, he keiki ʻōpio me ke komo ʻana o ka anogenital koʻikoʻi i mea maikaʻi i ka hoʻohaʻahaʻa ʻana i ka wela ma ka wahi abraded.48 Ua mālama ʻia kona maʻi hui pū me ka 10 mg acitretin a me nā lāʻau antibiotic a me nā lāʻau antifungal i kēlā me kēia lā, akā ua haʻahaʻa kona ʻano o ke ola a ua hoʻomau ʻia kona pilikia.ʻEkolu pule ma hope o ka hoʻokomo ʻia ʻana o ka botulinum toxin, ua hoʻomaikaʻi maikaʻi ʻia kona mau hōʻailona a me nā maʻi lapaʻau.
ʻO ka Eccrine nevus kahi hamartoma ʻili kakaʻikahi i hōʻike ʻia e ka piʻi ʻana o ka nui o nā kelepa eccrine akā ʻaʻohe ulu ʻana o ka moku koko.Ma muli o ka hiʻohiʻona hope loa, ʻokoʻa ka eccrine nevus mai nā maʻi ʻē aʻe e like me ka angiomatous eccrine hamartoma.49 He mea maʻamau nā mole liʻiliʻi hoʻoluhi ma nā lima, me ka liʻiliʻi o nā pilikia ʻili, akā aia nā wahi o ka hyperhidrosis.50 ʻO ka ʻokiʻoki ʻana a i ʻole ka lāʻau lapaʻau i kaulana loa, ma muli o ka nui o ka uhi a me ke ʻano o ka hyperhidrosis.Ua kākau ʻo Honeyman et al51 i kahi keiki 12 makahiki me ka nevi liʻiliʻi liʻiliʻi ma ka lima ʻākau i kū i nā antiperspirant topical.Ma muli o ka nui o ka ʻōpū a me kona wahi anatomical, ua kāpae ʻia ka ʻoki ʻoki ʻana.He mea paʻakikī ka Hyperhidrosis i ke komo ʻana i nā hana pilikanaka a me ka naʻauao.Ua koho nā mea noiʻi e hoʻokomo i ka 5 U o BoNT-A ma 0.5-1 cm mau manawa.ʻAʻole i wehewehe nā mea kākau i ka manawa i loaʻa ai ka pane mua i ka mālama ʻana i ka BoNT-A, akā ua ʻōlelo lākou ma hope o hoʻokahi makahiki, ʻike lākou ua hoʻemi nui ʻia ka nui o nā ʻuhu i hoʻokahi mahina, a ua hoʻomaikaʻi ka maikaʻi o ke ola o ka mea maʻi.Ua mālama ʻo Lera et al49 i ka mea maʻi me ka haʻahaʻa o ke ola a me ka helu HDSS o 3 ma ka forearm me ka naevi liʻiliʻi (HDSS) (koʻikoʻi).Hoʻohui hou ʻia ʻo BoNT-A (100 IU) i loko o 2.5 mL sterile saline solution i loaʻa ka 0.9% sodium chloride a hoʻokomo ʻia i loko o ka wahi hoʻāʻo iodine.Ma hope o 48 mau hola, ʻike ka mea maʻi i ka emi ʻana o ka sweating, me nā hopena maikaʻi loa i ke kolu o ka pule.Hāʻule ka helu HDDS i ka 1. Ma muli o ka hoʻi hou ʻana o ka hou ʻana, ua hana hou ʻia ka mālama ʻana iā BoNT-A i ʻeiwa mau mahina ma hope.I ka mālama ʻana i ka exocrine hemangioma hamartoma, pono ʻo BoNT-A injection therapy.52 ʻOiai he kakaikahi kēia maʻi, he maʻalahi ke ʻike i ke koʻikoʻi o kēia poʻe i ka loaʻa ʻana o nā koho lapaʻau kūpono.
ʻO ka Hidradenitis suppurativa (HS) he maʻi ʻili maʻamau i hōʻike ʻia e ka ʻeha, nā ʻulaʻula, nā sinuses, nā fistulas, nā nodules inflamed, a ʻike ʻia i loko o nā ʻōpū apocrine o ke kino i nā pae hope.53 ʻAʻole maopopo ka pathophysiology o ka maʻi, a ke hoʻopiʻi ʻia nei nā manaʻo i ʻae mua ʻia e pili ana i ka hoʻomohala ʻana o HS.He mea koʻikoʻi ka hoʻopaʻa ʻana o ka lauoho lauoho i nā hōʻailona o HS, ʻoiai ʻaʻole maopopo ke ʻano o ka hana o ka occlusion.ʻO ka hopena o ka ʻāʻī a me ka hui pū ʻana o ka congenital a me adaptive immune dysfunction, hiki i ka HS ke hoʻomohala i ka pōʻino ʻili.54 Ua hōʻike ʻia kahi haʻawina a Feito-Rodriguez et al.55 ua mālama pono ʻo BoNT-A i ka HS prepubertal i nā kaikamahine 6 makahiki.ʻO ka hōʻike hihia o Shi et al.56 i ʻike ʻia ua mālama maikaʻi ʻia ʻo BoNT-A i ka -3 HS pae o kahi wahine 41 makahiki.ʻO kahi noiʻi hou a Grimstad et al.57 i loiloi inā pono ka intradermal injection o BoNT-B no HS i nā maʻi 20.Ua hoʻonui ʻia ka DLQI o ka hui BoNT-B mai ka median o 17 ma ka papa kuhikuhi i ka 8 i nā mahina 3, aʻo ka DLQI o ka hui placebo ua emi mai ka 13.5 a i ka 11.
ʻO ka Notalgia paresthetica (NP) kahi neuropathy sensory mau loa e pili ana i ka wahi interscapular, ʻoi aku ka T2-T6 dermatome, me ka ʻeha hope a me nā hōʻailona ʻili e pili ana i ka friction a me ka scratching.Hiki ke kōkua ʻo BoNT-A i ka mālama ʻana i ka ʻeha kūloko ma ke kāohi ʻana i ka hoʻokuʻu ʻia ʻana o ka mea P, kahi mea hoʻoponopono ʻeha a me ka ʻeha.58 Weinfeld's case report59 loiloi i ka pono o BoNT-A i ʻelua mau hihia.Ua mālama maikaʻi ʻia lāua ʻelua me BoNT-A.ʻO kahi haʻawina a Perez-Perez et al.58 i loiloi i ka pono o BoNT-A i nā maʻi 5 i loaʻa i ka NP.Ma hope o ka hoʻokele intradermal o BoNT, ua ʻike ʻia nā hopena he nui.ʻAʻole i hoʻomaha loa ʻia ka ʻili o ke kanaka.Ua loiloi ka randomized controlled trial (RCT) o Maari et al60 i ka pono a me ka palekana o BoNT-A i nā maʻi me NP ma ka Canadian Dermatology Research Clinic mai Iulai 2010 a hiki i Nowemapa 2011. ʻAʻole i hōʻoia ka haʻawina i nā hopena maikaʻi o BoNT-A.Intradermal injection ma kahi ʻano o ka 200 U e hōʻemi i ka ʻili i nā mea maʻi me NP.
ʻO Pompholyx, ka mea i kapa ʻia ʻo hyperhidrosis eczema, he maʻi vesicular bullous mau e hoʻopilikia i nā poho lima a me nā wāwae.ʻOiai ʻaʻole maopopo ka pathophysiology o kēia ʻano, ua manaʻo ʻia he hōʻailona o ka dermatitis atopic.61 ʻO ka hana pulu, ka hou ʻana, a me ke keʻakeʻa ʻana, ʻo ia ka mea maʻamau.62 ʻO ka hoʻohana ʻana i nā mīkina lima a i ʻole nā ​​kāmaʻa hiki ke hōʻeha i ka ʻeha, ke kuni, ka ʻuʻu, a me ka hōʻoluʻolu i nā maʻi;maʻa mau ka maʻi bacteria.Ua ʻike ʻo Swartling et al61 i ka poʻe maʻi me ka hyperhidrosis palm i mālama ʻia me BoNT-A i hoʻomaikaʻi ʻia ka eczema lima.Ma 2002, hoʻopuka lākou i nā hopena o kahi noiʻi e pili ana i nā maʻi he ʻumi me ka bilateral vesicular hand dermatitis;Hoʻokahi lima i loaʻa i ka BoNT-A injection, a ʻo kekahi lima i lawelawe ma ke ʻano he mana i ka wā o ka hahai ʻana.He hopena maikaʻi a maikaʻi paha ka lāʻau lapaʻau ma 7 o 10 mau maʻi.ʻO nā maʻi 6, ua hoʻohana ʻo Wollina lāua ʻo Karamfilov63 i nā corticosteroids topical ma nā lima ʻelua a hoʻokomo i ka 100 U o BoNT-A intracutaneously ma nā lima ʻeha loa.I ka mālama lima ʻana i ka hui pū ʻana, ua ʻike nā mea kākau i ka emi ʻana o ka ʻili a me nā blisters.Ua manaʻo lākou i ka maikaʻi o BoNT-A i ka impetigo ma muli o kāna hopena non-perspirant a me ka pale ʻana o SP.
ʻO ka vasospasm manamana lima, ʻike ʻia hoʻi ʻo Raynaud's Syndrome, he mea paʻakikī ke mālama a kūʻē pinepine i nā lāʻau lapaʻau mua e like me ka bosentan, iloprost, phosphodiesterase inhibitors, nitrates, a me ka Agent blockers channel calcium.ʻO nā kaʻina hana e pili ana i ka hoʻihoʻi ʻana a me ka pani ʻana, e like me ka sympathectomy, he invasive.Ua mālama maikaʻi ʻia ke ʻano o Raynaud e pili ana i ka maʻi mua a me ka sclerosis e ka injection o BoNT.Uaʻike nā mea noiʻi 64,65 ua loaʻa i nā maʻi 13 ka hoʻomaha wikiwiki, a ua ho'ōlaʻia nā maʻi maʻi maʻi i loko o 60 mau lā ma hope o ka loaʻaʻana o 50-100 U o BoNT.Ua hāʻawi ʻia nā injections i nā mea maʻi 19 me ke ʻano o Raynaud.66 Ma hope o ʻeono pule, ua piʻi nui ka mahana o ka manamana lima i mālama ʻia me BoNT i ka hoʻohālikelike ʻia me ka hoʻoheheʻe ʻia ʻana o ka paʻakai maʻamau, e hōʻike ana he mea pono ʻo BoNT no ka mālama ʻana i ka vasospasm pili i ke ʻano o Raynaud.67 I kēia manawa, aia kekahi mau kaʻina hana injection standard i hoʻohana ʻia;Wahi a kekahi noiʻi ʻana, ʻaʻole i alakaʻi ʻia nā inikini ma nā manamana lima, nā lima lima, a i ʻole nā ​​iwi metacarpal distal i nā hopena lapaʻau ʻokoʻa loa, ʻoiai he mea maikaʻi ia i ka mālama ʻana i ka vasospasm pili i ke ʻano o Raynaud.68
50-100 U o BoNT-A no kēlā me kēia armpit, i lawelawe ʻia i loko o kahi hoʻolālā e like me ka grid, hiki ke hoʻohana ʻia e mālama i ka hyperhidrosis axillary mua.ʻIke ʻia nā hopena lapaʻau i loko o hoʻokahi pule a mau no 3 a 10 mau mahina.Ua māʻona ka hapa nui o nā maʻi i kā lākou mālama ʻana.Pono e hoʻomaopopo ʻia ka poʻe maʻi a hiki i ka 5% o nā hihia e loaʻa i ka sweating compensatory hou.Hiki i ka 69,70 BoNT ke mālama maikaʻi i ka pāma a me ka hyperhidrosis plantar (Figure 5A a me B).
Kiʻi 5 Hōʻike ke kiʻi lapaʻau kūlana kiʻekiʻe (A) i kekahi haumāna o ke kulanui me ka diffuse palm hyperhidrosis e hopohopo nei no kēia maʻi a ʻaʻole pane i ka lāʻau lapaʻau.Ua hōʻike ʻia nā maʻi like i loaʻa i ka lāʻau toxin botulinum i ka hoʻonā piha o ka hyperhidrosis (B).(ʻenehana: Ma hope o ka hōʻoia ʻana e ka starch iodine test; 100 units, 2.5 mL intradermal BoNT-A i hoʻopaʻa ʻia i hoʻokahi lima. ʻO ka huina o ʻelua mau papa like o 15 mau lā ma ke kaʻawale i hoʻopuka i kahi pane koʻikoʻi no 6 mau mahina).
ʻO kēlā me kēia manamana lima he 2-3 mau kūlana injection, a pono e hoʻonohonoho ʻia nā injections i loko o kahi pahu me kahi mamao o 1 cm.Hiki ke hāʻawi ʻia ʻo BoNT-A i kēlā me kēia lima ma ka laulā o 75-100 mau ʻāpana a i kēlā me kēia wāwae i ka laulā o 100-200 mau ʻāpana.Hiki ke ʻike ʻia nā hopena lapaʻau i hoʻokahi pule, a hiki ke lōʻihi no ʻekolu a ʻeono mahina.Ma mua o ka hoʻomaka ʻana i ka lāʻau lapaʻau, pono e hoʻomaopopo ʻia nā mea maʻi i nā hopena ʻaoʻao o ka BoNT injections ma nā poho lima a me nā wāwae.Ma hope o ka hoʻokomo ʻana i ka pāma, hōʻike paha ka mea maʻi i ka nāwaliwali.Ma ka ʻaoʻao ʻē aʻe, hiki ke paʻakikī ka hele ʻana o nā mea kanu kanu, ʻoiai inā hana ʻia nā poloka nerve ma mua o ka mālama ʻana iā BoNT.71,72 ʻO ka mea pōʻino, 20% o nā mea maʻi hyperhidrosis plantar ʻaʻole i pane i ka lāʻau ma hope o ka loaʻa ʻana o nā injections BoNT.72
I nā haʻawina hou, ua hoʻohana ʻia ʻo BoNT e mālama i ka hyperhidrosis ma kahi ala hou.I kekahi hihia, ua loaʻa i kahi kāne maʻi me ka maʻi maʻi maʻi he 100 U o BoNT-A injections i loko o ka gluteal cleft i kēlā me kēia 6-8 mau mahina e hōʻemi i ka hana hou a me ka maceration ʻeha;mālama ʻia ka pono o ka ʻili No ka ʻoi aku o ʻelua mau makahiki, ʻaʻohe hōʻeha kino o ka ʻeha puʻe.73 Ua hoʻohana ʻia kekahi haʻawina ʻo 2250 U o BoNT-B e hoʻokomo ʻia i loko o ke poʻo occipital, ka poʻo parietal, ka lae a me ka lae, a me nā ʻāpana perioral a me nā ʻaoʻao o ka maka i loko o ke ʻano hoʻohālike e mālama ai i ka hyperhidrosis craniofacial postmenopausal.ʻO ka DLQI o nā maʻi e loaʻa ana i ka BoNT-B ua hoʻomaikaʻi ʻia e 91% i loko o ʻekolu pule ma hope o ka mālama ʻana, aʻo ka maikaʻi o ke ola o nā mea maʻi e loaʻa ana i ka placebo ua hoʻemi ʻia e 18%.74 Hoʻohana maikaʻi ʻo BoNT injection i ka mālama ʻana i ka salivation a me Frey syndrome.Hoʻomaʻamaʻa pinepine nā Otolaryngologists ma muli o ka wahi anatomical o ka injection.75,76
Hiki i ka hou kala ke lilo i mea pilikia loa no ka mea ma'i.ʻOiai he kakaikahi loa kēia maʻi;ʻo ke komo ʻana o ka maka a me nā ʻūhā hiki ke hoʻonui i ka pilikia o ka mea maʻi.He nui nā hōʻike hihia a me nā paʻi e hōʻike ana i ka maikaʻi o BoNT-A ma hope o ka hoʻopaʻa ʻia ʻana i nā lā 7 wale nō.77-79
He mea hilahila a hoʻopailua paha ka ʻala maikaʻi ʻole mai ka hyperhidrosis armpit a me ke ʻala kino.He hopena maikaʻi paha kēia ma ka noʻonoʻo a me ka hilinaʻi o ka mea maʻi.ʻO ka mea i hala koke aku nei, ʻo Wu et al.Ua hōʻike ʻia ma hope o ka hoʻokomo ʻia ʻana o BoNT-A i loko o ke kino, ua aneane pau ka pilau o ka ʻāʻī.80 Ma kahi noiʻi ʻē aʻe o kēia manawa;Ua kiʻi ʻia nā ʻōpio 62 me kahi maʻi dermatological o ka ʻala underarm mua.Ua manaʻo ka 82.25% o nā maʻi ua hoʻemi nui ʻia ka pilau ma hope o ka hoʻokomo ʻia ʻana o BoNT-A i loko o ka wahi axillary.81
ʻIke ʻia ʻo Meh e nā maʻi cystic benign hoʻokahi a i ʻole he nui i nā wahine waena, aia ma ka ʻaoʻao waena, me ka lōʻihi o ka maʻi a me nā loli o ka wā.Hōʻike pinepine ʻia ʻo Meh i nā kūlana lā a pili pū me ka hyperhidrosis.Nui nā mea noiʻi i ʻike i nā hopena ʻino i kēia mau hihia ma hope o ka hoʻokomo ʻana iā BoNT-A.82 a puni ka lesion.
ʻO ka neuralgia post-herpetic (PHN) ka pilikia maʻamau maʻamau o ka maʻi herpes zoster, ka mea maʻamau i nā poʻe ma mua o 60 mau makahiki.Hoʻopuka pololei ʻo BoNT-A i nā hopena pan-inhibitory ma nā hopena nerve kūloko a hoʻoponopono i ka crosstalk microglia-astrocytic-neuronal.Ua ʻike nā haʻawina he nui ma hope o ka loaʻa ʻana o ka lāʻau lapaʻau BoNT-A, nā maʻi i hoʻemi ʻia ka ʻeha ma ka liʻiliʻi ma 30% a 50% ua hoʻemi nui i nā helu hiamoe a me ka maikaʻi o ke ola.83
Hōʻike ʻia ka lichen maʻalahi ma ke ʻano he maʻi ʻeha nui me ke kumu ʻole.Hiki i kēia ke hoʻonāwaliwali loa i ka mea maʻi.Ua hōʻike ʻia ka hoʻokolohua dermatological Clinical plaques erythema kaʻawale, hoʻonui ʻia ka ʻili a me ka exfoliation epidermal.Ua hōʻike ʻia kahi noiʻi ʻāina hou mai ʻAigupita mai hiki i ka BoNT-A ke mālama pono i ka lichen simplex maʻi, hypertrophic lichen planus, lichen planus, kuni, reverse psoriasis, a me ka intractability kūloko o post-herpetic neuralgia Pruritus.84
ʻO nā keloids he mau maʻi ʻiʻo ʻokoʻa i hiki mai ma hope o ka ʻeha.Pili nā keloids, a ua hoʻāʻo ʻia nā lāʻau he nui, akā ua kaupalena ʻia ka hopena.Eia naʻe, ʻaʻohe o lākou i hoʻōla loa ʻia.ʻOiai ʻo intralesional corticosteroids ke ʻano o ka mālama nui ʻana, ua lilo ka intralesional injection o BoNT-A i mea koho maikaʻi loa i kēia mau lā.Hiki i ka BoNT-A ke hoʻemi i nā pae o TGF-β1 a me CTGF, a hoʻonāwaliwali i ka ʻokoʻa o nā fibroblasts.Ua hōʻoia kekahi mau haʻawina i ka holomua o BoNT-A i ka mālama ʻana i nā keloids.ʻO ka ʻoiaʻiʻo, ua hōʻike ʻia ka hopena o nā maʻi keloid ʻelua i ka 100% pane, a ua ʻoluʻolu loa nā mea maʻi i ka hoʻohana ʻana i ka injection BoNT-A intralesional.85
ʻO ka onychomycosis mānoanoa congenital kahi maʻi maʻi maʻamau i hele pū ʻia me ka hyperkeratosis plantar, hypertrophy nail a me hyperhidrosis.ʻAʻole hiki i nā mea noiʻi liʻiliʻi ke hoʻomaikaʻi wale i ka hyperhidrosis, akā e hōʻemi i ka ʻeha a me ka ʻeha.86,87
He maʻi maʻamau ka keratosis no ka wai.Ke pili ka mea maʻi i ka wai, hiki mai nā ʻiliʻili keʻokeʻo mānoanoa ma nā kapuaʻi a me nā poho lima a me ka ʻili.Hōʻike kekahi mau hōʻike hihia i loko o ka puke moʻolelo i ka hoʻomaʻamaʻa maikaʻi ʻana a me ka hoʻomaikaʻi ʻana ma hope o ka mālama ʻana iā BoNT-A, ʻoiai i nā hihia kūpaʻa.88
ʻO ke koko, edema, erythema a me ka ʻeha ma ka wahi i hoʻopaʻa ʻia he hopena ʻaoʻao ia o BoNT.89 Hiki ke pale ʻia kēia mau hopena ʻaoʻao me ka hoʻohana ʻana i ka nila ʻoi aku ka lahilahi a me ka hoʻoheheʻe ʻana i ka BoNT me ka paʻakai.Hiki ke hoʻoulu ʻia ke poʻo o ka BoNT injections;akā naʻe, nalowale lākou ma hope o 2-4 mau pule.Hiki ke hoʻohana ʻia nā analgesics systemic e hoʻoponopono i kēia hopena ʻaoʻao.90,91 ʻO ka nausea, ka malaise, nā hōʻailona like-flu a me ka ptosis kekahi mau hopena ʻaoʻao i hoʻopaʻa ʻia.89 ʻO Ptosis ka wahi hopena o ka hoʻohana ʻana iā BoNT e mālama i nā kuʻemaka.Hoʻokumu ʻia ia e ka hoʻolaha BoNT kūloko.Hiki ke hoʻomau ʻia kēia diffusion no kekahi mau pule, akā hiki ke hoʻoholo ʻia me nā hāʻule o ka maka agonist alpha-adrenergic.Ke hoʻokomo ʻia ʻo BoNT i ka lihilihi haʻahaʻa, hiki iā ia ke hana i ka ectropion ma muli o ke kaʻina diffusion kūloko.Eia kekahi, hiki i nā poʻe maʻi ke loaʻa i ka BoNT injection no ka hoʻōla ʻana i nā kapuaʻi o ke kuʻi a i ʻole nā ​​ʻano rabbit (periorbital) hiki ke loaʻa i ka strabismus ma muli o ka ʻike ʻole ʻia o BoNT a me ka hoʻolaha ʻana o BoNT kūloko.89,92 Eia naʻe, e like me ka nalo ʻana o ka hopena paralytic o nā toxins, e nalo mālie kēia mau hopena āpau.93,94
He haʻahaʻa ka pilikia o ka hoʻopiʻi ʻana mai nā injection BoNT cosmetic.ʻO ka Ecchymosis a me ka purpura ka hopena maʻamau a hiki ke hoʻemi ʻia ma o ka hoʻopili ʻana i nā paʻi anu i ka wahi i hoʻopaʻa ʻia ma mua a ma hope o ka injection BoNT.90,91 BoNT pono e hoʻokomo ʻia ma kahi haʻahaʻa, ma kahi o 1 knm mai ka lihi o ka iwi orbital haʻahaʻa, luna a ʻaoʻao paha, me kahi ʻano kūpono.ʻAʻole pono ka mea maʻi e hoʻopololei i ka wahi injection i loko o 2-3 mau hola ma hope o ka mālama ʻana, a noho a kū pololei paha i loko o 3-4 mau hola ma hope o ka mālama ʻana.95
Ke hoʻāʻo ʻia nei ʻo BoNT-A i nā ʻano hana hou e mālama i nā laina glabellar a me nā laina maka.Ua aʻo ʻia ka topical a injectable daxibotulinumtoxinA, akā ua hōʻike ʻia nā ʻano hoʻoponopono kumuhana ʻaʻole pono.Ua komo ka injection DAXI i ka FDA's phase III ho'āʻo, e hōʻike ana i ka hopena a me nā hopena lapaʻau i ka mālama ʻana i nā laina glabellar a hiki i 5 mau pule ma mua o ka onabotulinumtoxinA.96 Aia ʻo LetibotulinumtoxinA ma ka mākeke ma Asia a ua ʻae ʻia e ka FDA no ka mālama ʻana i nā wrinkles periorbital.97 Ke hoʻohālikelike ʻia me ka incobotulinumtoxinA, ʻoi aku ka kiʻekiʻe o ka LetibotulinumtoxinA i ka protein neurotoxic i kēlā me kēia volume, akā ʻoi aku ka kiʻekiʻe o ka neurotoxin inactive, kahi e hoʻonui ai i ka hopena o ka pane ʻana.98
Ma waho aʻe o ka hoʻolālā BoNT-A hou, ke aʻo ʻia nei ka wai BoNT-E no ka mea ua ʻōlelo ʻia ʻoi aku ka wikiwiki o ka hoʻomaka ʻana o ka hana a me ka manawa pōkole o nā hopena lapaʻau (14-30 mau lā).Ua ʻike ʻia ʻo EB-001 he palekana a maikaʻi hoʻi i ka hōʻemi ʻana i ke ʻano o nā laina frown a me ka hoʻomaikaʻi ʻana i ke ʻano o nā ʻōpala lae ma hope o ka microsurgery Mohs.99 Hiki i nā Dermatologists ke hoʻohana i kēia mau puke.Ma kahi o nā kumu aesthetic o kēia manawa, ke ʻimi nei nā ʻoihana lāʻau lapaʻau i ka hoʻomākaukau ʻana iā BoNT-A no ka mālama ʻana i nā maʻi maʻi o nā maʻi ʻili.
ʻO ka BoNT kahi lāʻau injectable hiki ke hoʻololi ʻia e hiki ke hoʻohana ʻia e mālama i nā maʻi ʻili like ʻole, e like me ka hidradenitis suppurativa, psoriasis, maʻi ʻili bullous, nā ʻili maʻamau, ka lauoho lauoho, hyperhidrosis, a me nā keloids.Ma nā noi hoʻonaninani, ua manaʻo ʻia ʻo BoNT he palekana a maikaʻi hoʻi i ka hōʻemi ʻana i nā wrinkles maka, ʻoi aku ka hapakolu o nā wrinkles maka.ʻIke ʻia ʻo BoNT A no kona hoʻohana ʻana i ka hōʻemi ʻana i nā wrinkles ma ke kahua hoʻonaninani.ʻOiai palekana ʻo BoNT, he mea nui ka hoʻomaopopo ʻana i ka wahi i hoʻopaʻa ʻia no ka mea hiki ke pālahalaha a hoʻopilikia i nā wahi i pono ʻole ke mālama ʻia.Pono nā kauka lapaʻau e ʻike i nā pilikia ma nā wahi kikoʻī i ka wā e hoʻokomo ai i ka BoNT i nā wāwae, nā lima, a i ʻole ka ʻāʻī.Pono nā Dermatologists e kamaʻāina i ka hoʻohana ʻana ma ka lepili a me ka hoʻohana ʻole ʻana o BoNT i mea e hāʻawi ai i nā maʻi i nā lapaʻau kūpono a hōʻemi i ka maʻi maʻi pili.Pono e loiloi ʻia ka maikaʻi o ka lāʻau lapaʻau o BoNT ma nā hoʻonohonoho o waho a me nā pilikia palekana no ka wā lōʻihi ma o nā hoʻokolohua lapaʻau i hoʻolālā maikaʻi ʻia.
ʻAʻole pili ka kaʻana like ʻikepili i kēia ʻatikala no ka mea ʻaʻohe pūʻulu ʻikepili i hana ʻia a i kālailai ʻia i ka wā noiʻi o kēia manawa.
Hana ʻia ka nānā ʻana o nā maʻi e like me nā loina o ka Hōʻike o Helsinki.Hōʻoia ka mea kākau ua loaʻa iā ia nā palapala ʻae kūpono a pau e ʻae ai ka mea maʻi e hoʻokomo i nā kiʻi a me nā ʻike lapaʻau ʻē aʻe i loko o ka puke pai.Hoʻomaopopo ka poʻe maʻi ʻaʻole e hoʻolaha ʻia ko lākou mau inoa a me nā hua mua, a e hoʻāʻo lākou e hūnā i ko lākou ʻike.
Ua hāʻawi wale ʻo Kauka Piyu Parth Naik i ke kākau ʻana i ka palapala.Ua hāʻawi nui ka mea kākau i ka manaʻo a me ka hoʻolālā, ka loaʻa ʻana o ka ʻikepili a me ka wehewehe ʻikepili;ua komo i ka hana ʻana i nā ʻatikala a i ʻole i hoʻoponopono hou ʻia i ka ʻike koʻikoʻi;ua ʻae e waiho i ka puke pai o kēia manawa;ua ʻae ʻia ka mana e paʻi ʻia;a ʻae i ka hana kuleana no nā ʻano āpau.