Treatment of symptomatic epidermolysis bullosa simplex with botulinum toxin in a pediatric patient

EBS: epidermolysis bullosa simplex INTRODUCTION Botulinum toxin has been used to treat plantar blistering and pain in 7 epidermolysis bullosa simplex patients, includingone child,with excellent but transient success (Table I). Most of these patients were treated with abobotulinumtoxinA, including the indexed pediatric patient. We recently investigated the use of onabotulinumtoxinA to treat epidermolysis bullosa simplex (EBS) symptoms in a pediatric patient, making this successful treatment unusual. Dose equivalence ranging from 2:1 to 4:1 abobotulinumtoxinA to onabotulinumtoxinA, respectively, has been suggested for the treatment of glabellar wrinkles and axillary hyperhidrosis, but further evidence is needed to determine the appropriate dose for management of EBS symptoms in both pediatric and adult patients. Additionally, the relative importance of the toxin’s role inhyperhidrosis reductionandon localneurotransmitter release in neuropathic pathways deserves exploration.