BACKGROUND. Hailey-Hailey disease is an inherited acantholytic disorder aff
ecting the intertriginous areas of the body which is exacerbated by sweat,
moisture, and friction. The disease is frequently resistant to conventional
nonsurgical treatment.
OBJECTIVE. To evaluate whether chemodenervation of sweat glands would impro
ve the course of the disease in a patient with Hailey-Hailey.
METHODS. We used low-dose treatment of the left axilla with botulinum toxin
type A, the right axilla being used as a control, followed by treatment of
both axillae with the optimal dose routinely used for the treatment of axi
llary hyperhidrosis.
RESULTS. After one treatment with a low dose of botulinum toxin type A, we
observed partial improvement of the treated axilla. With subsequent treatme
nt of both axillae with the recommended dose for axillary hyperhidrosis, we
observed a sustained complete remission of the disease in the treated axil
lae.
CONCLUSION. Botulinum toxin type A may be an effective and safe nonsurgical
alternative for the treatment of benign familial pemphigus in intertrigino
us areas such as the axillae.