טיפול במחלת היילי היילי באמצעות בוטוקוס טופיקלי לאחר שימוש במכשיר הטיקסל

BACKGROUND: Hailey-Hailey disease (HHD) is a rare hereditary acantholytic dermatosis causing significant quality of life impairment. Successful treatment with botulinum toxin (BTX) injections has previously been reported. The main disadvantages of this approach are the risk of infections and the excruciating pain the patients must endure.

AIM: We sought to evaluate the clinical effectiveness and safety profile of a novel approach using an energy-based device (Tixel) that thermally decomposes the stratum corneum, followed by the topical application of BTX for the treatment of HHD.

METHODS: We conducted a retrospective study of histologically diagnosed cases of HHD treated with the Tixel device followed by topical application of BTX. Demographic, clinical, treatment and safety data were collected. Objective and subjective assessments of the patients were carried through the dermatology life quality index (DLQI), patient’s global impression of change (PGIC) scale and physician’s global assessment (PGA) scale.

RESULTS: In total, 8 patients with HHD were treated. Of them, two patients reported full remission, four reported nearly full remission, while one reported partial remission and only one patient reported no improvement. The average PGA, PGIC and DLQI scores significantly improved after treatment. The disease manifestations recurred after 7.125 months. No local or systemic complications were reported.

CONCLUSION: Tixel treatment followed by the topical application of botulinum toxin can be considered in the treatment of HHD. This approach is a safe, less invasive and painful, and yet effective for the treatment of HHD. Further studies comparing the efficacy of BTX injections to the described approach are warranted.