{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T11:15:35Z","timestamp":1787483735085,"version":"build-2736575974"},"reference-count":46,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2024,10,18]],"date-time":"2024-10-18T00:00:00Z","timestamp":1729209600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Toxins"],"abstract":"<jats:p>A literature search on the subject of botulinum toxin treatment in psoriasis found 15 relevant articles, 11 on human subjects and 4 on animal studies. Of the human data, eight were clinical trials and three were single case reports. Seven out of eight clinical trials, all open-label, reported improvement in psoriasis following intradermal or subcutaneous botulinum toxin injections. One double-blind, placebo-controlled study, which used a smaller dose than the open-label studies, did not note a healing effect. Animal studies have shown that injection of botulinum toxins in the skin heals psoriatic skin lesions and can reduce the level of interleukins (ILs) and cytokines as well as inflammatory cells in psoriatic plaques. There is a need for controlled, blinded studies conducted in larger numbers of patients with doses that have shown promise in open-label studies.<\/jats:p>","DOI":"10.3390\/toxins16100449","type":"journal-article","created":{"date-parts":[[2024,10,18]],"date-time":"2024-10-18T06:46:52Z","timestamp":1729234012000},"page":"449","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Botulinum Toxin Treatment of Psoriasis\u2014A Comprehensive Review"],"prefix":"10.3390","volume":"16","author":[{"given":"Ali","family":"Ghaseminejad-Bandpey","sequence":"first","affiliation":[{"name":"Biggs Institute, University of Texas Health Science Center San Antonio, San Antonio, TX 78229, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shahroo","family":"Etemadmoghadam","sequence":"additional","affiliation":[{"name":"Biggs Institute, University of Texas Health Science Center San Antonio, San Antonio, TX 78229, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bahman","family":"Jabbari","sequence":"additional","affiliation":[{"name":"Department of Neurology, Yale University School of Medicine, New Haven, CT 06516, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,10,18]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"205","DOI":"10.1111\/jdv.13854","article-title":"A systematic review of worldwide epidemiology of psoriasis","volume":"31","author":"Michalek","year":"2016","journal-title":"J. Eur. Acad. Dermatol. Venereol."},{"key":"ref_2","first-page":"187","article-title":"Prevalence of Psoriasis in Children and Adolescents in the United States: A Claims-Based Analysis","volume":"17","author":"Paller","year":"2018","journal-title":"J. Drugs Dermatol. JDD"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1945","DOI":"10.1001\/jama.2020.4006","article-title":"Pathophysiology, Clinical Presentation, and Treatment of Psoriasis: A Review","volume":"323","author":"Armstrong","year":"2020","journal-title":"JAMA"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"437","DOI":"10.1038\/s41392-023-01655-6","article-title":"Signaling pathways and targeted therapies for psoriasis","volume":"8","author":"Guo","year":"2023","journal-title":"Signal Transduct. Target. Ther."},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Lee, H.-J., and Kim, M. (2023). Challenges and Future Trends in the Treatment of Psoriasis. Int. J. Mol. Sci., 24.","DOI":"10.3390\/ijms241713313"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"281","DOI":"10.1067\/mjd.2000.106374","article-title":"Two considerations for patients with psoriasis and their clinicians: What defines mild, moderate, and severe psoriasis? What constitutes a clinically significant improvement when treating psoriasis?","volume":"43","author":"Krueger","year":"2000","journal-title":"J. Am. Acad. Dermatol."},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Saalbach, A., and Kunz, M. (2022). Impact of Chronic Inflammation in Psoriasis on Bone Metabolism. Front. Immunol., 13.","DOI":"10.3389\/fimmu.2022.925503"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"164","DOI":"10.1007\/s12016-024-08991-7","article-title":"The Immunology of Psoriasis\u2014Current Concepts in Pathogenesis","volume":"66","author":"Sieminska","year":"2024","journal-title":"Clin. Rev. Allergy Immunol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1131","DOI":"10.1002\/mds.27072","article-title":"Botulinum toxin: State of the art","volume":"32","author":"Jankovic","year":"2017","journal-title":"Mov. Disord."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"129","DOI":"10.2217\/pmt.13.75","article-title":"Botulinum Toxin for Neuropathic Pain and Spasticity: An Overview","volume":"4","author":"Brown","year":"2014","journal-title":"Pain Manag."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1531","DOI":"10.1517\/13543784.10.8.1531","article-title":"Botulinum toxin therapy for pain and inflammatory disorders: Mechanisms and therapeutic effects","volume":"10","author":"Borodic","year":"2001","journal-title":"Expert Opin. Investig. Drugs"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1011","DOI":"10.1111\/bjd.16080","article-title":"The non-neuronal and nonmuscular effects of botulinum toxin: An opportunity for a deadly molecule to treat disease in the skin and beyond","volume":"178","author":"Grando","year":"2018","journal-title":"Br. J. Dermatol."},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Zou, Y.P., Shan, X.F., Qiu, J.X., Wang, L.N., Xiang, R.L., and Cai, Z.G. (2024). Botulinum toxin type A inhibits M1 macrophage polarization by deactivation of JAK2\/STAT1 and I\u03baB\/NF\u03baB pathway and contributes to scar alleviation in aseptic skin wound healing. Biomed. Pharmacother., 174.","DOI":"10.1016\/j.biopha.2024.116468"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"431","DOI":"10.1111\/j.1468-3083.2007.02457.x","article-title":"Botulinum toxin type-A for the treatment of inverse psoriasis","volume":"22","author":"Zanchi","year":"2008","journal-title":"J. Eur. Acad. Dermatol. Venereol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"629","DOI":"10.1001\/archdermatol.2011.111","article-title":"Inverse Psoriasis and Hyperhidrosis of the Axillae Responding to Botulinum Toxin Type A","volume":"147","author":"Saber","year":"2011","journal-title":"Arch. Dermatol."},{"key":"ref_16","first-page":"1407","article-title":"Efficacy of botulinum neurotoxin type A for treating recalcitrant plaque psoriasis","volume":"13","author":"Gilbert","year":"2014","journal-title":"J. Drugs Dermatol."},{"key":"ref_17","first-page":"E81","article-title":"The effect of botulinum neurotoxin A in patients with plaque psoriasis\u2014An exploratory trial","volume":"32","author":"Todberg","year":"2017","journal-title":"J. Eur. Acad. Dermatol. Venereol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1156","DOI":"10.1016\/j.jaad.2018.07.058","article-title":"Neuromodulatory treatment of recalcitrant plaque psoriasis with onabotulinumtoxinA","volume":"79","author":"Aschenbeck","year":"2018","journal-title":"J. Am. Acad. Dermatol."},{"key":"ref_19","first-page":"e14319","article-title":"Breaking paradigms in the treatment of psoriasis: Use of botulinum toxin for the treatment of plaque psoriasis","volume":"33","author":"Franco","year":"2020","journal-title":"Dermatol. Ther."},{"key":"ref_20","first-page":"12","article-title":"Evaluation of Botulinum Toxin Type A Injection in the Treatment of Localized Chronic Pruritus","volume":"13","author":"Gharib","year":"2020","journal-title":"J. Clin. Aesthet. Dermatol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"3128","DOI":"10.1111\/jocd.14306","article-title":"Botulinum toxin type-A versus 5-fluorouracil in the treatment of plaque psoriasis: Comparative study","volume":"20","author":"Khattab","year":"2021","journal-title":"J. Cosmet. Dermatol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1418","DOI":"10.1111\/jocd.13633","article-title":"Management of nail psoriasis with a single injection of abobotulinum toxin","volume":"20","author":"Botsali","year":"2020","journal-title":"J. Cosmet. Dermatol."},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Popescu, M.N., Beiu, C., Iliescu, M.G., Mihai, M.M., Popa, L.G., St\u0103nescu, A.M.A., and Berteanu, M. (2022). Botulinum Toxin Use for Modulating Neuroimmune Cutaneous Activity in Psoriasis. Medicina, 58.","DOI":"10.3390\/medicina58060813"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1016\/j.jdin.2024.03.021","article-title":"Botulinum toxin injection shows promise in nail psoriasis: A comparative randomized controlled trial","volume":"16","author":"Juntongjin","year":"2024","journal-title":"JAAD Int."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1927","DOI":"10.1038\/jid.2012.60","article-title":"Botulinum Neurotoxin A Decreases Infiltrating Cutaneous Lymphocytes and Improves Acanthosis in the KC-Tie2 Mouse Model","volume":"132","author":"Ward","year":"2012","journal-title":"J. Investig. Dermatol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1016\/j.jdermsci.2020.11.003","article-title":"Suppression of neuropeptide by botulinum toxin improves imiquimod-induced psoriasis-like dermatitis via the regulation of neuroimmune system","volume":"101","author":"Amalia","year":"2020","journal-title":"J. Dermatol. Sci."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"267","DOI":"10.1007\/s00018-022-04299-x","article-title":"Cutaneous nerve fibers participate in the progression of psoriasis by linking epidermal keratinocytes and immunocytes","volume":"79","author":"Chen","year":"2022","journal-title":"Cell. Mol. Life Sci."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"5288","DOI":"10.1038\/s41467-024-49577-3","article-title":"Sensory ASIC3 channel exacerbates psoriatic inflammation via a neurogenic pathway in female mice","volume":"15","author":"Huang","year":"2024","journal-title":"Nat. Commun."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"339","DOI":"10.1016\/j.det.2024.02.001","article-title":"Biologics for Psoriasis","volume":"42","author":"Wride","year":"2024","journal-title":"Dermatol. Clin."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1038\/nature13199","article-title":"Nociceptive sensory neurons drive interleukin-23-mediated psoriasiform skin inflammation","volume":"510","author":"Perro","year":"2014","journal-title":"Nature"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1016\/j.toxicon.2019.12.153","article-title":"Botulinum toxin type A ameliorates adjuvant-arthritis pain by inhibiting microglial activation-mediated neuroinflammation and intracellular molecular signaling","volume":"178","author":"Shi","year":"2020","journal-title":"Toxicon"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1016\/j.pain.2003.10.008","article-title":"Subcutaneous administration of botulinum toxin A reduces formalin-induced pain","volume":"107","author":"Cui","year":"2004","journal-title":"Pain"},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"Izumi, M., Ikeuchi, M., Ji, Q., and Tani, T. (2012). Local ASIC3 modulates pain and disease progression in a rat model of osteoarthritis. J. Biomed. Sci., 19.","DOI":"10.1186\/1423-0127-19-77"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"209","DOI":"10.1139\/Y07-018","article-title":"Botulinum toxin type A inhibits rat pyloric myoelectrical activity and substance P release in vivo","volume":"85","author":"Hou","year":"2007","journal-title":"Can. J. Physiol. Pharmacol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"4143","DOI":"10.3390\/toxins7104143","article-title":"The Inhibitory Effect of Botulinum Toxin Type A on Rat Pyloric Smooth Muscle Contractile Response to Substance P In Vitro","volume":"7","author":"Shao","year":"2015","journal-title":"Toxins"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1159\/000083259","article-title":"Botulinum Toxin: Mechanisms of Action","volume":"53","author":"Dressler","year":"2005","journal-title":"Eur. Neurol."},{"key":"ref_37","first-page":"279","article-title":"Activity of botulinum toxin type A in cranial dura: Implications for treatment of migraine and other headaches","volume":"173","author":"Matak","year":"2015","journal-title":"Br. J. Pharmacol."},{"key":"ref_38","first-page":"50","article-title":"Effect of botulinum toxin type A on the expression of substance P, calcitonin gene-related peptide, transforming growth factor beta-1 and alpha smooth muscle actin A in wound healing in rats","volume":"25","author":"Wang","year":"2009","journal-title":"Zhonghua Zheng Xing Wai Ke Za Zhi"},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Huang, P.P., Khan, I., Suhail, M.S.A., Malkmus, S., and Yaksh, T.L. (2011). Spinal Botulinum Neurotoxin B: Effects on Afferent Transmitter Release and Nociceptive Processing. PLoS ONE, 6.","DOI":"10.1371\/annotation\/1fe31fa2-e930-4a72-a208-64eb42d99f02"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"269","DOI":"10.1111\/head.12250","article-title":"An Exploratory Study of Salivary Calcitonin Gene-Related Peptide Levels Relative to Acute Interventions and Preventative Treatment with OnabotulinumtoxinA in Chronic Migraine","volume":"54","author":"Cady","year":"2013","journal-title":"Headache: J. Head Face Pain"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"761","DOI":"10.1016\/j.neuro.2004.12.012","article-title":"Internalization and Mechanism of Action of Clostridial Toxins in Neurons","volume":"26","author":"Grumelli","year":"2005","journal-title":"NeuroToxicology"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1016\/j.toxicon.2017.10.010","article-title":"The binding of botulinum neurotoxins to different peripheral neurons","volume":"147","author":"Rossetto","year":"2018","journal-title":"Toxicon"},{"key":"ref_43","doi-asserted-by":"crossref","unstructured":"Matak, I., B\u00f6lcskei, K., Bach-Rojecky, L., and Helyes, Z. (2019). Mechanisms of Botulinum Toxin Type A Action on Pain. Toxins, 11.","DOI":"10.3390\/toxins11080459"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"1403","DOI":"10.1016\/S0006-2952(00)00260-4","article-title":"Capsaicin-stimulated release of substance P from cultured dorsal root ganglion neurons: Involvement of two distinct mechanisms","volume":"59","author":"Purkiss","year":"2000","journal-title":"Biochem. Pharmacol."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"357","DOI":"10.1016\/j.det.2024.02.013","article-title":"Oral Psoriasis Therapies","volume":"42","author":"James","year":"2024","journal-title":"Dermatol. Clin."},{"key":"ref_46","doi-asserted-by":"crossref","unstructured":"Martina, E., Diotallevi, F., Radi, G., Campanati, A., and Offidani, A. (2021). Therapeutic Use of Botulinum Neurotoxins in Dermatology: Systematic Review. Toxins, 13.","DOI":"10.3390\/toxins13020120"}],"container-title":["Toxins"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6651\/16\/10\/449\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T16:15:58Z","timestamp":1760112958000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6651\/16\/10\/449"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,10,18]]},"references-count":46,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2024,10]]}},"alternative-id":["toxins16100449"],"URL":"https:\/\/doi.org\/10.3390\/toxins16100449","relation":{},"ISSN":["2072-6651"],"issn-type":[{"value":"2072-6651","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,10,18]]}}}