{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T15:48:36Z","timestamp":1788364116192,"version":"build-2803163510"},"reference-count":42,"publisher":"Springer Science and Business Media LLC","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,10,31]]},"DOI":"10.7759\/cureus.95795","type":"journal-article","created":{"date-parts":[[2025,10,31]],"date-time":"2025-10-31T08:07:34Z","timestamp":1761898054000},"source":"Crossref","is-referenced-by-count":4,"title":["Hypersensitivity Reactions Associated With Aesthetic Botulinum Toxin A Injections: A Case Series"],"prefix":"10.7759","author":[{"given":"Elizabeth","family":"Buchholz","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rungsima","family":"Wanitphakdeedecha","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Santi","family":"Jaturawichanant","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kornvikka","family":"Pattanapran","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Niamh","family":"Corduff","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1124\/pr.116.012658","article-title":"Botulinum neurotoxins: biology, pharmacology, and toxicology","volume":"69","author":"Pirazzini M","year":"2017","unstructured":"Pirazzini M, Rossetto O, Eleopra R, Montecucco C. Botulinum neurotoxins: biology, pharmacology, and toxicology. Pharmacol Rev. 2017, 69:200-35. 10.1124\/pr.116.012658","journal-title":"Pharmacol Rev"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1093\/asj\/sju105","article-title":"Report of allergic reaction after application of botulinum toxin","volume":"35","author":"Careta MF","year":"2015","unstructured":"Careta MF, Delgado L, Patriota R. Report of allergic reaction after application of botulinum toxin. Aesthet Surg J. 2015, 35:NP102-5. 10.1093\/asj\/sju105","journal-title":"Aesthet Surg J"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1053\/sder.2001.25138","article-title":"Botulinum toxin type A: history and current cosmetic use in the upper face","volume":"20","author":"Carruthers A","year":"2001","unstructured":"Carruthers A, Carruthers J. Botulinum toxin type A: history and current cosmetic use in the upper face. Semin Cutan Med Surg. 2001, 20:71-84. 10.1053\/sder.2001.25138","journal-title":"Semin Cutan Med Surg"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1002\/mds.870120637","article-title":"Idiosyncratic adverse reactions to intramuscular botulinum toxin type A injection","volume":"12","author":"LeWitt PA","year":"1997","unstructured":"LeWitt PA, Trosch RM. Idiosyncratic adverse reactions to intramuscular botulinum toxin type A injection. Mov Disord. 1997, 12:1064-7. 10.1002\/mds.870120637","journal-title":"Mov Disord"},{"key":"ref5","doi-asserted-by":"crossref","DOI":"10.1016\/j.jns.2015.09.084","article-title":"Acute allergic reaction following injection of generic, government-provided botulinum toxin A (GGP-BTA) for hemifacial spasm","volume":"357","author":"Branco Germiniani F","year":"2015","unstructured":"Branco Germiniani F, Teive H, Scola RH, et al.. Acute allergic reaction following injection of generic, government-provided botulinum toxin A (GGP-BTA) for hemifacial spasm. J Neurol Sci. 2015, 357:E443.","journal-title":"J Neurol Sci"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1111\/ced.13342","article-title":"Can botulinum toxin cause anaphylaxis after an aesthetic treatment?","volume":"43","author":"Pickett A","year":"2018","unstructured":"Pickett A. Can botulinum toxin cause anaphylaxis after an aesthetic treatment?. Clin Exp Dermatol. 2018, 43:599-600. 10.1111\/ced.13342","journal-title":"Clin Exp Dermatol"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1016\/j.waojou.2019.100066","article-title":"Time to revisit the definition and clinical criteria for anaphylaxis?","volume":"12","author":"Turner PJ","year":"2019","unstructured":"Turner PJ, Worm M, Ansotegui IJ, et al.. Time to revisit the definition and clinical criteria for anaphylaxis?. World Allergy Organ J. 2019, 12:100066. 10.1016\/j.waojou.2019.100066","journal-title":"World Allergy Organ J"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000027787","article-title":"Sub-acute hypersensitive reaction to botulinum toxin type A following COVID-19 vaccination: case report and literature review","volume":"100","author":"Guo X","year":"2021","unstructured":"Guo X, Li T, Wang Y, Jin X. Sub-acute hypersensitive reaction to botulinum toxin type A following COVID-19 vaccination: case report and literature review. Medicine (Baltimore). 2021, 100:e27787. 10.1097\/MD.0000000000027787","journal-title":"Medicine (Baltimore)"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajem.2013.10.017","article-title":"A new facial expression to botox!","volume":"32","author":"Aggarwal A","year":"2014","unstructured":"Aggarwal A, Kaul V, Kaur G, Banas E, Sampath P, Roy AK. A new facial expression to botox!. Am J Emerg Med. 2014, 32:290.e5-6. 10.1016\/j.ajem.2013.10.017","journal-title":"Am J Emerg Med"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.1111\/ced.13108","article-title":"First case of anaphylaxis after botulinum toxin type A injection","volume":"42","author":"Moon IJ","year":"2017","unstructured":"Moon IJ, Chang SE, Kim SD. First case of anaphylaxis after botulinum toxin type A injection. Clin Exp Dermatol. 2017, 42:760-2. 10.1111\/ced.13108","journal-title":"Clin Exp Dermatol"},{"key":"ref11","article-title":"Fatal case of BOTOX-related anaphylaxis?","volume":"50","author":"Li M","year":"2005","unstructured":"Li M, Goldberger BA, Hopkins C. Fatal case of BOTOX-related anaphylaxis?. J Forensic Sci. 2005, 50:169-72.","journal-title":"J Forensic Sci"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.1007\/s00266-020-01684-4","article-title":"Hypersensitivity caused by cosmetic injection: systematic review and case report","volume":"45","author":"Wang C","year":"2021","unstructured":"Wang C, Sun T, Li H, Li Z, Wang X. Hypersensitivity caused by cosmetic injection: systematic review and case report. Aesthetic Plast Surg. 2021, 45:263-72. 10.1007\/s00266-020-01684-4","journal-title":"Aesthetic Plast Surg"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.1177\/1090820X14532648","article-title":"The first case report of a systemic allergy to onabotulinumtoxinA (botox) in a healthy patient","volume":"34","author":"Rosenfield LK","year":"2014","unstructured":"Rosenfield LK, Kardassakis DG, Tsia KA, Stayner G. The first case report of a systemic allergy to onabotulinumtoxinA (botox) in a healthy patient. Aesthet Surg J. 2014, 34:766-8. 10.1177\/1090820X14532648","journal-title":"Aesthet Surg J"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.1111\/ene.12076","article-title":"Xeomin(\u00ae) use in patients with systemic immune reactions to other botulinum toxins type A","volume":"20","author":"Ricciardi L","year":"2013","unstructured":"Ricciardi L, Bove F, Fasano A. Xeomin(\u00ae) use in patients with systemic immune reactions to other botulinum toxins type A. Eur J Neurol. 2013, 20:e45-6. 10.1111\/ene.12076","journal-title":"Eur J Neurol"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.1002\/jemt.1090","article-title":"Immunopathogenesis of delayed-type hypersensitivity","volume":"53","author":"Kobayashi K","year":"2001","unstructured":"Kobayashi K, Kaneda K, Kasama T. Immunopathogenesis of delayed-type hypersensitivity. Microsc Res Tech. 2001, 53:241-5. 10.1002\/jemt.1090","journal-title":"Microsc Res Tech"},{"key":"ref16","article-title":"Type I hypersensitivity reaction","author":"Abbas M","year":"2025","unstructured":"Abbas M, Goldin J. Type I hypersensitivity reaction. StatPearls [Internet]. StatPearls Publishing, Treasure Island (FL); 2025."},{"key":"ref17","doi-asserted-by":"publisher","DOI":"10.1177\/23742895211006844","article-title":"Educational case: dermatitis herpetiformis","volume":"8","author":"Markidan J","year":"2021","unstructured":"Markidan J, Pfau R, Drachenberg C, Stashek K. Educational case: dermatitis herpetiformis. Acad Pathol. 2021, 8:23742895211006844. 10.1177\/23742895211006844","journal-title":"Acad Pathol"},{"key":"ref18","article-title":"Type II hypersensitivity reaction","author":"Saavedra Torres JS","year":"2025","unstructured":"Saavedra Torres JS,  Mohammed RH. Type II hypersensitivity reaction. StatPearls [Internet]. StatPearls Publishing, Treasure Island (FL); 2025."},{"key":"ref19","article-title":"Type III hypersensitivity reaction","author":"Saavedra Torres JS","year":"2025","unstructured":"Saavedra Torres JS, Annamaraju P. Type III hypersensitivity reaction. StatPearls [Internet]. StatPearls Publishing, Treasure Island (FL); 2025."},{"key":"ref20","doi-asserted-by":"publisher","DOI":"10.1038\/s41581-023-00720-1","article-title":"Pathogenesis of autoimmune disease","volume":"19","author":"Pisetsky DS","year":"2023","unstructured":"Pisetsky DS. Pathogenesis of autoimmune disease. Nat Rev Nephrol. 2023, 19:509-24. 10.1038\/s41581-023-00720-1","journal-title":"Nat Rev Nephrol"},{"key":"ref21","article-title":"Allergy","author":"Little JW","year":"2013","unstructured":"Little JW, Falace DA, Miller CS, Rhodus NL. Allergy. Little and Falace's Dental Management of the Medically Compromised Patient (Eighth Edition). Mosby, St Louis, MO; 2013. 304-19."},{"key":"ref22","doi-asserted-by":"publisher","DOI":"10.1016\/j.iac.2022.10.005","article-title":"Drug hypersensitivity reactions","volume":"43","author":"Wilkerson RG","year":"2023","unstructured":"Wilkerson RG. Drug hypersensitivity reactions. Immunol Allergy Clin North Am. 2023, 43:473-89. 10.1016\/j.iac.2022.10.005","journal-title":"Immunol Allergy Clin North Am"},{"key":"ref23","article-title":"Type IV hypersensitivity reaction","author":"Marwa K","year":"2025","unstructured":"Marwa K, Goldin J, Kondamudi NP. Type IV hypersensitivity reaction. StatPearls [Internet]. StatPearls Publishing, Treasure Island (FL); 2025."},{"key":"ref24","doi-asserted-by":"publisher","DOI":"10.3390\/toxins16020101","article-title":"Complexing protein-free botulinum neurotoxin A formulations: implications of excipients for immunogenicity","volume":"16","author":"Martin MU","year":"2024","unstructured":"Martin MU, Frevert J, Tay CM. Complexing protein-free botulinum neurotoxin A formulations: implications of excipients for immunogenicity. Toxins (Basel). 2024, 16:101. 10.3390\/toxins16020101","journal-title":"Toxins (Basel)"},{"key":"ref25","doi-asserted-by":"crossref","DOI":"10.1016\/j.toxicon.2024.107447","article-title":"Free of complexing proteins - enough for low immunogenicity of botulinum neurotoxin formulations? A comparison of excipients","volume":"237","author":"Martin MU","year":"2024","unstructured":"Martin MU, Frevert J. Free of complexing proteins - enough for low immunogenicity of botulinum neurotoxin formulations? A comparison of excipients. Toxicon. 2024, 237:107447.","journal-title":"Toxicon"},{"key":"ref26","doi-asserted-by":"publisher","DOI":"10.1097\/GOX.0000000000002627","article-title":"Neurotoxin impurities: a review of threats to efficacy","volume":"8","author":"Park JY","year":"2020","unstructured":"Park JY, Sunga O, Wanitphakdeedecha R, Frevert J. Neurotoxin impurities: a review of threats to efficacy. Plast Reconstr Surg Glob Open. 2020, 8:e2627. 10.1097\/GOX.0000000000002627","journal-title":"Plast Reconstr Surg Glob Open"},{"key":"ref27","doi-asserted-by":"publisher","DOI":"10.1007\/s00702-012-0893-9","article-title":"Immunogenicity of botulinum toxins","volume":"120","author":"Naumann M","year":"2013","unstructured":"Naumann M, Boo LM, Ackerman AH, Gallagher CJ. Immunogenicity of botulinum toxins. J Neural Transm (Vienna). 2013, 120:275-90. 10.1007\/s00702-012-0893-9","journal-title":"J Neural Transm (Vienna)"},{"key":"ref28","doi-asserted-by":"publisher","DOI":"10.1111\/jocd.70145","article-title":"A rare case of delayed-onset hypersensitivity reaction and complete secondary treatment failure following repeated cosmetic botulinum toxin type A injections","volume":"24","author":"Bian Y","year":"2025","unstructured":"Bian Y, Zhang C, Wang S, Zhang L, Cai H. A rare case of delayed-onset hypersensitivity reaction and complete secondary treatment failure following repeated cosmetic botulinum toxin type A injections. J Cosmet Dermatol. 2025, 24:e70145. 10.1111\/jocd.70145","journal-title":"J Cosmet Dermatol"},{"key":"ref29","doi-asserted-by":"publisher","DOI":"10.1007\/s00266-024-04274-w","article-title":"Temporary delayed hypersensitivity reaction to botulinum toxin-A after COVID-19 vaccination: a case series","volume":"48","author":"Padilla-Pantoja FD","year":"2024","unstructured":"Padilla-Pantoja FD, Fakih-Gomez N, Mu\u00f1oz-Gonzalez C, Prazeres S, Galindo-Ferreiro A. Temporary delayed hypersensitivity reaction to botulinum toxin-A after COVID-19 vaccination: a case series. Aesthetic Plast Surg. 2024, 48:5162-70. 10.1007\/s00266-024-04274-w","journal-title":"Aesthetic Plast Surg"},{"key":"ref30","doi-asserted-by":"publisher","DOI":"10.4103\/0019-5154.60343","article-title":"Botulinum toxin","volume":"55","author":"Nigam PK","year":"2010","unstructured":"Nigam PK, Nigam A. Botulinum toxin. Indian J Dermatol. 2010, 55:8-14. 10.4103\/0019-5154.60343","journal-title":"Indian J Dermatol"},{"key":"ref31","article-title":"Sarcoidal granulomas following injections of botulic toxin A (Botox) for corrections of wrinkles (Article in French)","volume":"133","author":"Ahbib S","year":"2006","unstructured":"Ahbib S, Lachapelle JM, Marot L. Sarcoidal granulomas following injections of botulic toxin A (Botox) for corrections of wrinkles (Article in French). Ann Dermatol Venereol. 2006, 133:43-45.","journal-title":"Ann Dermatol Venereol"},{"key":"ref32","doi-asserted-by":"publisher","DOI":"10.1111\/anae.14497","article-title":"Anaphylaxis to intravenous gelatin-based solutions: a case series examining clinical features and severity","volume":"74","author":"Farooque S","year":"2019","unstructured":"Farooque S, Kenny M, Marshall SD. Anaphylaxis to intravenous gelatin-based solutions: a case series examining clinical features and severity. Anaesthesia. 2019, 74:174-9. 10.1111\/anae.14497","journal-title":"Anaesthesia"},{"key":"ref33","article-title":"Anaphylaxis after booster influenza vaccine due to gelatin allergy","volume":"20","author":"Lasley MV","year":"2007","unstructured":"Lasley MV. Anaphylaxis after booster influenza vaccine due to gelatin allergy. AIMM. 2007, 20:201-205.","journal-title":"AIMM"},{"key":"ref34","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2008.12.042","article-title":"Serious issues relating to the clinical use of unlicensed botulinum toxin products","volume":"61","author":"Pickett A","year":"2009","unstructured":"Pickett A, Mewies M. Serious issues relating to the clinical use of unlicensed botulinum toxin products. J Am Acad Dermatol. 2009, 61:149-50. 10.1016\/j.jaad.2008.12.042","journal-title":"J Am Acad Dermatol"},{"key":"ref35","doi-asserted-by":"publisher","DOI":"10.18176\/jiaci.0924","article-title":"Usefulness of the lymphocyte transformation test in allergy to botulinum toxin type A","volume":"34","author":"Giraldo-Tugores M","year":"2024","unstructured":"Giraldo-Tugores M, Mart\u00ednez-Rodr\u00edguez ME, Fern\u00e1ndez-Lozano C, Mart\u00ednez-Botas J, De-la-Hoz-Caballer B, Gonz\u00e1lez-de-Olano D, Terrados-Cepeda S. Usefulness of the lymphocyte transformation test in allergy to botulinum toxin type A. J Investig Allergol Clin Immunol. 2024, 34:64-6. 10.18176\/jiaci.0924","journal-title":"J Investig Allergol Clin Immunol"},{"key":"ref36","doi-asserted-by":"publisher","DOI":"10.1097\/GOX.0000000000005845","article-title":"Mild allergic reactions after botulinum toxin injection: a case series and literature review","volume":"12","author":"Li Y","year":"2024","unstructured":"Li Y, Zheng Q, Lin J, Su X, Zhuang J, Wei Q, Hu J. Mild allergic reactions after botulinum toxin injection: a case series and literature review. Plast Reconstr Surg Glob Open. 2024, 12:e5845. 10.1097\/GOX.0000000000005845","journal-title":"Plast Reconstr Surg Glob Open"},{"key":"ref37","article-title":"One-year, randomised, multicenter, two-period study of the safety and efficacy of repeated treatments with botulinum toxin type A in patients with glabellar lines","volume":"7","author":"Carruthers A","year":"2004","unstructured":"Carruthers A, Carruthers J, Lowe NJ, Menter A, Nordquist M, Mordaunt J. One-year, randomised, multicenter, two-period study of the safety and efficacy of repeated treatments with botulinum toxin type A in patients with glabellar lines. J Clin Res. 2004, 7:1-20.","journal-title":"J Clin Res"},{"key":"ref38","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-022-11395-2","article-title":"Significantly lower antigenicity of incobotulinumtoxin than abo- or onabotulinumtoxin","volume":"270","author":"Hefter H","year":"2023","unstructured":"Hefter H, Rosenthal D, Jansen A, et al.. Significantly lower antigenicity of incobotulinumtoxin than abo- or onabotulinumtoxin. J Neurol. 2023, 270:788-96. 10.1007\/s00415-022-11395-2","journal-title":"J Neurol"},{"key":"ref39","article-title":"Clinical relevance of immunoresistance to botulinum therapy","author":"Frevert J","year":"2016","unstructured":"Frevert J, Dressler D. Clinical relevance of immunoresistance to botulinum therapy. Botulinum Toxin Therapy Manual for Dystonia and Spasticity. Rosales RL,  (ed): IntechOpen, London, UK; 2016."},{"key":"ref40","doi-asserted-by":"publisher","DOI":"10.3390\/toxins12080499","article-title":"Clinical implications of difference in antigenicity of different botulinum neurotoxin type A preparations: clinical take-home messages from our research pool and literature","volume":"12","author":"Samadzadeh S","year":"2020","unstructured":"Samadzadeh S, \u00dcrer B, Brauns R, Rosenthal D, Lee JI, Albrecht P, Hefter H. Clinical implications of difference in antigenicity of different botulinum neurotoxin type A preparations: clinical take-home messages from our research pool and literature. Toxins (Basel). 2020, 12:499. 10.3390\/toxins12080499","journal-title":"Toxins (Basel)"},{"key":"ref41","doi-asserted-by":"publisher","DOI":"10.1007\/s12325-021-01882-9","article-title":"Immunogenicity of botulinum toxin formulations: potential therapeutic implications","volume":"38","author":"Carr WW","year":"2021","unstructured":"Carr WW, Jain N, Sublett JW. Immunogenicity of botulinum toxin formulations: potential therapeutic implications. Adv Ther. 2021, 38:5046-64. 10.1007\/s12325-021-01882-9","journal-title":"Adv Ther"},{"key":"ref42","article-title":"IncobotulinumtoxinA: a highly purified and precisely manufactured botulinum neurotoxin type A","volume":"18","author":"Kerscher M","year":"2019","unstructured":"Kerscher M, Wanitphakdeedecha R, Trindade de Almeida A, Maas C, Frevert J. IncobotulinumtoxinA: a highly purified and precisely manufactured botulinum neurotoxin type A. JDD. 2019, 18:52-57.","journal-title":"JDD"}],"container-title":["Cureus"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cureus.com\/articles\/403214-hypersensitivity-reactions-associated-with-aesthetic-botulinum-toxin-a-injections-a-case-series","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,31]],"date-time":"2025-10-31T08:07:36Z","timestamp":1761898056000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cureus.com\/articles\/403214-hypersensitivity-reactions-associated-with-aesthetic-botulinum-toxin-a-injections-a-case-series"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,31]]},"references-count":42,"URL":"https:\/\/doi.org\/10.7759\/cureus.95795","relation":{},"ISSN":["2168-8184"],"issn-type":[{"value":"2168-8184","type":"print"}],"subject":[],"published":{"date-parts":[[2025,10,31]]}}}