Botulinum toxin injections showed high complete response rates in digital ischemia, ulcers, and gangrene with minimal adverse events.
2
The primary outcome of complete response was achieved in 93% of acute digital ischemia patients, 90% of ulcer patients, and 88% of gangrene patients.
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Most patients required only a single injection, with higher doses linked to better response rates, particularly in autoimmune-related ischemia.
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Adverse events were rare, with transient muscle weakness in 8% and injection site pain in 6%, with no severe or irreversible complications reported.
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The analysis included 31 studies and highlighted the efficacy of botulinum toxin, especially in autoimmune diseases, despite limitations in study heterogeneity.
Off-label ivarmacitinib rapidly relieved pruritus and improved skin lesions in a patient with refractory primary cutaneous amyloidosis, according to a case report.
