Effectiveness of botulinum toxin A in treatment of refractory erythromelalgia

Kuan Hsiang Lin*, Shuu Jiun Wang, Jong Ling Fuh, Shih Pin Chen

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

6 Scopus citations


Erythromelalgia is characterized by intense burning pain, erythema, and heat in affected areas after precipitating factors such as warm temperature or stress. It is refractory to treatment in some situations. We describe a woman with adenosquamous cell carcinoma of the lung and medically refractory erythromelalgia. The symptoms of erythromelalgia presented as refractory to any medical treatment. Due to the unresponsive nature of her condition, botulinum toxin type A (onabotulinumtoxin A) was injected over both of her cheeks, periodically for six cycles. Her symptoms responded dramatically to subcutaneous and intradermal injection of botulinum toxin type A. Repetitive injection demonstrated consistent and reproducible responses, and the efficacy was maintained for approximately 1 month. No adverse effects or complications were noted. Botulinum toxin type A might be safe and effective as an alternative treatment for refractory erythromelalgia, but further large-scale studies are required.

Original languageEnglish
Pages (from-to)296-298
Number of pages3
JournalJournal of the Chinese Medical Association
Issue number5
StatePublished - May 2013


  • Erythromelalgia
  • Neurogenic inflammation
  • Neuropathic pain
  • Onabotulinumtoxin A
  • Small-fiber neuropathy


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