Neutralizing antibodies to botulinum neurotoxin type A in aesthetic medicine: five case reports
A 41-year-old Caucasian woman was initially treated for hyperhidrosis in 2006 with 100 U of onabotulinumtoxinA (BOTOX®) (). The treatment effect lasted 5 months. In 2009, the woman received a further 100 U of onabotulinumtoxinA for hyperhidrosis and an additional 50 U over ten injection points in the frontalis muscle, four injection points in the corrugator muscles, one injection point in the procerus, and four injection points in each orbicularis oculi muscle. The treatment effect was 2–3 months. In 2010, she received a repeat treatment for hyperhidrosis with 150 U of onabotulinumtoxinA with clinical effect lasting 2–3 months. At her last treatment for hyperhidrosis, she received 500 U of abobotulinumtoxinA (Dysport®) with a duration of effect of only 1.5 months. The patient was considered a nonresponder, as the treatment effect was very weak and the sweating partially remained. The patient tested positive (++) for antibodies to botulinum toxin type A.