Botulinum Toxin A Delivery via MMP Technique: An Emerging Therapeutic Approach for Frontal Fibrosing Alopecia

Main Article Content

Simone Ramos Nogueira Guerra Neri
https://orcid.org/0009-0004-7380-4795
Marta de Oliveira Domingos
https://orcid.org/0000-0003-4492-0709
Nílceo Schwery Michalany
Alexandre Ozores Michalany
Celia Luiza Petersen Vitello Kalil
https://orcid.org/0000-0002-1294-547X

Abstract

Frontal Fibrosing Alopecia (FFA) is a disease of unknown etiology and pathogenesis whose prevalence has been increasing since its first description in 1994. With no cure, treatments only control the inflammatory process and disease progression, but do not reverse the changes induced by it. We report the case of a patient with early-stage FFA who underwent three monthly sessions of 30 units of Botulinum Toxin Type A administered by MMP® (Microinfusion of drugs through the skin) technique. The results showed a substantial improvement in the patient's clinical condition with inhibition of the inflammatory process and an evident increase in follicular density in the treated area.

Article Details

How to Cite
Neri, S. R. N. G., Domingos, M. de O., Michalany, N. S., Michalany, A. O., & Kalil, C. L. P. V. (2023). Botulinum Toxin A Delivery via MMP Technique: An Emerging Therapeutic Approach for Frontal Fibrosing Alopecia. Brazilian Journal of Case Reports, 4(1), 3–7. https://doi.org/10.52600/2763-583X.bjcr.2024.4.1.3-7
Section
Clinical Case Reports
Author Biographies

Simone Ramos Nogueira Guerra Neri, Brazilian Society of Dermatology

Brazilian Society of Dermatology, São Paulo, Brazil.

Marta de Oliveira Domingos, Laboratory of Bacteriology, Instituto Butantan

Laboratory of Bacteriology, Instituto Butantan, São Paulo, SP, Brazil.

Nílceo Schwery Michalany, Department of Pathology Laboratory of Pathological Anatomy, Federal University of São Paulo (UNIFESP)

Department of Pathology Laboratory of Pathological Anatomy, Federal University of São Paulo (UNIFESP), São Paulo, SP, Brazil.

Alexandre Ozores Michalany, Department of Dermatology, University of Santo Amaro (UNISA)

Department of Dermatology, University of Santo Amaro (UNISA), São Paulo, SP, Brazil.

Celia Luiza Petersen Vitello Kalil, Dermatology Services, Federal University of Fronteira Sul

Dermatology Services, Federal University of Fronteira Sul, Passo Fundo, RS, Brazil.

References

Kepinska K, Jolowska M, Bowszyc-Dmochowska M. Frontal Fibrosing Alopecia a Review and a Practical Guide for Clinicians. Annals of Agricultural guide for Clinicians. Annals of Agricultural and Environmental Medicine. 2022; 29(2): 169-184.

Porriño-Bustamante MLL, Fernandez-Pugnaire MA, Arias-Santiago S. Frontal Fibrosing Alopecia: A Review. Journal of Clinical Medicine. 2021; 10(1875):1-27.

Kossard S, Lee MS, Wilkinson B. Postmenopausal Frontal Fibrosing Alopecia: a Frontal Variant of Lichen Planopilaris. J Am Acad Dermatol. 1997; 36:59-66.

MacDonald A, Clarc C, Holmes S. Frontal fibrosing alopecia: A review of 60 cases. J. Am. Acad. Dermatol. 012; 67(5):955-961.

Iorizzo M, Tosti A. Frontal Fibrosing Alopecia: An Update on Pathogenesis, Diagnosis, and Treatment. Am J Clin Dermatol. 2019; 20(3):379-390.

Miteva M, Tosti A. The follicular triad: a pathological clue to the diagnosis of early frontal fibrosing alopecia. Br J Derma-tol.2012;166(2):440-2.

Rácz E, Gho C, Moorman PW, Hegt VN, Neumann HAM. Treatment of frontal fibrosing alopecia and lichen planopilaris: a systemic review. Journal of the European Academy of Dermatology. 2013; (27):1461-1470.

Zhou Y, Yu S, Zhao J, Xinyue Feng X, Zhang M, Zhao Z. Effectiveness and Safety of Botulinum Toxin Type A in the Treatment of Androgenetic Alopecia. Biomed Res Int. 2020: 1501893.

Neri SRNG, Franzolin MR, Kalil CLPV, Michalany NS, Michalany AO, Domingos MO. Botulinum toxin A as na alternativa treatment for folliculitis decalvans. JAAD Case Reports. 2023 (35): 77-79.

Barletta M, Gasques L. Succesful Treatment of Alopecia Areata Patches with Triamcinolone Acetonide Using MMP®: Report of 2 Cases. Skin Appendage Disord. 2020 (6): 229-234.

Preisler L, Souza LG, Cunha MG. Microinfusão de medicamentos na pele (MMP®): uma visão geral, revisão de indicações e perfil de segurança. Surg Cosmet Dermatol. 2020; 12 (4):316-319.

Cardoso C, Tolentino S, Gratieri T, Cunha-Filho M, Lopes RFV, Gelfuso GM. Topical Treatment for Scarring and non-scarring Alopecia: An Overview of the Current Evidence. Clinical Cosmetic and Investigational Dermatology. 2021; 14:485-499.

Rocha VB, Machado CJ, Contin LA. Subtipos incomuns da alopecia frontal fibrosante: análise retrospectiva das características clínicas e prognósticas. Anais Brasileiros de Dermatologia. 2022; 97(2):247-262.

Gamret AC, Potluri VS, Krishnamurthy K, Raymond M Fertig RM. Frontal fibrosing alopecia: efficacy of treatment modalities. 2019. Int. J. Womens Health. 11:273-285.