BOTULINUM TOXIN FOR THE TREATMENT OF MICROSTOMIA IN SYSTEMIC SCLEROSIS: A LITERATURE REVIEW

Systemic sclerosis (SSc) is a multisystem autoimmune disease characterized by brosis and vasculopathy, commonly leading to microstomia – an abnormally reduced oral aperture that impairs speech, nutrition, and quality of life. Conventional options for managing SSc-related microstomia – for example, stretching exercises, physiotherapy, and various surgical procedures – usually provide only partial or short lived improvement, and results vary widely between patients. Against this background, botulinum toxin (BoNT), a neuromuscular blocker already widely used in neurology and dermatology, has been suggested as an alternative approach to address perioral brosis and increase mouth opening in patients with SSc. This literature review summarizes the current evidence on the effectiveness and safety of BoNT injections for treating microstomia in SSc. We found only a few relevant clinical studies: one small prospective trial, one completed clinical trial (with results not yet available), a case series, and a single case report. These studies suggest that BoNT therapy can lead to short-term improvements in mouth opening and function, with few side effects. However, the data are limited by small sample sizes and a lack of controlled trials. BoNT looks promising as an additional treatment for SSc-related microstomia, but larger studies are needed to conrm its long-term benefts, best dosing, and safety.