Cutaneous granulomatous reaction to injectable hyaluronic acid gel.
Injectable hyaluronic acid (HA) derivatives are the most used reabsorbable dermal fillers for soft tissue augmentation today and their utilization is considered safe. We report a cutaneous granulomatous reaction that developed in a woman 5 weeks after the first treatment with a nonanimal HA derivative for the correction of facial wrinkling. We describe the clinicopathological findings and course of the cutaneous reaction. The adverse reaction showed clinical and histopathological characteristics comparable to the few previously reported cases. All cutaneous lesions spontaneously disappeared without scars within 3 months. We conclude that even nonanimal injectable HA derivatives can be associated with delayed granulomatous reactions. The patient should be informed of this potential long-term complication.
Institute of Dermatological Sciences of the University of Milan-IRCCS, Fondazione Policlinico, Mangiagalli and Regina Elena, via Pace 9, 20122 Milan, Italy. max.ghisla@libero.it
M
M
Ghislanzoni
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F
Bianchi
M
M
Barbareschi
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E
Alessi
D000328:Adult; D003875:Drug Eruptions / Q000209:etiology* / Q000473:pathology; D005148:Facial Dermatoses / Q000139:chemically induced* / Q000473:pathology; D005260:Female; D015745:Granuloma, Foreign-Body / Q000139:chemically induced* / Q000473:pathology; D006801:Humans; D006820:Hyaluronic Acid / Q000009:adverse effects / Q000031:analogs & derivatives*; D007271:Injections, Intradermal; D015595:Skin Aging
D006820:Hyaluronic Acid; C445361:Restylane