title: Delayed immune-mediated adverse effects of polyalkylimide dermal fillers: clinical findings and long-term follow-up.
abstract: OBJECTIVE
  To evaluate the clinical complaints, laboratory data, treatment, and follow-up of patients with delayed adverse effects related to polyalkylimide implants (PAIs).
  
  
  METHODS
  Prospective case series of patients injected with PAIs.
  
  
  METHODS
  A university tertiary teaching hospital.
  
  
  METHODS
  A prospectively acquired series of 25 patients with severe and/or persistent delayed adverse effects after PAI injection. The patients underwent clinical follow-up, a battery of blood tests, and when possible, biopsy and chest radiography.
  
  
  METHODS
  Clinical evaluation of granulomas, skin manifestations, and other local and systemic immune-mediated disorders possibly related to PAIs.
  
  
  RESULTS
  The average latency period for onset of symptoms was 13.4 months. Eight patients were previously injected with another implant. Tender inflammatory nodules were seen in 24 patients. Systemic or distant manifestations appeared in 6 cases. Laboratory abnormalities were found in 20 cases. After an average of 21.3 months of follow-up, 11 patients appeared to be free of adverse effects, and 10 still had recurrent bouts.
  
  
  CONCLUSIONS
  Although infrequent, delayed and recurrent chronic inflammatory and granulomatous reactions may complicate PAI fillers.
authors.affiliation: Josep M de Segarra, 2-F, 08190-Sant Cugat del Vallés, Barcelona, Spain. 16297jar@comb.es
authors.forename: Jaume
authors.initials: J
authors.lastname: Alijotas-Reig
authors.forename: Victor
authors.initials: V
authors.lastname: Garcia-Gimenez
authors.forename: Francesc
authors.initials: F
authors.lastname: Miró-Mur
authors.forename: Miquel
authors.initials: M
authors.lastname: Vilardell-Tarrés
mesh_terms: D004487:Edema / Q000276:immunology; D005260:Female; D005500:Follow-Up Studies; D006099:Granuloma / Q000276:immunology*; D006801:Humans; D007249:Inflammation / Q000276:immunology*; D008297:Male; D011073:Polyamines / Q000276:immunology*; D011446:Prospective Studies; D019736:Prostheses and Implants / Q000009:adverse effects*; D012008:Recurrence; D012871:Skin Diseases / Q000276:immunology; D013997:Time Factors
chemical_list: D011073:Polyamines