title: Factitious thyrotoxicosis induced by mesotherapy: a case report.
abstract: BACKGROUND
  Mesotherapy consists of cutaneous injections of a mixture of compounds and has recently been used for cosmetic purposes to reduce local fat and cellulite. To date, several reports have described only local adverse events related to this therapy. We describe the first report of a female patient who developed thyrotoxicosis due to cosmetic mesotherapy with triiodothyroacetic acid in its formulation. Apart from mechanical rupture of the epidermal barrier, a disturbance of type III deiodinase activity or skin fibroblast paracrine function and vascular alterations related to simultaneously injected vasoactive compounds were observed. These findings could be related to thyroid hormone metabolite absorption and systemic consequences in the reported case.
  
  
  CONCLUSIONS
  We describe factitious thyrotoxicosis induced by mesotherapy, to raise awareness of a systemic adverse effect resulting from this widespread cosmetic practice.
authors.affiliation: Laboratório de Endocrinologia Celular e Molecular (LIM 25), Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, Brazil.
authors.forename: Debora Lucia Seguro
authors.initials: DL
authors.lastname: Danilovic
authors.forename: Walter
authors.initials: W
authors.lastname: Bloise
authors.forename: Meyer
authors.initials: M
authors.lastname: Knobel
authors.forename: Suemi
authors.initials: S
authors.lastname: Marui
mesh_terms: D000273:Adipose Tissue / Q000187:drug effects; D000328:Adult; D003357:Cosmetic Techniques / Q000009:adverse effects*; D005260:Female; D006801:Humans; D009765:Obesity / Q000188:drug therapy; D013971:Thyrotoxicosis / Q000139:chemically induced* / Q000175:diagnosis*; D014284:Triiodothyronine / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use
chemical_list: D014284:Triiodothyronine; C010642:3,3',5-triiodothyroacetic acid