title: [Facial angioedema after filler injections. Description of five cases].
abstract: The use of fillers for cosmetic purposes is becoming increasingly frequent. Although initially considered inert, these products produce adverse reactions around the injection site. We present 5 cases of women with a history of filler injections who presented a hard and persistent angioedema followed by local subcutaneous nodules. They were referred to the allergist for suspected allergy related angioedema without response to usual antihistamine treatment. The angioedema episodes initiated 27.6 months (range 1 to 48) after the fillers treatment. The patients underwent exacerbations and remissions of angioedema, partially relieved with oral steroids and, in 2 cases, local triamcinolone injections. Mean time from onset of symptoms to remission of angioedema was 8.75 months (range 1 to 24). Until October 2009 four patients continued into remission after 24.5 months (range 7 to 36) free of symptoms. One patient continued with exacerbations 11 months after the initial symptoms. Fillers may cause angioedema as an adverse event and should be considered in the differential diagnosis of persistent angioedema. They are only sensitive to steroid treatment and in some steroid dependent cases they respond to ciclosporin. The frequency of angioedema after filler injections among patients with angioedema in the Unit of Asthma Allergy and Clinical Immunology was 0.5%.
authors.affiliation: Unidad de Alergia, Asma e Inmunología Clínica, Hospital Británico de Buenos Aires, Argentina. micaelacosatti@yahoo.com.ar
authors.forename: Micaela
authors.initials: M
authors.lastname: Cosatti
authors.forename: Diego S
authors.initials: DS
authors.lastname: Fernández Romero
authors.forename: María Cecilia
authors.initials: MC
authors.lastname: Juri
authors.forename: Alejandro
authors.initials: A
authors.lastname: Malbrán
mesh_terms: D000328:Adult; D000368:Aged; D000799:Angioedema / Q000188:drug therapy / Q000209:etiology / Q000473:pathology*; D003357:Cosmetic Techniques / Q000009:adverse effects* / Q000145:classification; D003937:Diagnosis, Differential; D005148:Facial Dermatoses / Q000188:drug therapy / Q000209:etiology / Q000473:pathology*; D005260:Female; D006801:Humans; D007279:Injections, Subcutaneous; D008875:Middle Aged; D012074:Remission Induction; D015361:Rhytidoplasty; D013256:Steroids / Q000627:therapeutic use; D040521:Subcutaneous Tissue / Q000473:pathology*; D013997:Time Factors
chemical_list: D013256:Steroids