title: Granulomatous reaction after injection of a new resorbable filler Novabel.
abstract: A new resorbable filler, Novabel, became commercially available in January 2010 in France. A 52-year-old general practitioner injected 0.1 cm3 of a 1 cm3 alginate solution (Novabel) into the deep dermis of her left arm to test it before using it on her patients. Ten days later, she observed a small pink nodule at the injection site forming secondary a bluish papule. A biopsy was performed 2 months after the injection. Histopathology showed a granulomatous reaction involving the deep dermis and the subcutaneous fat. The inflammatory reaction surrounded a nonpolarizing exogenous material consisting of slightly bluish deposits of variable size and shape, some of which were well delineated, others with a blurred or spiky perimeter, frequently showing retraction in a clear vacuole. The papule regressed, resolving completely 5 months after the injection. Novabel is a totally new type of aesthetic injectable resorbable filler consisting of a purified polysaccharide, alginate, which is extracted from crusted brown algae. No side effects have been reported to date and we describe here a first granulomatous reaction after filler injection which has a distinctive appearance in keeping with the histopathological findings.
authors.affiliation: Cabinet d'Histopathologie Cutanée, Mathurin Moreau, Paris, France. imoulonguetmichau@gmail.com
authors.forename: Isabelle
authors.initials: I
authors.lastname: Moulonguet
authors.forename: Catherine
authors.initials: C
authors.lastname: de Goursac
authors.forename: Françoise
authors.initials: F
authors.lastname: Plantier
mesh_terms: D000464:Alginates / Q000009:adverse effects*; D001672:Biocompatible Materials / Q000009:adverse effects*; D003357:Cosmetic Techniques; D005260:Female; D020723:Glucuronic Acid / Q000009:adverse effects; D006099:Granuloma / Q000139:chemically induced* / Q000473:pathology; D006603:Hexuronic Acids / Q000009:adverse effects; D006801:Humans; D008875:Middle Aged; D012871:Skin Diseases / Q000139:chemically induced* / Q000473:pathology
chemical_list: D000464:Alginates; D001672:Biocompatible Materials; D006603:Hexuronic Acids; D020723:Glucuronic Acid