title: Mycobacterial infection after cosmetic procedure with botulinum toxin a.
abstract: We report a case of mycobacterial infection at the sites of previous injections of botulinum toxin A in a 45-year-old woman. She presented with erythematous, swollen, warm, and tender plaques and nodules at the points of injection from which a biopsy was taken, demonstrating a deep dermal and hypodermal abscessified epithelioid granulomatous inflammatory infiltrate in which some acid-fast bacilli were identified with Ziehl-Neelsen and Fite-Faraco stains. The lesion was first treated with clarithromycin plus azithromycin, to which rifampicin was later added. A good therapeutic response was obtained.
authors.affiliation: Consultant Dermatologist, Department of Pathology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Hospital Angeles Lomas , Centro Medico ABC, Mexico City, Mexico .
authors.forename: Marcela
authors.initials: M
authors.lastname: Saeb-Lima
authors.affiliation: Dermatology, Private Practice.
authors.forename: Gerardo-Victor
authors.initials: GV
authors.lastname: Solis-Arreola
authors.affiliation: Dermatopathologist, Department of Cellular Pathology, Hospital El Bierzo , Ponferrada, Spain .
authors.forename: Angel
authors.initials: A
authors.lastname: Fernandez-Flores
keywords: Botox; Iatrogenic infection; Mycobacteria; Tuberculosis