title: Delayed immunologic complications due to injectable fillers by unlicensed practitioners: our experiences and a review of the literature.
abstract: For a number of years, there have been unauthorized practitioners who have been illegally injecting substances. In this series of cases, delayed type hypersensitivity reactions occurred after having unknown material fillers injected by unlicensed practitioners. When injecting an unknown material, there can be a severe immune reaction due to the unknown number of antigens in the material, and therefore may act as a much stronger superantigen than conventional filler materials. It appears that the adverse effects in these cases are more severe and have tendency to break out after a longer period of time in comparison with those caused by approved fillers, likely due to operative technique and use of unverified materials. It is important to recognize the danger of such illegal procedures and to increase awareness of the public, as this has evolved into a significant public health issue.
authors.affiliation: Department of Dermatology, Chung-Ang University College of Medicine, Seoul, Korea.
authors.forename: Joon
authors.initials: J
authors.lastname: Seok
authors.affiliation: Department of Dermatology, Chung-Ang University College of Medicine, Seoul, Korea.
authors.forename: Ji Yeon
authors.initials: JY
authors.lastname: Hong
authors.affiliation: Department of Dermatology, Chung-Ang University College of Medicine, Seoul, Korea.
authors.forename: Kui Young
authors.initials: KY
authors.lastname: Park
authors.affiliation: Department of Dermatology, Chung-Ang University College of Medicine, Seoul, Korea.
authors.forename: Beom Joon
authors.initials: BJ
authors.lastname: Kim
authors.affiliation: Department of Dermatology, Chung-Ang University College of Medicine, Seoul, Korea.
authors.forename: Seong Jun
authors.initials: SJ
authors.lastname: Seo
authors.affiliation: Department of Dermatology, Chung-Ang University College of Medicine, Seoul, Korea.
authors.forename: Myeung Nam
authors.initials: MN
authors.lastname: Kim
authors.affiliation: Department of Dermatology, Chung-Ang University College of Medicine, Seoul, Korea.
authors.forename: Chang Kwun
authors.initials: CK
authors.lastname: Hong
mesh_terms: D001706:Biopsy; D003357:Cosmetic Techniques; D003415:Crime; D000067548:Dermal Fillers / Q000008:administration & dosage* / Q000009:adverse effects*; D005260:Female; D005549:Foreign-Body Reaction / Q000139:chemically induced* / Q000175:diagnosis / Q000188:drug therapy / Q000276:immunology; D006282:Health Personnel / Q000592:standards*; D006633:Histamine Antagonists / Q000627:therapeutic use; D006801:Humans; D006968:Hypersensitivity, Delayed / Q000139:chemically induced* / Q000175:diagnosis / Q000188:drug therapy / Q000276:immunology; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007271:Injections, Intradermal; D008004:Licensure / Q000592:standards*; D008875:Middle Aged; D011361:Professional Competence / Q000592:standards; D012060:Rejuvenation; D015595:Skin Aging; D013256:Steroids / Q000627:therapeutic use; D013997:Time Factors
chemical_list: D000067548:Dermal Fillers; D006633:Histamine Antagonists; D007166:Immunosuppressive Agents; D013256:Steroids
keywords: delayed-type hypersensitivity; filler; unknown material