Cutaneous foreign body granulomas associated with lipolytic cocktail: Who is the enemy, mesotherapy or drugs injected?

Abstract

Mesotherapy is widely used for its lipolytic effect as an alternative procedure to surgical methods. Although many benefits of lipolytic mesotherapy have been observed, numerous side effects have also been reported. Here, we report a case of cutaneous foreign body granulomas that occurred after lipolytic mesotherapy.

Mesotherapy: Safety profile and management of complications

“…Granulomatous foreign body reactions have been reported to occur after the mesotherapy application of agents such as phosphatidylcholine, deoxycholate, buflomedil, silica, or carnitine, as well as a large number of several other different substances, in some cases even oil‐based, which are widely used for lipolytic purposes . The management in these cases can include the application of intralesional steroids, such as triamcinolone acetonide, in several sessions .…”

“…Granulomatous foreign body reactions have been reported to occur after the mesotherapy application of agents such as phosphatidylcholine, deoxycholate, buflomedil, silica, or carnitine, as well as a large number of several other different substances, in some cases even oil‐based, which are widely used for lipolytic purposes . The management in these cases can include the application of intralesional steroids, such as triamcinolone acetonide, in several sessions . Approaches with the administration of systemic corticosteroids have also been described, however, without significant benefits, while the administration of 100 mg of dapsone daily for several weeks has been reported by Gokdemir et al lead to a substantial improvement of the granulomatous lesions .…”

“…[22][23][24][25] The management in these cases can include the application of intralesional steroids, such as triamcinolone acetonide, in several sessions. 22 Approaches with the administration of systemic corticosteroids have also been described, however, without significant benefits, 22,25 while the administration of 100 mg of dapsone daily for several weeks has been reported by Gokdemir et al lead to a substantial improvement of the granulomatous lesions. 24 Ramos-e-Silva et al describe a case of an oleoma, a severe granulomatous reaction after injection of an oil-based mesotherapeutic cocktail for the cellulite treatment.…”

Clinical efficacy of intense pulsed light combined with low‐dose intralesional corticosteroids in treating noninfectious granulomas after mesotherapy: A case series analysis

“…When it comes to noninfectious causes, several common mild symptoms have been described, including pain, erythema, ecchymosis, and skin sensitivity. Moreover, a less frequent type of noninfectious symptom characterized by the formation of granuloma exists; however, its specific etiology remains incompletely understood and may be associated with immune function, endocrine factors, or foreign material exposure 5,6 . Although the incidence rate of noninfectious granuloma is relatively low, there has been an increasing trend in recent years.…”

“…Moreover, a less frequent type of noninfectious symptom characterized by the formation of granuloma exists; however, its specific etiology remains incompletely understood and may be associated with immune function, endocrine factors, or foreign material exposure. 5,6 Although the incidence rate of noninfectious granuloma is relatively low, there has been an increasing trend in recent years. The primary clinical manifestations encompass chronic and refractory papules or subcutaneous nodules that can persist for months or even years.…”