Delayed hypersensitivity reaction to cosmetic filler following two COVID-19 vaccinations and infection

Abstract

Background With ongoing COVID-19 vaccination schedules and the popularity of cosmetic fillers, it is important to examine and record associated adverse reactions to a more general audience of health care professionals. Case reports exist in subspecialty journals outlining reactions after SARS-CoV-2 infection and vaccination. This is one of the first cases published in Canada, and it highlights priorities and challenges faced by physicians in assessing and managing patients presenting with adverse reactions post vaccination. Case Presentation We present a case of a 43 -year-old women with delayed type 4 hypersensitivity reaction to hyaluronic acid cosmetic filler triggered by COVID-19 mRNA vaccination. We outline the clinical presentation, diagnosis, complications, and treatment of a late inflammatory reaction to hyaluronic acid filler and highlight the treatment priorities for clinicians faced with similar presentations. Conclusion The differential diagnosis of delayed onset nodules formation post filler injection is broad and includes redistribution of fillers, inflammatory reaction to biofilm, and delayed hypersensitivity reaction. As result, in order to make the right diagnosis, administer the appropriate treatment and achieve great cosmetic results, we highly recommend seeking expert opinion from dermatologist, plastic surgeon and allergist immunologist in a timely manner.

Adverse events associated with the vaccine and SARS-CoV 2 virus in patients with facial aesthetic procedures

“…In human cells, ACE2 is expressed in keratinocytes, fibroblasts, dermal vascular endothelium, and adipocytes of the subcutaneous tissue, where HA is deposited. The accumulation of angiotensin II triggers a pro-inflammatory reaction and increases the activity of CD44 glycoprotein, which has an affinity for pro-inflammatory properties and are present in the infiltration that develops around the deposits injected into the skin in the subcutaneous tissue (Azzouz et al, 2023).…”