Granulomatous Reaction After Intradermal Injections of Hyaluronic AcidGel

Rongioletti, Franco; Cattarini, G.; Sottofattori, Enzo; Rebora, Alfredo

doi:10.1001/archderm.139.6.815

Cited by 69 publications

(40 citation statements)

References 4 publications

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“…1,[4][5][6][7][8][9][10][11][12][13][14][15][16][17][18] Before 1999, the reported rate of delayed reactions to HA fillers was 0.07%. The introduction of highly purified products decreased the incidence of such side effects to 0.02%, 1 which is now the accepted safety threshold for HA-based products.…”

Section: Discussionmentioning

confidence: 99%

Resistant and Recurrent Late Reaction to Hyaluronic Acid–Based Gel

Artzi

Loizides²,

Verner

et al. 2016

Dermatologic Surgery

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Section: Discussionmentioning

confidence: 99%

Resistant and Recurrent Late Reaction to Hyaluronic Acid–Based Gel

Artzi

Loizides²,

Verner

et al. 2016

Dermatologic Surgery

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“…93,94 The too superficial placement of hyaluronic acid fillers or an uneven distribution of the injected product can lead to visible, pale nodules in the skin. Uncommon additional nonallergic reactions that have been described secondary to hyaluronic acid injections into the skin include herpes reactivation, bacterial infections, aseptic abscess, 95 generalized scleromyxedema, 96 scar sarcoidosis, 97 interferon-induced systemic sarcoidosis in patients with chronic hepatitis C-who also developed sarcoidal granulomas around the injected hyaluronic acid filler 98 -and necrosis and livedoid pattern after accidental arterial embolization. 99 There are reports describing an outbreak of Mycobacterium chelonae infection after soft tissue augmentation with hyaluronic acid derivate fillers, 100,101 but is not clear whether the injected material was contaminated with the mycobacteria during the manufacturing process or whether they were inoculated during the injection procedure, because the administration was performed in a nonmedical setting.…”

Section: Bovine Collagen Key Pointsmentioning

confidence: 99%

Adverse reactions to injectable soft tissue fillers

Requena

Christensen

et al. 2011

Journal of the American Academy of Dermatology

282

237

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“…10,26,57,122,123 Patients with permanent injectables should be warned and antibiotic intake at the onset of a severe infection should be recommended for the next 10 years after implantation.…”

Section: Possible Causes Of Granuloma Formationmentioning

confidence: 99%

Foreign Body Granulomas after All Injectable Dermal Fillers: Part 1. Possible Causes

Lemperle

Gauthier-Hazan

Wolters

et al. 2009

Plastic and Reconstructive Surgery

216

243

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Summary Genuine granuloma formation following implantation of injectable dermal fillers is a rare complication, with incidences ranging from one in 100 patients (1 percent) to one in 5000 (0.02 percent). Foreign body granulomas occur several months to years after injection at all implantation sites at the same time. Without treatment, they may grow to the size of beans, remain virtually unchanged for some years, and then resolve spontaneously. Three clinical and histologic types of foreign body granulomas can be distinguished: 1. Cystic granulomas (synonyms: inflammatory, palisading, collagenolytic): these are caused mainly by injected biological gels such as collagens and hyaluronic acids. Their clinical signs are fluctuation (sterile abscess), extreme redness, and induration. Cystic granulomas are small and superficial, occur within the first year, and disappear spontaneously within another year. They are surrounded by a significant number of giant cells. 2. Edematous granulomas (synonym: lipogranuloma): these are caused by artificial fluids such as silicone and polyacrylamides. They appear suddenly years after injection with extensive swelling and are surrounded and infiltrated by mononuclear and inflammatory cells. 3. Sclerosing granulomas (synonyms: sarcoidal and xanthelasmic): these are caused by particulate injectables composed of polymethylmethacrylate, polylactic acid, hydroxyethylmethacrylate, calcium-hydroxylapatite, or dextran microspheres. Sclerosing granulomas occur generally 6 months to 3 years after implantation and are visible, often bluish confined nodules. Histologically, the implant is infiltrated by many macrophages and giant cells, fibroblasts, and collagen fibers but few inflammatory cells. Permanent implants are not characterized by a higher rate of foreign body granuloma per se than temporary implants; however, their clinical appearance is more pronounced and their persistence longer if not treated adequately. (Plast.

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Granulomatous Reaction After Intradermal Injections of Hyaluronic AcidGel

Cited by 69 publications

References 4 publications

Resistant and Recurrent Late Reaction to Hyaluronic Acid–Based Gel

Resistant and Recurrent Late Reaction to Hyaluronic Acid–Based Gel

Adverse reactions to injectable soft tissue fillers

Foreign Body Granulomas after All Injectable Dermal Fillers: Part 1. Possible Causes

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