Oral foreign body granuloma to soft tissue fillers. 
Report of two cases and review of the literature

Tamiolakis, Paris; Piperi, Evangelia; Christopoulos, Panagiotis; Sklavounou‐Andrikopoulou, Alexandra

doi:10.4317/jced.54191

Cited by 10 publications

(15 citation statements)

References 37 publications

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“…It is used to restore bulkiness and elasticity that have been lost with age 1 . Nevertheless, soft tissue fillers are used in a wide age range 2 . Hyaluronic acid represents 78% of the dermal filler injections in the United States, 3 been the second most popular nonsurgical cosmetic procedure after botulinum toxin injection 4 .…”

Section: Discussionmentioning

confidence: 99%

Multiple oral granulomatous nodules to hyaluronic acid filler

Pozuelo

Dios

Rojas

2020

J of Cosmetic Dermatology

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A 74‐year‐old Caucasian woman presented with a 2‐week history of multiple nodules in both lips and perioral region that caused her mild discomfort while eating. The patient reported hyaluronic acid infiltration on both lips 5 months prior to presentation. The examination revealed multiple, well‐defined, millimetric, and firm nodules on both lips and oral mucosa. An excisional biopsy of one of the nodules was performed under local anesthesia. Histopathological analysis demonstrated acute eosinophilic inflammation, fibrosis, and granulomas on mucoid material, positive for colloidal iron stain and Alcian blue stain, alongside a minor salivary gland showed mild atrophy, fibrosis, and fat infiltration. Enhancement of the aged lip using hyaluronic acid, to restore the bulkiness and elasticity that have been lost with age, is very common. Nevertheless, soft tissue fillers are used in a wide age range. Hyaluronic acid represents 78% of the dermal filler injections in the United States, been the second most popular nonsurgical cosmetic procedure after botulinum toxin injection. Foreign body granulomatous reaction is a rare delayed complication that has been well documented elsewhere and it has been associated with poor injection technique. Although it also has been related to hypersensitivity reactions that may be caused by impurities developed during the bacterial fermentation process, treatment of granulomatous reactions with hyaluronidase is recommended.

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Section: Discussionmentioning

confidence: 99%

Multiple oral granulomatous nodules to hyaluronic acid filler

Pozuelo

Dios

Rojas

2020

J of Cosmetic Dermatology

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“…Aesthetic procedures, in an attempt to slow down aging through injectable soft tissue fillers, are increasingly frequent [ 23 ]. However, the increasing performance of these procedures, regardless of the type of material used, also causes an increase in the number of side effects [ 24 ], the most common being foreign body granulomas [ 25 , 26 ]. The treatment approach for this type of granulomatous reaction by an exogenous foreign body has good resolvability through intralesional injections of corticosteroids [ 21 , 26 ].…”

Section: Discussionmentioning

confidence: 99%

“…However, the increasing performance of these procedures, regardless of the type of material used, also causes an increase in the number of side effects [ 24 ], the most common being foreign body granulomas [ 25 , 26 ]. The treatment approach for this type of granulomatous reaction by an exogenous foreign body has good resolvability through intralesional injections of corticosteroids [ 21 , 26 ]. On the other hand, when foreign body granuloma lesions are caused by other exogenous factors, such as that presented by this clinical case, surgical excision by enucleation of the lesion should be the first option of choice, since this technique can be used both for definitive laboratory diagnosis and for therapy [ 7 , 26 , 27 ].…”

Section: Discussionmentioning

confidence: 99%

Foreign Body Granuloma in the Tongue by a Pequi Spine

Pereira

Rodrigues

et al. 2020

Case Reports in Dentistry

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Substances considered foreign to the human organism can penetrate it due to local trauma, initially causing an acute inflammatory response against these substances, involving a neutrophilic infiltrate that, when it fails to deal with these foreign bodies, ends up generating a granulomatous inflammatory response. Granuloma formation has been associated with a variety of conditions. The correct clinical and imaging diagnoses are extremely important for the dentist to choose an appropriate therapeutic approach, aiming at the best possible treatment. This work is aimed at describing a case report of a foreign body granuloma, formed on the tongue, from the penetration of a pequi spine, in a 76-year-old patient, in whom, after an imaging diagnosis with ultrasound, surgical removal of the lesion was performed, and the piece was sent for histopathological examination, which confirmed the initial diagnostic hypothesis of a foreign body granuloma. The initial diagnosis of foreign body granulomas is challenging. For this reason, more sophisticated means of diagnosis such as tomography and magnetic resonance become important in the diagnosis, as they can show with greater clarity and reliability the nature of the lesion and its relationship with adjacent anatomical structures. In the case in question, an ultrasound examination was chosen, which was extremely important as an aid to diagnosis, considerably improving surgical planning. In addition, after surgical removal, the result of the histopathological analysis is essential to determine the definitive diagnosis, as it determines the granulomatous characteristic of the lesion.

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“…Hyaluronic acid (HA) fillers in cosmetic medicine are widely used and considered relatively safe, though not all the fillers used in European countries and throughout the world have been approved by the Regulatory Agencies . Nevertheless, a wide range of medical compounds has been authorized as fillers for HA injections .…”

Section: Discussionmentioning

confidence: 99%

“…On the basis of manufacturers' and some authors' claims, all commonly used injection materials for esthetic correction and different formulations of hyaluronic acid (HA), with or without adjunctive substances, result in no immunogenic reactions or other complications; nevertheless, unexpected, late, or early adverse reactions have been reported . Overall, poly‐hydroxyethyl‐methacrylate (HEMA) suspended in HA can promote the formation of late foreign body granulomas (FBGs) .…”

Section: Introductionmentioning

confidence: 99%