Resolution of microneedling-associated granulomatous dermatitis with oral methotrexate

Martin, Elise D; Huang, William W.

doi:10.1016/j.jdcr.2021.02.011

Cited by 3 publications

(3 citation statements)

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“…A case of granulomatous dermatitis following microneedling of striae distensae on the thigh was successfully treated with oral fumaric acid ester (Fumaderm ® ). 9 More recently, Martin and Huang 10 reported successful treatment of microneedling-associated granulomatous dermatitis with Methotrexate.…”

Section: Discussionmentioning

confidence: 99%

“…In Soltani-Arabshahi et al’s 4 original report of granulomatous dermatitis following microneedling, polarizable material was observed in the biopsy specimen, whereas in subsequent reports, similar to our case, no polarizable material was observed. 10 Whether the granulomatous reactions following microneedling represent foreign body reactions to the cosmeceutical injected into the skin during the procedure, true allergic type IV hypersensitivity reactions, or an overlap between the two processes is unclear.…”

Section: Discussionmentioning

confidence: 99%

“…This is a rare complication, with only 10 previous cases found upon review of the literature. [4][5][6][7][8][9][10][11] Soltani-Arabshahi et al originally described three similar cases of women who developed facial granulomas following microneedling, with evidence of foreign body-type granulomas on biopsy and a positive patch test reaction to vitamin C serum in two cases. They hypothesized that these cases represented true delayed-type hypersensitivity granulomas secondary to an immunologic response after intradermal tattooing of an antigenic topical product.…”

Section: Discussionmentioning

confidence: 99%

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A case of a delayed granulomatous reaction on the face following microneedling: A case report

Heck

Traboulsi

2022

SAGE Open Medical Case Reports

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Background: Microneedling is a common non-invasive procedure used for a variety of dermatologic conditions. It is associated with a low rate of adverse events which are typically temporary. Hypersensitivity reactions, including granuloma formation, are a rare adverse event, with only 10 cases previously reported. Case Summary: We report a case of a 49-year-old female who presented with asymptomatic edematous erythematous annular plaques on her left cheek following a microneedling procedure in which a Vitamin C cosmeceutical was applied to the skin beforehand. Skin biopsy confirmed non-necrotizing granulomatous dermatitis with negative tissue cultures. Systemic workup for sarcoidosis was negative. Conclusion: Delayed facial granulomatous reaction is an uncommon adverse event following microneedling. Increased risk may be related to peri-procedure use of cosmeceuticals such as Vitamin C. Given the popularity of microneedling, and that it is an unregulated procedure, it is important for dermatologists to be aware of this possible sequela in order to counsel patients appropriately and understand management options.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%