Sclerosing Lipogranuloma Seconda y to Supposed Vitamin E Injection for Facial Rejuvenation: Successful Treatment with Intralesional Steroids

Facial lipogranulomas due to self-injection of vitamin A oil

“…Treatment of these lesions is challenging but necessary to prevent clinical progression and disfigurement (Kamouna et al, 2014). A prolonged course of broad spectrum antibiotic treatments, which was successful in our case, oral and intralesional steroidal agents, allopurinol, imiquimod, isotretinoin, surgical excision, and other anecdotal treatments have been indicated for the management of foreign-body granulomatous reactions (Ficarra et al, 2002, Friedrich and Zustin, 2014, Lemperle and Gauthier-Hazan, 2009, Robenzadeh et al, 1998).…”

“…Whether substance purity, patient susceptibility, amount injected, or specific injection site is the most important contributing cause of the inflammatory response is unknown; however, a combination of these factors is suspected (Robenzadeh et al, 1998). The cosmetic and adverse effects of these injections are likely due to the oil suspension rather than the presence of active ingredients alone.…”

“…Another report of facial injection of vitamin E oil was successfully treated with an initial week-long course of cephalexin, followed by 5 mg of intralesional triamcinolone monthly for 4 months with resolution, and no reported recurrence (Robenzadeh et al, 1998). Improvement can also be seen as early as 2 weeks after initiation of treatment with combination therapies, such as broad-spectrum antibiotic medications and systemic corticosteroid treatments (0.5-0.7 mg/kg), with no reported recurrences at the 6-month follow-up visit (Kamouna et al, 2014, Kamouna et al, 2015).…”

No pain no gain: tender nodules in a competitive bodybuilder

“…In the decades that followed, people would explore applications of numerous other primitive fillers in hopes of finding the perfect injectable to repair, restore, refine, or enhance their bodies. The medical literature has chronicled the conquests and magnificent failures of these pioneers, with highlights including injections of sunflower oil for breast enhancement [2], injections of vitamin E for facial rejuvenation [3], and a few hundred cases of injections of various substances (paraffin, mineral oil, cod liver oil, olive oil, motor vehicle transmission oil) into the penis and scrotum for male enhancement [4][5][6].…”

Sclerosing lipogranuloma of the penis

“…It also allows for migration of foreign material with extension of granulomatous reaction, leading to more difficult reconstructions and potentially compromising vasculature for grafts and flaps. There have been cases of extragenital lipogranuloma managed successfully with intralesional and oral corticosteroids; however, efficacy in treating genital lesions is unproven 14,15 . Corticosteroids may have a role as a temporizing measure during acute exacerbations in those unwilling to undergo definitive surgical treatment 14 .…”