Tacrolimus in the Treatment of Chronic and Refractory Late-Onset Immune-Mediated Adverse Effects Related to Silicone Injections

Alijotas‐Reig, Jaume; Garcia-Gimenez, Victor; Vilardell‐Tarrés, Miquel

doi:10.1111/j.1524-4725.2011.02221.x

Cited by 23 publications

(11 citation statements)

References 39 publications

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“…Eight human studies (including 168 patients) have investigated the presence of bacteria on samples from LIRs after filler use [ 7 , 8 , 19 , 23 , 28 , 31 – 33 ]. Six studies were cross-sectional studies, while two studies were case series.…”

Section: Resultsmentioning

confidence: 99%

“…Numerous human studies have shown the presence of bacteria in material derived from patients with LIRs (Table 7 in ESM) [7,8,23,28,31,32]. Two studies did not detect any bacteria in the collected samples [19,33]. The (mainly Staphylococcus epidermidis) and Propionibacterium acnes, which were detected in up to 98% of positive cultures, and which lead to the hypothesis that the presence of these bacteria is involved in development of LIRs [7,8,24,28,31,32].…”

Section: Discussion Bacterial Contamination and Lirsmentioning

confidence: 99%

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The Aetiopathogenesis of Late Inflammatory Reactions (LIRs) After Soft Tissue Filler Use: A Systematic Review of the Literature

Bachour

Kadouch²,

Niessen

2021

Aesth Plast Surg

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Background Late inflammatory reactions (LIRs) are the most challenging complications after filler use. The immune system plays a prominent role in its etiology, albeit to an unknown extent. Bacterial contamination in situ has been hypothesized to be causative for LIRs. How this relates to the immunological processes involved is unknown. This article aims to provide an overview of immunological and bacterial factors involved in development of LIRs. Methods We undertook a systematic literature review focused on immunological factors and microbiota in relation to LIRs after filler use. This systematic review was performed in accordance with the PRISMA guidelines. PubMed, EMBASE and the Cochrane databases were searched from inception up to August 2019. Included studies were assessed for the following variables: subject characteristics, number of patients, primary indication for filler injection, implant type/amount and injection site, type of complication, follow-up or injection duration, study methods, type of antibiotics or medical therapies and outcomes related to microbiota and immunological factors. Results Data on immunological factors and bacterial contamination were retrieved from 21 included studies. Notably, the presence of histocytes, giant cells and Staphylococcus epidermidis within biopsies were often associated with LIRs. Conclusion This review provides a clear overview of the immunological factors associated with LIRs and provides a hypothetical immunological model for development of the disease. Furthermore, an overview of bacterial contamination and associations with LIRs has been provided. Follow-up research may result in clinical recommendations to prevent LIRs. Level of Evidence III This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors-www.springer.com/00266..

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Section: Resultsmentioning

confidence: 99%

Section: Discussion Bacterial Contamination and Lirsmentioning

confidence: 99%

The Aetiopathogenesis of Late Inflammatory Reactions (LIRs) After Soft Tissue Filler Use: A Systematic Review of the Literature

Bachour

Kadouch²,

Niessen

2021

Aesth Plast Surg

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“…The ability of silicone to initiate immunologic processes remains to be clarified. An exhaustive federally sponsored review failed to find evidence to support immunological effects [70]. …”

Section: Resultsmentioning

confidence: 99%

Clinical Application of Development of Nonantibiotic Macrolides That Correct Inflammation-Driven Immune Dysfunction in Inflammatory Skin Diseases

Rodríguez-Cerdeira

Sánchez-Blanco

Molares-Vila

2012

Mediators of Inflammation

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Background. Inflammation-driven immune dysfunction supports the development of several chronic human disorders including skin diseases. Nonantibiotic macrolides have anti-inflammatory and/or immunomodulatory activity that suggests the exploitation of these in the treatment of skin diseases characterized by inflammatory disorders. Materials and Methods. We performed an extensive review of the nonantibiotic macrolide literature published between 2005 and 2012, including cross-references of any retrieved articles. We also included some data from our own experience. Results. Calcineurin antagonists such as tacrolimus and ascomycins (e.g., pimecrolimus) act by inhibiting the activation of the nuclear factor for activated T cells (NFAT). There are new applications for these macrolides that have been available for several years and have been applied to skin and hair disorders such as atopic dermatitis, oral lichen planus, vitiligo, chronic autoimmune urticaria, rosacea, alopecia areata, pyoderma gangrenosum, Behcet's disease, neutrophilic dermatosis, and lupus erythematosus. We also reviewed new macrolides, like rapamycin, everolimus, and temsirolimus. In addition to the literature review, we report a novel class of nonantibiotic 14-member macrocycle with anti-inflammatory and immunomodulatory effects. Conclusions. This paper summarizes the most important clinical studies and case reports dealing with the potential benefits of nonantibiotic macrolides which have opened new avenues in the development of anti-inflammatory strategies in the treatment of cutaneous disorders.

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“…Studies published after the patient received treatment suggest tacrolimus may be beneficial in the treatment of chronic and refractory late-onset immune-mediated adverse effects secondary to silicone injections [11]. However, the small sample size of the study necessitates further validation of the results [12].…”

Section: Discussionmentioning

confidence: 96%

Gluteal silicone injections leading to extensive filler migration with induration and arthralgia

Gold¹,

Wang²,

Meehan³

et al. 2015

Dermatology Online Journal

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Silicone injections have been used for cosmetic soft tissue augmentation for over five decades [1] with documented consequences both systemic and dermatologic. We present a case of extensive filler migration causing bilateral lower extremity woody induration in a 53 year old woman. She presented with a multi-year history of progressive joint stiffening at the knees, accompanied by induration and pain of the bilateral lower extremities. The patient had received two injections of an unknown substance placed into her bilateral buttocks 11 years prior. MRI indicated an infiltrative process of both lower extremities and pathology was consistent with migration of injected tissue augmentation material, most likely silicone. Owing to the extent of involvement the patient was started on a trial of doxycycline 100 mg PO BID.

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Tacrolimus in the Treatment of Chronic and Refractory Late-Onset Immune-Mediated Adverse Effects Related to Silicone Injections

Abstract: Tacrolimus is an effective and well-tolerated drug in cases of severe and refractory late-onset inflammatory reactions, including large panniculitis, that complicate silicone gel injections.

Cited by 23 publications

References 39 publications

The Aetiopathogenesis of Late Inflammatory Reactions (LIRs) After Soft Tissue Filler Use: A Systematic Review of the Literature

The Aetiopathogenesis of Late Inflammatory Reactions (LIRs) After Soft Tissue Filler Use: A Systematic Review of the Literature

Clinical Application of Development of Nonantibiotic Macrolides That Correct Inflammation-Driven Immune Dysfunction in Inflammatory Skin Diseases

Gluteal silicone injections leading to extensive filler migration with induration and arthralgia

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