Tuberculosis cutánea por mesoterapia, estudio de seis casos

Abstract

Introduction. Cutaneous tuberculosis as a result of a needle injection is a rare event; it generally occurs among medical and laboratory personnel and among patients receiving percutaneous treatment. Objective. Six patients are presented who developed cutaneous tuberculosis after mesotherapy cosmetic treatment. Material and methods. One to four months after injection of an unknown product as treatment for obesity and cellulites, five women and a man developed papules, nodules and drainage of wax like material at the inoculated sites; this was interpreted clinically as a non tuberculous mycobacterium infection. Skin biopsies were taken for a histopathologic study; the biopsy and exudates were cultured to make a phenotypic identification. Polymerase chain reaction and restriction enzyme pattern analyses (PCR-restriction pattern analysis)) procedures were applied to the skin biopsies. Results. Mycobacterium tuberculosis was confirmed in the culture and by PRA analysis in the paraffinembedded biopsies. The patients had never had tuberculosis. Their thoracic X rays were normal and the size of the tuberculin reaction was 17 to 20 mm. Five patients recovered with antituberculosis treatment and the sixth spontaneously healed after the removal of the largest cutaneous module. No satellite adenopathy or recurrences were observed. Conclusions. A previously undescribed mode of acquisition cutaneous tuberculosis was described. This was the second incident of a demonstrated cutaneous tuberculosis following mesotherapy in Colombia. Skin lesions induced by injections must be tested to detect mycobacterias to include M. tuberculosis.Keywords: tuberculosis, cutaneous; Mycobacterium tuberculosis, case studies. Tuberculosis cutánea por mesoterapia, estudio de seis casosIntroducción. La tuberculosis cutánea secundaria a la inyección con agujas es rara; se presenta en personal médico y de laboratorio, y en pacientes que reciben tratamientos percutáneos. Objetivo. Presentar seis pacientes con tuberculosis cutánea secundaria a tratamiento por mesoterapia. Materiales y métodos. Entre 1 y 4 meses después de la inyección en la piel glútea y abdominal de material no precisado, como tratamiento para la obesidad y la celulitis, cinco mujeres y un hombre desarrollaron pápulas, nódulos y senos de drenaje de material seroso en los sitios de inoculación, interpretados clínicamente como infección por micobacterias no tuberculosas. Se practicaron cultivos de las secreciones y de las biopsias de piel para la identificación fenotípica y estudio de histopatología. Con los resultados iniciales se realizaron pruebas moleculares de PRA (PCR-restriction pattern analysis) en las biopsias de piel y estudio ampliado de los pacientes. Resultados. Se demostró Mycobacterium tuberculosis en los cultivos, hallazgo confirmado por la técnica de PRA en las biopsias incluidas en parafina. Los pacientes no habían padecido tuberculosis. Las placas de tórax fueron normales y la tuberculina midió entre 17 y 20 mm. Cinco curaron con terapia antituberculosa y otro curó es...

An Update on Facial Skin Rejuvenation Effectiveness of Mesotherapy EBM V

“…There are several reports in the literature about cutaneous infections with mycobacteria and nocardia especially when performed by nonlicensed physicians. [40][41][42] Noninfectious complications on the other hand, include granuloma formation, dermal microcalcifications, panniculitis with extensive fat necrosis, cyst formation, and even skin ulceration. 43 Following mesotherapy for androgenic alopecia, such complications may worsen the condition and result in cicatricial or noncicatricial alopecia.…”

“…Although it appears to be a simple, easy, and financially attractive therapeutic modality, and despite reported amelioration of skin texture, wrinkles, and skin appearance, skin rejuvenation mesotherapy remains a controversial cosmetic procedure and rigorous proof of its efficacy is still lacking. 8,40 Evaluation of currently available data is difficult given the great variability of solutions and recommended dosages injected, the different techniques of injection, and the lack of recommended standardized protocols. It is also difficult given the fact that claims of skin rejuvenation reported by many studies are mostly based on none randomized, none blinded clinical trials with no effective control groups as well as on subjective data collection and analysis with biased outcome evaluation.…”

“…The risk of infection remains among the main encountered complications of this procedure, mainly due to sterility issues. There are several reports in the literature about cutaneous infections with mycobacteria and nocardia especially when performed by nonlicensed physicians 40–42 . Noninfectious complications on the other hand, include granuloma formation, dermal microcalcifications, panniculitis with extensive fat necrosis, cyst formation, and even skin ulceration 43 .…”

“…Although it appears to be a simple, easy, and financially attractive therapeutic modality, and despite reported amelioration of skin texture, wrinkles, and skin appearance, skin rejuvenation mesotherapy remains a controversial cosmetic procedure and rigorous proof of its efficacy is still lacking 8,40 . Evaluation of currently available data is difficult given the great variability of solutions and recommended dosages injected, the different techniques of injection, and the lack of recommended standardized protocols.…”

Side effects of mesotherapy - review

“…Powikłania związane z infekcjami oraz nieprzestrzeganiem sterylności należą do jednych z głównych powikłań mezoterapii [8].…”