Delayed immune-mediated adverse effects related to hyaluronic acid and acrylic hydrogel dermal fillers: clinical findings, long-term follow-up and review of the literature.

摘要: Introduction  Implantation of dermal filler for cosmetic purposes is becoming increasingly common worldwide. It thought that hyaluronic acid (HA) alone or combined with acrylic hydrogels (HA-AH) does not have severe nor persistent side-effects. However, recent evidence may show major, local and/or systemic, immediate delayed adverse effects appear in relation its use. Objective  To evaluate the clinical complaints, laboratory data, treatment and follow-up patients related to HA HA-AH implant fillers. Design  Prospective, case-series study filled compounds. Setting  The has been done a tertiary, teaching university hospital. Patients  We report on series 25 patients, 15 them prospective manner, severe, side-effects HA-AH. Inclusion criteria drawn up. Patients were excluded. submitted follow-up, battery blood tests thorax X-ray films. Besides, review literature was made. undertook computed-assisted (MEDLINE), National Library Medicine, Bethesda, MD, USA, search from 1996 up December 2005. Main outcome  Clinical evaluation granulomas, skin manifestations other systemic immune-mediated disorders possibly fillers their cumulative interaction previously administered fillers. Results  Of cases, 16 9 compounds. cases analysed long-term 10 alone, remaining five Time latency average beginning symptoms 13.7 months. Three these had before silicone another one Artecoll. Tender nodules seen 14 patients. Systemic appeared three cases. Laboratory abnormalities noted all studied After 16-month seven seem be cured, six recurrent bouts. Two lost during follow-up. Conclusion  Although some complications might associated previous unknown foreign bodies, we feel that, although infrequently, chronic inflammatory granulomatous reactions complicate fillers.