Novel management of granuloma formation secondary to dermal filler: A multi‐modality approach

Novel management of granuloma formation secondary to dermal filler: A multi‐modality approach

Background Dermal fillers for soft tissue augmentation have become increasingly popular among patients of all ages and ethnicities. With more widespread use, there has been an increased incidence of adverse reactions, one of which is the granulomatous foreign body reaction (GFBR). Materials & Me...

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Bibliographic Details
Published in:Journal of cosmetic dermatology Vol. 22; no. 4; pp. 1233 - 1237
Main Authors: Bowles, Alexandra, Ghalili, Sabrina, Ojong, Oben B., Vasile, Gabriella F., Li, Yumeng M., Aguilera, Shino Bay
Format: Journal Article
Language:English
Published: England John Wiley & Sons, Inc 01-04-2023
Subjects:
Atrophy
Biopolymers
Biopsy
Blood vessels
Cosmetic Techniques - adverse effects
Counterfeiting
dermal filler
Dermal fillers
Dermal Fillers - adverse effects
Erythema
Fluorouracil - adverse effects
Foreign bodies
Foreign-Body Reaction - etiology
granuloma
Granuloma, Foreign-Body - chemically induced
Granuloma, Foreign-Body - therapy
Granulomas
Humans
hyaluronic acid
Hyaluronic Acid - adverse effects
hyaluronidase
Inflammation
Leukocytes
Neutrophils
Particle size
Patients
Proteins
Skin
Success
treatment
Treatment Outcome
Triamcinolone - adverse effects
hyaluronidase
treatment
dermal filler
granuloma
hyaluronic acid
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Summary:Background Dermal fillers for soft tissue augmentation have become increasingly popular among patients of all ages and ethnicities. With more widespread use, there has been an increased incidence of adverse reactions, one of which is the granulomatous foreign body reaction (GFBR). Materials & Methods We present a three patient case series in which GFBR secondary to dermal filler was successfully treated with a multi‐leveled approach. The first modality involves intralesional injection of a mixture containing 1 cc of 5‐fluorouracil (5‐FU), 0.5 cc of dexamethasone sodium phosphate, and 0.1 cc of triamcinolone 10. The lesion is injected intradermally in small aliquots, similar to scar treatment. The patient then takes colchicine 1.2 mg loading dose on day 1, then 0.6 mg twice per day for 4 days concurrently with naproxen 500 mg orally once daily for 5–7 days. This process may be repeated in 6 weeks if the lesions have not resolved and PDL laser may be employed for residual post‐inflammatory erythema. Results All three patients presented in this case series had significant aesthetic improvement in their dermal filler‐derived foreign body granulomatous reactions. Conclusion GFBR provides both a medical and aesthetic issue for these patients including mental distress, pain, and dysfunction, therefore having an effective treatment for GFBR will affect medical management of these patients, improving patient outcomes and satisfaction. Our proposed regimen for GFBR has been shown to be highly efficacious and safe for these patients, providing a significant improvement in both function and cosmesis of the area.
Bibliography:Correction added on 3 January 2023, after first online publication: The fourth author's name and the fifth author's degree have been corrected in this version.
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ISSN:1473-2130
1473-2165
DOI:10.1111/jocd.15579