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VIGNETTES
Granulomatous Reaction After Intradermal Injections of Hyaluronic Acid Gel
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Rarely does injectable hyaluronic acid for soft tissue augmentation produce adverse skin reactions.1-2 We report a unique case in which the patient not only had a delayed granulomatous reaction at the injection sites, but also developed scleromyxedema, which appeared to be temporally related to the intradermal injection of the hyaluronic acid.
Report of a Case
In September 1999, the glabellar and melolabial folds of a 72-year-old woman with a history of tubercular pleurisy were injected with hyaluronic acid gel (Restylane) for the first time. In May 2000, a relapse of her pleurisy was promptly controlled, but soon afterward, indurated erythematous areas developed at the hyaluronic acid injection sites. A skin biopsy specimen revealed a foreign body–type granuloma encircling round and ovoid clear spaces of variable sizes and shapes. Under polarized light, no foreign birefringent material was seen. Alcian blue stain at a pH of 2.5 showed mucin deposits in the sclerotic stroma, but not . . . [Full Text of this Article]
Comment
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