Delayed inflammatory reaction of hyaluronic acid fillers against the background of flu-like illness

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Abstract

Traditionally, it is considered that inflammatory reactions with delayed onset that occur due to the use of fillers based on hyaluronic acid (HA) are included in the category of rare complications. But in recent years, due to the increasing popularity of injection procedures, such reactions have become more common, which attracts the attention of both the scientific community and clinicians.

This article presents a clinical case of a late inflammatory response, describes the diagnosis and tactics of therapy, and provides an overview of the etiology, pathogenesis, diagnosis, and therapy of such reactions. 7 months ago, HA filler was injected into the area of both tear troughs. 3 months after the procedure, the patient underwent acute respiratory viral infection, against which for the first time she noted the sudden appearance of inflammation. 3 months after the first episode of an inflammatory reaction in the tear troughs, against the background of acute pharyngitis, its relapse occurred, accompanied by similar symptoms.

Similar inflammatory reactions can occur with any HA filler, but their frequency may vary depending on various factors. Timely detection and proper treatment can successfully eliminate the inflammatory reaction within a few days.

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About the authors

Evgeniya V. Ikonnikova

Central State Medical Academy of Department of Presidential Affairs; Institute of Plastic Surgery and Cosmetology

Author for correspondence.
Email: evikonnikova@bk.ru
ORCID iD: 0000-0002-8813-9132
SPIN-code: 9210-8396

Cand. Sci. (Med.), Associate Professor

Russian Federation, 19, Marshala Timoshenko str., Moscow, 121359; Moscow

Nataliya E. Manturova

Institute of Plastic Surgery and Cosmetology; The Russian National Research Medical University named after N.I. Pirogov

Email: manturovane@mail.ru
ORCID iD: 0000-0003-4281-1947
SPIN-code: 5232-0412

Dr. Sci. (Med.), Professor

Russian Federation, 19, Marshala Timoshenko str., Moscow, 121359; Moscow

Larisa S. Kruglova

Central State Medical Academy of Department of Presidential Affairs; Institute of Plastic Surgery and Cosmetology

Email: kruglovals@mail.ru
ORCID iD: 0000-0002-5044-5265
SPIN-code: 1107-4372

Dr. Sci. (Med.), Professor

Russian Federation, 19, Marshala Timoshenko str., Moscow, 121359; Moscow

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2. Fig. 1. Patient B., 53 years old, diagnosis: L08.9 Local infection of the skin and subcutaneous tissue, unspecified; T81.9 Complication of procedure, unspecified Edema and erythema in the area of the nasolacrimal groove on the left: а ― at the time of going to the clinic; б ― ultrasound examination of the skin and soft tissues in the area of the left nasolacrimal groove.

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3. Fig. 2. The same patient. The area of the nasolacrimal groove on the left 3 weeks after the end of therapy.

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