Multiple Embolism after Injection of Hyaluronic acid Filler in Nasal Dorsum: A Case Report of Skin Necrosis, Blindness, Oculomotor Palsy and Cerebral Infraction

As hyaluronic acid filler commonly applied in many cosmetic fields, tissue necrosis due to filler embolism is reported infrequently. Herein we report the first case of nasal hyaluronic acid filler injection resulting in nasal necrosis, multifocal brain infarction and ocular ischemia with hypotonia. A 25-year-old female, who had received an injection of hyaluronic acid filler along the nasal dorsum a month before, visited our hospital to manage the skin ulcer of nasal ala. Immediately after the injection, the patient had complained of nausea, vomiting, headache and nose pain without neurologic symptom. The skin had bluish change at her nose and forehead. And the right eyelid ptosis was observed with decreased eyeball movement and visual loss. Multifocal punctuated infarctions were found on both frontal lobes on brain MRI. The necrotic skin of right nasal ala was healed in 3 months. But, the width of the right nasal ala was smaller than the left side, and the right eye remained blind with extropia at 8 months after injection. Although hyaluronic acid filler is safe in most cases, patients should be informed of the possibility of this rare complication.

A Case of Ingrown Toenail Associated with Tinea Unguium Treated with K-D(R) Wire / 대한의진균학회지

Ingrown toenail is a common disorder resulting from various etiologies including excessive external pressure, ill-fitting footwear, and improper nail-trimming techniques. Patients commonly present with pain in the affected nail but with progression, drainage, infection and difficulty walking occur. It is often difficult to manage and frequently recurs, despite the multitude of treatment techniques that have been reported. Conservative therapy is a reasonable approach in patients with a mild to moderate ingrown toenail that do not have significant pain, substantial erythema, or purulent drainage from the lateral nail edge. We report a case of ingrown toenail in a 45-year-old female treated with K-D(R) wire, a corrective device. After application of K-D(R) wire for 3 weeks, ingrown toenail healed and the nail deformity was corrected.