Complications of dermal fillers - an experience from Middle-East

Dermal fillers have become exceedingly common globally in recent years for body rejuvenation, but with their widespread use and increasing profitability, cases of complications of dermal fillers are being widely reported. To document the complications related to dermal fillers as managed by the authors while working in different hospitals of Riyadh city. Demographic and clinical data of 47 cases, reporting with complications of dermal fillers over a period of two years from June 2009 to June 2011, were analysed. The complications were categorised by a self designed category system based on management and outcome. 44 females and 3 males, ranging in age from 23 years to 62 years were managed for complications of dermal fillers affecting face, hands, buttocks and external genitalia. 83% of cases had moderate to severe complications, and 51% were unaware of the nature of dermal filler received by them. 20 cases [42.5%] required surgical treatment and interventions under anesthesia. With increased use of dermal fillers, the complications are also being frequently encountered. Dermatologists should be wary of these avoidable untoward effects and their proper management

Post clubfoot release skin necrosis: a preventable disaster

Complications of pedal wounds closed primarily after release of neglected cases of club foot are well known in literature. We treated a 12-year-old boy presenting with widespread necrosis involving medial aspect of foot after release of neglected talipes equinovarus. Such widespread necrosis is even known to end up in amputations and permanent disabilities. In our case, the foot was successfully salvaged by resorting to dedicated wound care, multiple debridements, use of topical negative pressure [vacuum-assisted closure [VAC], and skin grafting. Various means to prevent such adverse events are also presented. The aim of publishing this case is to stress the need to: 1. Take proper measures preoperatively in neglected club feet to decrease the impact of deformity. 2. To be aware of various different flaps and methods of closure as mentioned in literature and to reaffirm the fact that primary closures done under tension are bound to fail and end up in disasters. 3. To be patient and use the modern concepts of wound management like topical negative pressure if such unfortunate complications do occur and thereby attempt to salvage the feet

Multiple facial pilomatricomas

Pilomatricoma is a benign and often misdiagnosed tumor arising from hair matrix cells. It is predominantly found in children below the age of 10 years and is characterized histologically by basaloid and eosinoplilic ghost or empty cells. Pilomatricoma is generally solitary and multiple tumors are rarely reported. We report one such rare case of multiple facial pilomatricomas in a one-year-old girl