ABSTRACT
The pandemic of a new coronavirus infection has posed many challenges and questions for medicine. Dermatologists, in particular, have encountered a wide variety of cutaneous manifestations of this infection. Apart from a fairly broad coverage of various rashes and features of the course of many chronic dermatoses, only sporadic descriptions of inflammatory reactions to cosmetic fillers are available. Objec-tives. An extremely rare complication is described: an inflammatory reaction to the injection of a hyaluronic acid-based filler, which, in turn, led to the occurrence of xanthelasma at the sites of filler localization during the recovery period after COVID-19. Material and methods. A patient presented with yellow lesions in the nasolacrimal sulcus area following the resolution of an inflammatory response to the injection of a hyaluronic acid-based filler during the recovery period after a COVID-19 infection. Results. The diagnosis was confirmed by ultrasound of the face skin and soft tissues, and the optimal therapy regimen was determined. Conclusion. In the global medical practice, only single cases of xanthelasma and xanthelasma-like reactions after the filler injection are report-ed. In a scientific first, the pathogenetic chain including COVID-19, filler inflammatory response, and xanthelasma is described. The patho-genesis of this complication is also of particular interest and needs further study. Although extremely rare, physicians should be aware of this complication and its treatment options.
ABSTRACT
Actuality. In recent years in aesthetic medicine, there has been a steadily increasing popularity of the use of various fillers in order to correct aesthetic imperfections and age-related changes. Traditionally, the most widely used fillers are based on hyaluronic acid due to their high safety profile, biocompatibility, a wide range of indications and the presence of an antidote in the form of hyaluronidase preparations. However, in some cases, a late complication such as a delayed inflammatory response may occur. Various triggering factors can lead to its appearance, including influenza-like illnesses, and also coronavirus infection caused by the SARS-CoV-2 virus. Objective. The article provides a detailed description of the occurrence of a delayed inflammatory reaction in the localization of a filler based on hyaluronic acid against the background of a new coronavirus infection (COVID-19), as well as analyzes clinical cases presented in scientific publications. Material and methods. A 49-year-old female patient complained of recurrent inflammation in the areas of injection of a filler based on hyaluronic acid. For the first time, the onset of an inflammatory reaction occurred against the background of the COVID-19 disease. Results. After additional examination methods (ultrasound of the skin and soft tissues of the face), a diagnosis was made and therapy was prescribed (antibiotics, dexamethasone per os for a long time, enzymatic resorption of the filler by hyaluronidase, external therapy: tacrolimus). Conclusions. Delayed inflammatory responses of hyaluronic acid fillers, despite the rarity of occurrence, are currently the focus of attention. The worldwide interest in this problem is associated with the etiology and pathogenesis of their occurrence, which are complex and multifactorial and are not fully understood. As practical observations show during the ongoing pandemic, the SARS-CoV-2 virus may be a risk factor for the occurrence of delayed inflammation in this category of patients with an aesthetic profile. © 2021, Media Sphera Publishing Group. All rights reserved.