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Kussini J, Mühlenbein S, Didona D, Pfützner W. Cutaneous reactions to vaccination. J Dtsch Dermatol Ges 2025; 23:195-209. [PMID: 39865751 PMCID: PMC11803346 DOI: 10.1111/ddg.15477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Accepted: 05/05/2024] [Indexed: 01/28/2025]
Abstract
Vaccination is a fundamental principle of preventive health care. Administration of the vaccine, which contains the antigen(s) of a pathogen, activates the immune system and provides protection against infection. The immunogenicity and allergenicity of a vaccine may lead to various adverse reactions, depending on the responsiveness and susceptibility of the vaccinated individual. Cutaneous adverse events are among the most common and can manifest as various local or generalized vaccination reactions. Understanding their pathogenesis and clinical manifestations is essential for therapy, for further diagnostic clarification if necessary, and for managing any booster vaccination that may be required. Appropriate dermatological expertise therefore plays a crucial role in managing patients with a history of vaccination reactions.
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Affiliation(s)
- Jacqueline Kussini
- Department of Dermatology and AllergologyUniversity Hospital MarburgPhilipps University MarburgMarburgGermany
| | - Stefan Mühlenbein
- Department of Dermatology and AllergologyUniversity Hospital MarburgPhilipps University MarburgMarburgGermany
| | - Dario Didona
- Department of Dermatology and AllergologyUniversity Hospital MarburgPhilipps University MarburgMarburgGermany
| | - Wolfgang Pfützner
- Department of Dermatology and AllergologyUniversity Hospital MarburgPhilipps University MarburgMarburgGermany
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Justiz-Vaillant A, Roopnarine K, Solomon S, Phillips A, Sandy S, Subero A, Seepersad S, Span N, Ramnath P, Ramnarine A, Ramdath B, Rampaul C, Ramdial R, Phagoo D, Ramdhanie T, Moonilal V, Poliah EM, Poonwassie S, Punilal K, Panchoo S, Parris J, Oudit S, Muir T, Nicholas-Joseph J, Pandit BR, Pakeerah S, Sookoo V, Richards P, John T, Gopaul D, Soodeen S, Arozarena-Barbosa O, Williams A, Unakal C, Fundora RA, Thompson R, Akpaka PE. COVID-19 Vaccines Effectiveness and Safety in Trinidad and Tobago: A Systematic Review and Meta-Analysis. Microorganisms 2025; 13:135. [PMID: 39858903 PMCID: PMC11767614 DOI: 10.3390/microorganisms13010135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2024] [Revised: 12/03/2024] [Accepted: 01/07/2025] [Indexed: 01/27/2025] Open
Abstract
This systematic review evaluated the effectiveness and side effects of various COVID-19 vaccines, with a focus on Trinidad and Tobago. The Pfizer-BioNTech and Moderna vaccines demonstrated the highest efficacy, particularly against COVID-19 variants, while Janssen and Sinopharm were comparatively less effective. mRNA vaccines, such as Pfizer-BioNTech and Oxford-AstraZeneca, were associated with more frequent and severe side effects, including soreness, fever, and cardiovascular issues. The review also identified significant gaps in the current scientific literature regarding COVID-19 vaccination issues in Trinidad and Tobago. These gaps highlight the need for comprehensive research to address vaccination challenges, including public health communication, equitable access, and local perceptions of vaccine safety. This analysis provides a foundation for developing targeted strategies to improve vaccine effectiveness in the region.
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Affiliation(s)
- Angel Justiz-Vaillant
- Department of Para-Clinical Sciences, University of the West Indies, St. Augustine Campus, St. Augustine 330912, Trinidad and Tobago; (K.R.); (S.S.); (A.P.); (A.S.); (S.S.); (N.S.); (P.R.); (A.R.); (B.R.); (C.R.); (R.R.); (D.P.); (T.R.); (V.M.); (E.-M.P.); (S.P.); (K.P.); (S.P.); (J.P.); (S.O.); (T.M.); (J.N.-J.); (B.R.P.); (S.P.); (V.S.); (P.R.); (T.J.); (S.S.); (A.W.); (C.U.); (R.T.); (P.E.A.)
| | - Kimberly Roopnarine
- Department of Para-Clinical Sciences, University of the West Indies, St. Augustine Campus, St. Augustine 330912, Trinidad and Tobago; (K.R.); (S.S.); (A.P.); (A.S.); (S.S.); (N.S.); (P.R.); (A.R.); (B.R.); (C.R.); (R.R.); (D.P.); (T.R.); (V.M.); (E.-M.P.); (S.P.); (K.P.); (S.P.); (J.P.); (S.O.); (T.M.); (J.N.-J.); (B.R.P.); (S.P.); (V.S.); (P.R.); (T.J.); (S.S.); (A.W.); (C.U.); (R.T.); (P.E.A.)
| | - Shaundell Solomon
- Department of Para-Clinical Sciences, University of the West Indies, St. Augustine Campus, St. Augustine 330912, Trinidad and Tobago; (K.R.); (S.S.); (A.P.); (A.S.); (S.S.); (N.S.); (P.R.); (A.R.); (B.R.); (C.R.); (R.R.); (D.P.); (T.R.); (V.M.); (E.-M.P.); (S.P.); (K.P.); (S.P.); (J.P.); (S.O.); (T.M.); (J.N.-J.); (B.R.P.); (S.P.); (V.S.); (P.R.); (T.J.); (S.S.); (A.W.); (C.U.); (R.T.); (P.E.A.)
| | - Alyssa Phillips
- Department of Para-Clinical Sciences, University of the West Indies, St. Augustine Campus, St. Augustine 330912, Trinidad and Tobago; (K.R.); (S.S.); (A.P.); (A.S.); (S.S.); (N.S.); (P.R.); (A.R.); (B.R.); (C.R.); (R.R.); (D.P.); (T.R.); (V.M.); (E.-M.P.); (S.P.); (K.P.); (S.P.); (J.P.); (S.O.); (T.M.); (J.N.-J.); (B.R.P.); (S.P.); (V.S.); (P.R.); (T.J.); (S.S.); (A.W.); (C.U.); (R.T.); (P.E.A.)
| | - Solange Sandy
- Department of Para-Clinical Sciences, University of the West Indies, St. Augustine Campus, St. Augustine 330912, Trinidad and Tobago; (K.R.); (S.S.); (A.P.); (A.S.); (S.S.); (N.S.); (P.R.); (A.R.); (B.R.); (C.R.); (R.R.); (D.P.); (T.R.); (V.M.); (E.-M.P.); (S.P.); (K.P.); (S.P.); (J.P.); (S.O.); (T.M.); (J.N.-J.); (B.R.P.); (S.P.); (V.S.); (P.R.); (T.J.); (S.S.); (A.W.); (C.U.); (R.T.); (P.E.A.)
| | - Alyssa Subero
- Department of Para-Clinical Sciences, University of the West Indies, St. Augustine Campus, St. Augustine 330912, Trinidad and Tobago; (K.R.); (S.S.); (A.P.); (A.S.); (S.S.); (N.S.); (P.R.); (A.R.); (B.R.); (C.R.); (R.R.); (D.P.); (T.R.); (V.M.); (E.-M.P.); (S.P.); (K.P.); (S.P.); (J.P.); (S.O.); (T.M.); (J.N.-J.); (B.R.P.); (S.P.); (V.S.); (P.R.); (T.J.); (S.S.); (A.W.); (C.U.); (R.T.); (P.E.A.)
| | - Sarah Seepersad
- Department of Para-Clinical Sciences, University of the West Indies, St. Augustine Campus, St. Augustine 330912, Trinidad and Tobago; (K.R.); (S.S.); (A.P.); (A.S.); (S.S.); (N.S.); (P.R.); (A.R.); (B.R.); (C.R.); (R.R.); (D.P.); (T.R.); (V.M.); (E.-M.P.); (S.P.); (K.P.); (S.P.); (J.P.); (S.O.); (T.M.); (J.N.-J.); (B.R.P.); (S.P.); (V.S.); (P.R.); (T.J.); (S.S.); (A.W.); (C.U.); (R.T.); (P.E.A.)
| | - Nicholas Span
- Department of Para-Clinical Sciences, University of the West Indies, St. Augustine Campus, St. Augustine 330912, Trinidad and Tobago; (K.R.); (S.S.); (A.P.); (A.S.); (S.S.); (N.S.); (P.R.); (A.R.); (B.R.); (C.R.); (R.R.); (D.P.); (T.R.); (V.M.); (E.-M.P.); (S.P.); (K.P.); (S.P.); (J.P.); (S.O.); (T.M.); (J.N.-J.); (B.R.P.); (S.P.); (V.S.); (P.R.); (T.J.); (S.S.); (A.W.); (C.U.); (R.T.); (P.E.A.)
| | - Phalmanie Ramnath
- Department of Para-Clinical Sciences, University of the West Indies, St. Augustine Campus, St. Augustine 330912, Trinidad and Tobago; (K.R.); (S.S.); (A.P.); (A.S.); (S.S.); (N.S.); (P.R.); (A.R.); (B.R.); (C.R.); (R.R.); (D.P.); (T.R.); (V.M.); (E.-M.P.); (S.P.); (K.P.); (S.P.); (J.P.); (S.O.); (T.M.); (J.N.-J.); (B.R.P.); (S.P.); (V.S.); (P.R.); (T.J.); (S.S.); (A.W.); (C.U.); (R.T.); (P.E.A.)
| | - Akaasha Ramnarine
- Department of Para-Clinical Sciences, University of the West Indies, St. Augustine Campus, St. Augustine 330912, Trinidad and Tobago; (K.R.); (S.S.); (A.P.); (A.S.); (S.S.); (N.S.); (P.R.); (A.R.); (B.R.); (C.R.); (R.R.); (D.P.); (T.R.); (V.M.); (E.-M.P.); (S.P.); (K.P.); (S.P.); (J.P.); (S.O.); (T.M.); (J.N.-J.); (B.R.P.); (S.P.); (V.S.); (P.R.); (T.J.); (S.S.); (A.W.); (C.U.); (R.T.); (P.E.A.)
| | - Bimala Ramdath
- Department of Para-Clinical Sciences, University of the West Indies, St. Augustine Campus, St. Augustine 330912, Trinidad and Tobago; (K.R.); (S.S.); (A.P.); (A.S.); (S.S.); (N.S.); (P.R.); (A.R.); (B.R.); (C.R.); (R.R.); (D.P.); (T.R.); (V.M.); (E.-M.P.); (S.P.); (K.P.); (S.P.); (J.P.); (S.O.); (T.M.); (J.N.-J.); (B.R.P.); (S.P.); (V.S.); (P.R.); (T.J.); (S.S.); (A.W.); (C.U.); (R.T.); (P.E.A.)
| | - Chelsea Rampaul
- Department of Para-Clinical Sciences, University of the West Indies, St. Augustine Campus, St. Augustine 330912, Trinidad and Tobago; (K.R.); (S.S.); (A.P.); (A.S.); (S.S.); (N.S.); (P.R.); (A.R.); (B.R.); (C.R.); (R.R.); (D.P.); (T.R.); (V.M.); (E.-M.P.); (S.P.); (K.P.); (S.P.); (J.P.); (S.O.); (T.M.); (J.N.-J.); (B.R.P.); (S.P.); (V.S.); (P.R.); (T.J.); (S.S.); (A.W.); (C.U.); (R.T.); (P.E.A.)
| | - Renissa Ramdial
- Department of Para-Clinical Sciences, University of the West Indies, St. Augustine Campus, St. Augustine 330912, Trinidad and Tobago; (K.R.); (S.S.); (A.P.); (A.S.); (S.S.); (N.S.); (P.R.); (A.R.); (B.R.); (C.R.); (R.R.); (D.P.); (T.R.); (V.M.); (E.-M.P.); (S.P.); (K.P.); (S.P.); (J.P.); (S.O.); (T.M.); (J.N.-J.); (B.R.P.); (S.P.); (V.S.); (P.R.); (T.J.); (S.S.); (A.W.); (C.U.); (R.T.); (P.E.A.)
| | - Dana Phagoo
- Department of Para-Clinical Sciences, University of the West Indies, St. Augustine Campus, St. Augustine 330912, Trinidad and Tobago; (K.R.); (S.S.); (A.P.); (A.S.); (S.S.); (N.S.); (P.R.); (A.R.); (B.R.); (C.R.); (R.R.); (D.P.); (T.R.); (V.M.); (E.-M.P.); (S.P.); (K.P.); (S.P.); (J.P.); (S.O.); (T.M.); (J.N.-J.); (B.R.P.); (S.P.); (V.S.); (P.R.); (T.J.); (S.S.); (A.W.); (C.U.); (R.T.); (P.E.A.)
| | - Thalia Ramdhanie
- Department of Para-Clinical Sciences, University of the West Indies, St. Augustine Campus, St. Augustine 330912, Trinidad and Tobago; (K.R.); (S.S.); (A.P.); (A.S.); (S.S.); (N.S.); (P.R.); (A.R.); (B.R.); (C.R.); (R.R.); (D.P.); (T.R.); (V.M.); (E.-M.P.); (S.P.); (K.P.); (S.P.); (J.P.); (S.O.); (T.M.); (J.N.-J.); (B.R.P.); (S.P.); (V.S.); (P.R.); (T.J.); (S.S.); (A.W.); (C.U.); (R.T.); (P.E.A.)
| | - Vinaya Moonilal
- Department of Para-Clinical Sciences, University of the West Indies, St. Augustine Campus, St. Augustine 330912, Trinidad and Tobago; (K.R.); (S.S.); (A.P.); (A.S.); (S.S.); (N.S.); (P.R.); (A.R.); (B.R.); (C.R.); (R.R.); (D.P.); (T.R.); (V.M.); (E.-M.P.); (S.P.); (K.P.); (S.P.); (J.P.); (S.O.); (T.M.); (J.N.-J.); (B.R.P.); (S.P.); (V.S.); (P.R.); (T.J.); (S.S.); (A.W.); (C.U.); (R.T.); (P.E.A.)
| | - Emily-Marie Poliah
- Department of Para-Clinical Sciences, University of the West Indies, St. Augustine Campus, St. Augustine 330912, Trinidad and Tobago; (K.R.); (S.S.); (A.P.); (A.S.); (S.S.); (N.S.); (P.R.); (A.R.); (B.R.); (C.R.); (R.R.); (D.P.); (T.R.); (V.M.); (E.-M.P.); (S.P.); (K.P.); (S.P.); (J.P.); (S.O.); (T.M.); (J.N.-J.); (B.R.P.); (S.P.); (V.S.); (P.R.); (T.J.); (S.S.); (A.W.); (C.U.); (R.T.); (P.E.A.)
| | - Steffan Poonwassie
- Department of Para-Clinical Sciences, University of the West Indies, St. Augustine Campus, St. Augustine 330912, Trinidad and Tobago; (K.R.); (S.S.); (A.P.); (A.S.); (S.S.); (N.S.); (P.R.); (A.R.); (B.R.); (C.R.); (R.R.); (D.P.); (T.R.); (V.M.); (E.-M.P.); (S.P.); (K.P.); (S.P.); (J.P.); (S.O.); (T.M.); (J.N.-J.); (B.R.P.); (S.P.); (V.S.); (P.R.); (T.J.); (S.S.); (A.W.); (C.U.); (R.T.); (P.E.A.)
| | - Karishta Punilal
- Department of Para-Clinical Sciences, University of the West Indies, St. Augustine Campus, St. Augustine 330912, Trinidad and Tobago; (K.R.); (S.S.); (A.P.); (A.S.); (S.S.); (N.S.); (P.R.); (A.R.); (B.R.); (C.R.); (R.R.); (D.P.); (T.R.); (V.M.); (E.-M.P.); (S.P.); (K.P.); (S.P.); (J.P.); (S.O.); (T.M.); (J.N.-J.); (B.R.P.); (S.P.); (V.S.); (P.R.); (T.J.); (S.S.); (A.W.); (C.U.); (R.T.); (P.E.A.)
| | - Sarah Panchoo
- Department of Para-Clinical Sciences, University of the West Indies, St. Augustine Campus, St. Augustine 330912, Trinidad and Tobago; (K.R.); (S.S.); (A.P.); (A.S.); (S.S.); (N.S.); (P.R.); (A.R.); (B.R.); (C.R.); (R.R.); (D.P.); (T.R.); (V.M.); (E.-M.P.); (S.P.); (K.P.); (S.P.); (J.P.); (S.O.); (T.M.); (J.N.-J.); (B.R.P.); (S.P.); (V.S.); (P.R.); (T.J.); (S.S.); (A.W.); (C.U.); (R.T.); (P.E.A.)
| | - Justice Parris
- Department of Para-Clinical Sciences, University of the West Indies, St. Augustine Campus, St. Augustine 330912, Trinidad and Tobago; (K.R.); (S.S.); (A.P.); (A.S.); (S.S.); (N.S.); (P.R.); (A.R.); (B.R.); (C.R.); (R.R.); (D.P.); (T.R.); (V.M.); (E.-M.P.); (S.P.); (K.P.); (S.P.); (J.P.); (S.O.); (T.M.); (J.N.-J.); (B.R.P.); (S.P.); (V.S.); (P.R.); (T.J.); (S.S.); (A.W.); (C.U.); (R.T.); (P.E.A.)
| | - Steven Oudit
- Department of Para-Clinical Sciences, University of the West Indies, St. Augustine Campus, St. Augustine 330912, Trinidad and Tobago; (K.R.); (S.S.); (A.P.); (A.S.); (S.S.); (N.S.); (P.R.); (A.R.); (B.R.); (C.R.); (R.R.); (D.P.); (T.R.); (V.M.); (E.-M.P.); (S.P.); (K.P.); (S.P.); (J.P.); (S.O.); (T.M.); (J.N.-J.); (B.R.P.); (S.P.); (V.S.); (P.R.); (T.J.); (S.S.); (A.W.); (C.U.); (R.T.); (P.E.A.)
| | - Trudy Muir
- Department of Para-Clinical Sciences, University of the West Indies, St. Augustine Campus, St. Augustine 330912, Trinidad and Tobago; (K.R.); (S.S.); (A.P.); (A.S.); (S.S.); (N.S.); (P.R.); (A.R.); (B.R.); (C.R.); (R.R.); (D.P.); (T.R.); (V.M.); (E.-M.P.); (S.P.); (K.P.); (S.P.); (J.P.); (S.O.); (T.M.); (J.N.-J.); (B.R.P.); (S.P.); (V.S.); (P.R.); (T.J.); (S.S.); (A.W.); (C.U.); (R.T.); (P.E.A.)
| | - Johnson Nicholas-Joseph
- Department of Para-Clinical Sciences, University of the West Indies, St. Augustine Campus, St. Augustine 330912, Trinidad and Tobago; (K.R.); (S.S.); (A.P.); (A.S.); (S.S.); (N.S.); (P.R.); (A.R.); (B.R.); (C.R.); (R.R.); (D.P.); (T.R.); (V.M.); (E.-M.P.); (S.P.); (K.P.); (S.P.); (J.P.); (S.O.); (T.M.); (J.N.-J.); (B.R.P.); (S.P.); (V.S.); (P.R.); (T.J.); (S.S.); (A.W.); (C.U.); (R.T.); (P.E.A.)
| | - Bijey Raj Pandit
- Department of Para-Clinical Sciences, University of the West Indies, St. Augustine Campus, St. Augustine 330912, Trinidad and Tobago; (K.R.); (S.S.); (A.P.); (A.S.); (S.S.); (N.S.); (P.R.); (A.R.); (B.R.); (C.R.); (R.R.); (D.P.); (T.R.); (V.M.); (E.-M.P.); (S.P.); (K.P.); (S.P.); (J.P.); (S.O.); (T.M.); (J.N.-J.); (B.R.P.); (S.P.); (V.S.); (P.R.); (T.J.); (S.S.); (A.W.); (C.U.); (R.T.); (P.E.A.)
| | - Sanjeev Pakeerah
- Department of Para-Clinical Sciences, University of the West Indies, St. Augustine Campus, St. Augustine 330912, Trinidad and Tobago; (K.R.); (S.S.); (A.P.); (A.S.); (S.S.); (N.S.); (P.R.); (A.R.); (B.R.); (C.R.); (R.R.); (D.P.); (T.R.); (V.M.); (E.-M.P.); (S.P.); (K.P.); (S.P.); (J.P.); (S.O.); (T.M.); (J.N.-J.); (B.R.P.); (S.P.); (V.S.); (P.R.); (T.J.); (S.S.); (A.W.); (C.U.); (R.T.); (P.E.A.)
| | - Vesham Sookoo
- Department of Para-Clinical Sciences, University of the West Indies, St. Augustine Campus, St. Augustine 330912, Trinidad and Tobago; (K.R.); (S.S.); (A.P.); (A.S.); (S.S.); (N.S.); (P.R.); (A.R.); (B.R.); (C.R.); (R.R.); (D.P.); (T.R.); (V.M.); (E.-M.P.); (S.P.); (K.P.); (S.P.); (J.P.); (S.O.); (T.M.); (J.N.-J.); (B.R.P.); (S.P.); (V.S.); (P.R.); (T.J.); (S.S.); (A.W.); (C.U.); (R.T.); (P.E.A.)
| | - Patrice Richards
- Department of Para-Clinical Sciences, University of the West Indies, St. Augustine Campus, St. Augustine 330912, Trinidad and Tobago; (K.R.); (S.S.); (A.P.); (A.S.); (S.S.); (N.S.); (P.R.); (A.R.); (B.R.); (C.R.); (R.R.); (D.P.); (T.R.); (V.M.); (E.-M.P.); (S.P.); (K.P.); (S.P.); (J.P.); (S.O.); (T.M.); (J.N.-J.); (B.R.P.); (S.P.); (V.S.); (P.R.); (T.J.); (S.S.); (A.W.); (C.U.); (R.T.); (P.E.A.)
| | - Tishia John
- Department of Para-Clinical Sciences, University of the West Indies, St. Augustine Campus, St. Augustine 330912, Trinidad and Tobago; (K.R.); (S.S.); (A.P.); (A.S.); (S.S.); (N.S.); (P.R.); (A.R.); (B.R.); (C.R.); (R.R.); (D.P.); (T.R.); (V.M.); (E.-M.P.); (S.P.); (K.P.); (S.P.); (J.P.); (S.O.); (T.M.); (J.N.-J.); (B.R.P.); (S.P.); (V.S.); (P.R.); (T.J.); (S.S.); (A.W.); (C.U.); (R.T.); (P.E.A.)
| | - Darren Gopaul
- Department of Surgery, Morehouse School of Medicine, Atlanta, GA 30310, USA;
| | - Sachin Soodeen
- Department of Para-Clinical Sciences, University of the West Indies, St. Augustine Campus, St. Augustine 330912, Trinidad and Tobago; (K.R.); (S.S.); (A.P.); (A.S.); (S.S.); (N.S.); (P.R.); (A.R.); (B.R.); (C.R.); (R.R.); (D.P.); (T.R.); (V.M.); (E.-M.P.); (S.P.); (K.P.); (S.P.); (J.P.); (S.O.); (T.M.); (J.N.-J.); (B.R.P.); (S.P.); (V.S.); (P.R.); (T.J.); (S.S.); (A.W.); (C.U.); (R.T.); (P.E.A.)
| | - Odette Arozarena-Barbosa
- Eric Williams Medical Sciences Complex, North Central Regional Health Authority, Champs Fleurs 330912, Trinidad and Tobago (R.A.F.)
| | - Arlene Williams
- Department of Para-Clinical Sciences, University of the West Indies, St. Augustine Campus, St. Augustine 330912, Trinidad and Tobago; (K.R.); (S.S.); (A.P.); (A.S.); (S.S.); (N.S.); (P.R.); (A.R.); (B.R.); (C.R.); (R.R.); (D.P.); (T.R.); (V.M.); (E.-M.P.); (S.P.); (K.P.); (S.P.); (J.P.); (S.O.); (T.M.); (J.N.-J.); (B.R.P.); (S.P.); (V.S.); (P.R.); (T.J.); (S.S.); (A.W.); (C.U.); (R.T.); (P.E.A.)
| | - Chandrashehkar Unakal
- Department of Para-Clinical Sciences, University of the West Indies, St. Augustine Campus, St. Augustine 330912, Trinidad and Tobago; (K.R.); (S.S.); (A.P.); (A.S.); (S.S.); (N.S.); (P.R.); (A.R.); (B.R.); (C.R.); (R.R.); (D.P.); (T.R.); (V.M.); (E.-M.P.); (S.P.); (K.P.); (S.P.); (J.P.); (S.O.); (T.M.); (J.N.-J.); (B.R.P.); (S.P.); (V.S.); (P.R.); (T.J.); (S.S.); (A.W.); (C.U.); (R.T.); (P.E.A.)
| | - Rodolfo Arozarena Fundora
- Eric Williams Medical Sciences Complex, North Central Regional Health Authority, Champs Fleurs 330912, Trinidad and Tobago (R.A.F.)
- Department of Clinical and Surgical Sciences, Faculty of Medical Sciences, University of the West Indies, St. Augustine 330912, Trinidad and Tobago
| | - Reinand Thompson
- Department of Para-Clinical Sciences, University of the West Indies, St. Augustine Campus, St. Augustine 330912, Trinidad and Tobago; (K.R.); (S.S.); (A.P.); (A.S.); (S.S.); (N.S.); (P.R.); (A.R.); (B.R.); (C.R.); (R.R.); (D.P.); (T.R.); (V.M.); (E.-M.P.); (S.P.); (K.P.); (S.P.); (J.P.); (S.O.); (T.M.); (J.N.-J.); (B.R.P.); (S.P.); (V.S.); (P.R.); (T.J.); (S.S.); (A.W.); (C.U.); (R.T.); (P.E.A.)
| | - Patrick Eberechi Akpaka
- Department of Para-Clinical Sciences, University of the West Indies, St. Augustine Campus, St. Augustine 330912, Trinidad and Tobago; (K.R.); (S.S.); (A.P.); (A.S.); (S.S.); (N.S.); (P.R.); (A.R.); (B.R.); (C.R.); (R.R.); (D.P.); (T.R.); (V.M.); (E.-M.P.); (S.P.); (K.P.); (S.P.); (J.P.); (S.O.); (T.M.); (J.N.-J.); (B.R.P.); (S.P.); (V.S.); (P.R.); (T.J.); (S.S.); (A.W.); (C.U.); (R.T.); (P.E.A.)
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Ng CL, Tay EY, D’Souza AR. Localised swelling at sites of dermal filler injections following administration of Covid-19 vaccines: a systematic review. Singapore Med J 2024; 65:665-668. [PMID: 37077055 PMCID: PMC11698283 DOI: 10.4103/singaporemedj.smj-2021-157] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Accepted: 09/07/2021] [Indexed: 04/21/2023]
Abstract
INTRODUCTION Localised swelling at sites of filler injections has been reported in the Moderna mRNA-1273 coronavirus disease 2019 (COVID-19) vaccine trial. METHODS We conducted a review of the existing data and literature on the potential pathophysiology for this adverse event and its potential management. RESULTS Data from the Moderna and Pfizer COVID-19 vaccine Phase 3 trial and one case series were available. Three out of 30,400 subjects developed possible filler reaction in the Moderna trial. Two other cases were reported after emergency use authorisation. Reactions occurred at a mean of 1.4 days post-vaccination. Fillers were injected at a mean of 14.1 months before vaccination. Areas involved included lips, infraorbital areas and tear troughs. Treatment included observation, corticosteroids, antihistamine, hyaluronidase and 5-fluorouracil. CONCLUSION Rare, self-limiting adverse reactions to dermal fillers have been reported following COVID-19 vaccination. Clinicians should be aware of this clinical phenomenon and its management, as vaccination is carried out globally.
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Affiliation(s)
- Chew Lip Ng
- Department of Otolaryngology-Head and Neck Surgery, Ng Teng Fong General Hospital, Singapore
| | | | - Alwyn Ray D’Souza
- Department of Otolaryngology, Lewisham and Greenwich NHS Trust, London, United Kingdom
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Proietti I, Spagnoli A, Favaroni A, Gritti A, Dal Canton M, Quartucci S, Sciuto C, Bertossi D, Patalano M, Cavallini M, Saliani MT, Kefalas N, Angelone E, Mogavero S. HArmonyCa™ hybrid filler to restore connective tissue: An Italian real-life retrospective study. J Cosmet Dermatol 2024; 23:3883-3892. [PMID: 39360597 PMCID: PMC11626326 DOI: 10.1111/jocd.16503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2024] [Revised: 07/01/2024] [Accepted: 07/23/2024] [Indexed: 10/04/2024]
Abstract
BACKGROUND Facial aging and dermal conditions may negatively influence the quality of life, leading patients to seek aesthetic procedures to restore a more satisfying appearance. HArmonyCa™ is a recently developed hybrid filler that combines the actions of the most common dermal fillers, hyaluronic acid (HA) and calcium hydroxylapatite (CaHA). AIMS This study investigates the efficacy and safety of HArmonyCa™ in patients affected by chrono- and photoaging and several facial skin conditions. PATIENTS/METHODS One hundred and twenty-nine patients, affected by chrono- and photoaging, and skin conditions such as oily and acne-prone skin, rosacea, or scarring, were treated with HArmonyCa™. Injections followed the retrograde linear fanning technique. A physicians' consensus identified five optimal entry points. The physician and patients assessed treatment outcomes using the Global Aesthetic Improvement Scale (GAIS) 9 months after treatment (including immediate lift effect, skin firmness, and elasticity), and 3D images were taken for documentation. Adverse events (AEs) were evaluated immediately after the procedure and after 9 months. RESULTS According to the physician's assessments, all patients displayed an improvement in facial appearance, particularly during movement, with the patients' evaluation showing agreement. Only minor AEs were reporte, which resolved spontaneously. Moreover, HArmonyCa™ treatment proved compatible with different medications and aesthetic procedures. CONCLUSIONS This study shows that one treatment with HArmonyCa™ yields highly satisfactory outcomes in patients affected by skin conditions. For the first time, we show that HArmonyCa™ is a dynamic filler that improves facial laxity during movement. The treatment proved to be safe and fully compatible with other cosmetic procedures and medications.
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Affiliation(s)
- Ilaria Proietti
- Department of Medical‐Surgical Sciences and Biotechnologies, Polo PontinoSapienza University of RomeRomeItaly
| | - Alessandra Spagnoli
- Department of Public Health and Infectious DiseasesSapienza University of RomeRomeItaly
| | | | | | | | | | | | - Dario Bertossi
- Section of Oral and Maxillofacial Surgery, Department of Surgical SciencesUniversity of VeronaVeronaItaly
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de Oliveira Ciaramicolo N, Bisson GB, Piedade EDFDS, Osny FJ. Late Facial Edema After Lip Filling With Hyaluronic Acid: Possible Association With the Use of Ozempic. J Craniofac Surg 2024; 35:2110-2112. [PMID: 39190785 DOI: 10.1097/scs.0000000000010588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2024] [Accepted: 07/31/2024] [Indexed: 08/29/2024] Open
Abstract
In recent years there has been an extraordinary increase in the use of different filler materials as facial cosmetic treatments. The popularity of injectable tissue fillers among individuals who wish to restore volume and gain a more youthful appearance is because it is a minimally invasive esthetic procedure for soft tissue augmentation. However, although they are considered efficient and safe, they can trigger complications such as swelling, bruising, erythema, pain, infection, nodule formation, vascular occlusion, and pigmentary changes. The objective of this article was to present a case of a 46-year-old patient who presented with significant facial edema 3 months after lip and infraorbital filling with hyaluronic acid, resistant to medication, which appeared and worsened after starting to use Ozempic for weight loss. Therefore, we chose to perform an intralesional application of hyaluronidase 2.000utr, immediately observing the decrease in edema. After a week, the patient was completely recovered, with no signs of edema, no allergic reactions and feeling very well. The etiology of late inflammatory reactions is unclear and we believe that some medications may be capable of initiating these immune responses. Hyaluronidase is an effective treatment to reverse adverse reactions from hyaluronic acid injection, dissolving the peptide bond proteins within the hyaluronic acid, increasing the viscosity of the material and allowing it to be dispersed throughout the soft tissue.
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Affiliation(s)
- Nathaly de Oliveira Ciaramicolo
- Department of Oral Surgery, Stomatology, Oral Pathology and Oral Radiology, Bauru School Dentistry, University of São Paulo, Bauru, Brazil
| | | | | | - Ferreira Junior Osny
- Department of Oral Surgery, Stomatology, Oral Pathology and Oral Radiology, Bauru School Dentistry, University of São Paulo, Bauru, Brazil
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6
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Bohac M, Chotárová M, Mitevová D, Mayer A. COVID-19 Infection and Vaccination Effects on Breast Implant Illness: A Case Report. Cureus 2024; 16:e69772. [PMID: 39429336 PMCID: PMC11491132 DOI: 10.7759/cureus.69772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/13/2024] [Indexed: 10/22/2024] Open
Abstract
Breast implant illness (BII) is a term used to describe a range of symptoms associated with silicone breast implants. This condition suggests that silicone may trigger symptoms in individuals who are immunologically predisposed, and the spectrum of symptoms may be linked to autonomic dysregulation in these patients. We present the case of a female patient in her mid-40s with a history of autoimmune thyroiditis who had not required prior therapy. She underwent breast augmentation and subsequently developed gradual difficulties. After recovering from a COVID-19 infection, her nonspecific symptoms, consistent with BII, worsened. These symptoms included chronic fatigue, hair loss, dry skin, petechiae, low-grade fever, and frequent urination. Additionally, she developed symptoms associated with long COVID. A subsequent Pfizer-BioNTech COVID-19 vaccination further exacerbated her symptoms and overall condition. Due to the broad spectrum of nonspecific symptoms, the patient underwent numerous screenings over an 18-month period, which were inconclusive. We hypothesize that the vaccination and previous infection had a synergistic effect on her ongoing BII symptoms, contributing to the worsening of her condition. An isolated right-sided seroma with left-sided lymphadenopathy appeared to be a side effect of the vaccine. Additionally, the patient developed a newly diagnosed allergy to polyethylene glycol and other allergic manifestations, such as chronic urticaria, which are consistent with autonomic nervous system dysregulation and long COVID. These symptoms resolved within three weeks of explantation with en bloc capsulectomy. It is noteworthy that the patient was unaware of BII until an MRI revealed a suspected intracapsular implant rupture on the right side, which led to the decision to remove the implants.
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Affiliation(s)
- Martin Bohac
- Plastic Surgery, Faculty of Medicine, Institute of Medical Biology, Genetics and Clinical Genetics, Comenius University Bratislava, Bratislava, SVK
| | | | | | - Alexander Mayer
- Surgery, IV. Department of Surgery, Comenius University in Bratislava, Faculty of Medicine and University Hospital Bratislava, Bratislava, SVK
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7
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Li Y, Jiang Q, Wang H, Wang X. Hypersensitivity Reactions Following Onabotulinum Toxin A Touch-up Injection Possibly Associated with Covid-19 Infection. Aesthetic Plast Surg 2024; 48:3053-3055. [PMID: 37612476 DOI: 10.1007/s00266-023-03584-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 07/28/2023] [Indexed: 08/25/2023]
Abstract
As one of the most common cosmetic procedures, botulinum toxin A (BTX-A) injections are basically safe. The typical allergic reactions include erythema, edema, pruritus, and wheal, which generally occur at the initial injection. Herein, we reported two cases of hypersensitivity reactions following cosmetic BTX-A touch-up injection. Type I allergic reactions provoked by re-exposure to the excipients such as gelatin may play a role in the event. In addition, this condition may be associated with the preceding Covid-19 infection, even with complete symptoms remission and negative tests results. Noteworthily, one case developed anaphylactic symptoms resembling purpuric drug eruption (PDE). These cases may serve as a significant complement to the botulinum toxin treatment safety profiles. LEVEL OF EVIDENCE V: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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Affiliation(s)
- Yiming Li
- Department of Dermatology and Venerology, West China Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China
| | - Qinqin Jiang
- Department of Dermatology, Better and Better Aesthetic Plastic Surgery Hospital, Chengdu, Sichuan, People's Republic of China
| | - Hui Wang
- Department of Plastic Surgery, Better and Better Aesthetic Plastic Surgery Hospital, 335 Shuhan Road, Jinniu district, Chengdu, Sichuan, 610000, People's Republic of China
| | - Xiang Wang
- Department of Plastic Surgery, Better and Better Aesthetic Plastic Surgery Hospital, 335 Shuhan Road, Jinniu district, Chengdu, Sichuan, 610000, People's Republic of China.
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McCarthy AD, van Loghem J, Martinez KA, Aguilera SB, Funt D. A Structured Approach for Treating Calcium Hydroxylapatite Focal Accumulations. Aesthet Surg J 2024; 44:869-879. [PMID: 38366791 PMCID: PMC11333958 DOI: 10.1093/asj/sjae031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 01/23/2024] [Accepted: 01/30/2024] [Indexed: 02/18/2024] Open
Abstract
BACKGROUND Radiesse, a widely utilized calcium hydroxylapatite (CaHA) dermal filler, has shown effectiveness in soft tissue augmentation and regeneration. As with all dermal fillers, the potential for nodules may arise. Understanding the pathogenesis of these nodules and exploring effective treatment methodologies are crucial for optimizing patient outcomes. OBJECTIVES A literature search was carried out to identify published literature documenting reversal of CaHA nodules. After identification, a consensus panel developed a structured approach, denoted by levels, for applying such reversal methods. METHODS This concise review presents an algorithmic approach to addressing CaHA focal accumulations (noninflammatory nodules) based on invasiveness, cost, and potential risks based on published literature. RESULTS Level 0 involves no intervention, relying on natural degradation for asymptomatic nodules. Level 1 interventions utilize mechanical dispersion techniques, including massage and in situ dispersion, which have demonstrated high success rates, cost effectiveness, and minimal invasiveness. Level 2 introduces alternative modalities such as pharmacological treatments with 5-fluorouracil and corticosteroids, lasers, and experimental approaches. Level 3 represents last-resort options, including calcium-chelating agents, manual removal, and surgical excision. CONCLUSIONS The article offers a structured approach to managing CaHA focal accumulations. LEVEL OF EVIDENCE: 4
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Affiliation(s)
| | | | | | | | - David Funt
- Corresponding Author: Dr David Funt, Department of Plastic and Reconstructive Surgery, 1 Gustave L. Levy Pl, New York, NY 10029, USA. E-mail:
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9
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Baranska-Rybak W, Lajo-Plaza JV, Walker L, Alizadeh N. Late-Onset Reactions after Hyaluronic Acid Dermal Fillers: A Consensus Recommendation on Etiology, Prevention and Management. Dermatol Ther (Heidelb) 2024; 14:1767-1785. [PMID: 38907876 PMCID: PMC11265052 DOI: 10.1007/s13555-024-01202-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2024] [Accepted: 05/31/2024] [Indexed: 06/24/2024] Open
Abstract
Hyaluronic acid (HA) dermal fillers, generally considered low-risk, can lead to rare late-onset reactions (LORs) manifesting between 3 and 4 months postinjection, occasionally even as early as 24 h postinjection. The Complication Assessment and Risk Evaluation (CARE) board was established to review these reactions. In this publication, the authors aims to explore the etiological hypotheses underlying LORs, associated risk factors, prevention, and management approaches suggested by the CARE board. The CARE board identified three etiological hypotheses contributing to LORs. Firstly, the physicochemical structure of the filler, particularly low molecular weight HA, which may trigger an immune response. Secondly, infection, potentially introduced during injection or by dormant biofilm activation. Lastly, an imbalance in the host immune system, caused by factors like autoimmune diseases or viral infections, may lead to extended foreign body reactions, delayed type IV hypersensitivity, or adjuvant-based reactions. Based on these hypotheses, the board categorized various risk factors as patient-related (e.g., recent dental treatment, current medical status, active autoimmune disease), product-related (e.g., molecular weight), and procedure-related (e.g., aseptic technique and trauma). To reduce the risk of LORs, the CARE board recommends diligent patient selection, including comprehensive medical history assessment and informed consent. Practitioners should maintain an effective aseptic technique, and choose an appropriate product and injection depth for the anatomical location. Post-procedure, patients should receive education on proper filler care. Management of LORs depends on the suspected etiology, and the CARE board has proposed an algorithm to determine the most appropriate treatment. Hyaluronidase is recommended for noninflammatory reactions in the absence of active infection, while watchful waiting and/or steroid treatment may be preferred for inflammatory reactions. Hyaluronidase is not recommended as a first-line treatment for infections, which require drainage, bacterial culture, and antibiotic treatment. However, the board emphasizes the need for individualized evaluation and treatment in all cases.
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Affiliation(s)
- Wioletta Baranska-Rybak
- Department of Dermatology, Venereology and Allergology, Medical University of Gdansk, Ul. Smoluchowskiego 17, 80-214, Gdańsk, Poland.
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10
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Maredia H, Campbell E, Munavalli G, Cohen J, Comfere N, Wyles S. Delayed foreign body reaction to polymethyl methacrylate-based dermal filler following SARS-CoV-2 vaccination. Int J Dermatol 2024; 63:966-967. [PMID: 38402538 DOI: 10.1111/ijd.17095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2023] [Revised: 01/20/2024] [Accepted: 02/05/2024] [Indexed: 02/26/2024]
Affiliation(s)
- Hasina Maredia
- Department of Dermatology, Mayo Clinic, Rochester, MN, USA
| | | | - Girish Munavalli
- Dermatology, Laser, & Vein Specialists of the Carolinas, Charlotte, NC, USA
| | - Joel Cohen
- Department of Dermatology, University of California Irvine, Irvine, CA, USA
| | - Nneka Comfere
- Department of Dermatology, Mayo Clinic, Rochester, MN, USA
| | - Saranya Wyles
- Department of Dermatology, Mayo Clinic, Rochester, MN, USA
- Center for Aesthetic Medicine and Surgery, Mayo Clinic, Rochester, MN, USA
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11
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Wu Q, Zhang P, Zhou G, Fu Q, Bai R, Ding H, Meng F, Xu X, Chen M. Impact of SARS-CoV-2 Vaccination or Infection on the Safety and Efficacy of Aesthetic Injections: A Systematic Review. Aesthetic Plast Surg 2024; 48:2343-2352. [PMID: 38302710 DOI: 10.1007/s00266-023-03769-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2023] [Accepted: 11/17/2023] [Indexed: 02/03/2024]
Abstract
BACKGROUND Aesthetic injections have become increasingly popular for maintaining a youthful appearance. However, with the rise of SARS-CoV-2, there have been concerns about potential complications. This study aims to summarize and understand the complications that occur in individuals who have received cosmetic injections after SARS-CoV-2 infection or vaccination. By doing so, we hope to provide recommendations to minimize these complications and ensure the safety of aesthetic treatments in the current COVID-19 era. METHODS The PRISMA guidelines, the Preferred Reporting Program for Systematic Reviews and Meta-Analyses, were used for this review. Databases including PubMed, EMBASE, Medline, Web of Science and ScienceDirect were searched. The last search time of each database was May 10, 2023. In addition, relevant references were manually searched. RESULTS A total of 26 studies containing 139 patients were searched. The complication with the highest percentage of reported patients was delayed inflammatory response (DIR) (n = 68; 48.92%), followed by diminished efficacy (n = 45; 32.37%) and filler reaction (n = 12; 8.63%). The remaining complications include hypersensitivity reactions, symptomatic hypercalcemia, sub-acute hypersensitive reactions, hyperalgesia, infection, fat necrosis and granulomatous reaction. CONCLUSIONS Cosmetic injectable procedures are generally safe but may have adverse effects, particularly during the pandemic. It is important for individuals to fully understand these risks beforehand. Clinicians should be knowledgeable about adverse event mechanisms and management to prevent issues. Industry leaders should strengthen risk management efforts to ensure safe and steady development of cosmetic injections. Overall, a comprehensive understanding, effective communication and risk management are crucial for the safe use of cosmetic injectable procedures. LEVEL OF EVIDENCE III This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors at www.springer.com/00266 .
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Affiliation(s)
- Qian Wu
- Department of Medical Service, The Sixth Medical Center of Chinese PLA General Hospital, Beijing, China
- Department of Plastic and Reconstructive Surgery, Senior Department of Burns and Plastic Surgery, The Forth Medical Center of Chinese PLA General Hospital, No. 51 Fucheng Road, Haidian District, Beijing, 10048, China
| | - Peixuan Zhang
- Department of Plastic and Reconstructive Surgery, Senior Department of Burns and Plastic Surgery, The Forth Medical Center of Chinese PLA General Hospital, No. 51 Fucheng Road, Haidian District, Beijing, 10048, China
| | - Guiwen Zhou
- Department of Plastic and Reconstructive Surgery, Senior Department of Burns and Plastic Surgery, The Forth Medical Center of Chinese PLA General Hospital, No. 51 Fucheng Road, Haidian District, Beijing, 10048, China
| | - Qiang Fu
- Department of Plastic and Reconstructive Surgery, Senior Department of Burns and Plastic Surgery, The Forth Medical Center of Chinese PLA General Hospital, No. 51 Fucheng Road, Haidian District, Beijing, 10048, China
| | - Ruiqi Bai
- Department of Plastic and Reconstructive Surgery, Senior Department of Burns and Plastic Surgery, The Forth Medical Center of Chinese PLA General Hospital, No. 51 Fucheng Road, Haidian District, Beijing, 10048, China
| | - Hongfan Ding
- Department of Plastic and Reconstructive Surgery, Senior Department of Burns and Plastic Surgery, The Forth Medical Center of Chinese PLA General Hospital, No. 51 Fucheng Road, Haidian District, Beijing, 10048, China
| | - Fanting Meng
- Department of Plastic and Reconstructive Surgery, Senior Department of Burns and Plastic Surgery, The Forth Medical Center of Chinese PLA General Hospital, No. 51 Fucheng Road, Haidian District, Beijing, 10048, China
| | - Xiao Xu
- Department of Ophthalmology, The Third Medical Center of Chinese PLA General Hospital, No. 69 Yongding Road, Haidian District, Beijing, 100039, China.
| | - Minliang Chen
- Department of Plastic and Reconstructive Surgery, Senior Department of Burns and Plastic Surgery, The Forth Medical Center of Chinese PLA General Hospital, No. 51 Fucheng Road, Haidian District, Beijing, 10048, China.
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12
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Wu PC, Lin WC, Wang CW, Chung WH, Chen CB. Cutaneous adverse reactions associated with COVID-19 vaccines: Current evidence and potential immune mechanisms. Clin Immunol 2024; 263:110220. [PMID: 38642783 DOI: 10.1016/j.clim.2024.110220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 03/04/2024] [Accepted: 04/14/2024] [Indexed: 04/22/2024]
Abstract
As the number of vaccinated individuals has increased, there have been increasing reports of cutaneous hypersensitivity reactions. The main COVID-19 vaccines administered include messenger ribonucleic acid vaccines, non-replicating viral vector vaccines, inactivated whole-virus vaccines, and protein-based vaccines. These vaccines contain active components such as polyethylene glycol, polysorbate 80, aluminum, tromethamine, and disodium edetate dihydrate. Recent advances in understanding the coordination of inflammatory responses by specific subsets of lymphocytes have led to a new classification based on immune response patterns. We categorize these responses into four patterns: T helper (Th)1-, Th2-, Th17/22-, and Treg-polarized cutaneous inflammation after stimulation of COVID-19 vaccines. Although the association between COVID-19 vaccination and these cutaneous adverse reactions remains controversial, the occurrence of rare dermatoses and their short intervals suggest a possible relationship. Despite the potential adverse reactions, the administration of COVID-19 vaccines is crucial in the ongoing battle against severe acute respiratory syndrome coronavirus 2.
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Affiliation(s)
- Po-Chien Wu
- Department of Dermatology, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan; Drug Hypersensitivity Clinical and Research Center, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan; Research Center of Big Data and Meta-Analysis, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Wan-Chen Lin
- Department of Dermatology, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan; Drug Hypersensitivity Clinical and Research Center, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan
| | - Chuang-Wei Wang
- Department of Dermatology, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan; Drug Hypersensitivity Clinical and Research Center, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan; Research Center of Big Data and Meta-Analysis, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan; Cancer Vaccine and Immune Cell Therapy Core Laboratory, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan; Chang Gung Immunology Consortium, Chang Gung Memorial Hospital, Linkou, and Chang Gung University, Taoyuan, Taiwan; Department of Dermatology, Xiamen Chang Gung Hospital, Xiamen, China; College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Wen-Hung Chung
- Department of Dermatology, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan; Drug Hypersensitivity Clinical and Research Center, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan; Cancer Vaccine and Immune Cell Therapy Core Laboratory, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan; Chang Gung Immunology Consortium, Chang Gung Memorial Hospital, Linkou, and Chang Gung University, Taoyuan, Taiwan; Department of Dermatology, Xiamen Chang Gung Hospital, Xiamen, China; College of Medicine, Chang Gung University, Taoyuan, Taiwan; Whole-Genome Research Core Laboratory of Human Diseases, Chang Gung Memorial Hospital, Keelung, Taiwan; Immune-Oncology Center of Excellence, Chang Gung Memorial Hospital, Linkou, Taiwan; Department of Dermatology, Beijing Tsinghua Chang Gung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China; Department of Dermatology, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China; Genomic Medicine Core Laboratory, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Chun-Bing Chen
- Department of Dermatology, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan; Drug Hypersensitivity Clinical and Research Center, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan; Cancer Vaccine and Immune Cell Therapy Core Laboratory, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan; Chang Gung Immunology Consortium, Chang Gung Memorial Hospital, Linkou, and Chang Gung University, Taoyuan, Taiwan; Department of Dermatology, Xiamen Chang Gung Hospital, Xiamen, China; College of Medicine, Chang Gung University, Taoyuan, Taiwan; Whole-Genome Research Core Laboratory of Human Diseases, Chang Gung Memorial Hospital, Keelung, Taiwan; Immune-Oncology Center of Excellence, Chang Gung Memorial Hospital, Linkou, Taiwan; Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan; Genomic Medicine Core Laboratory, Chang Gung Memorial Hospital, Linkou, Taiwan; School of Medicine, National Tsing Hua University, Hsinchu, Taiwan.
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Gibson R, Krug L, Ramsey DL, Safaei A, Aspley S. Beneficial Effects of Multi-Micronutrient Supplementation with Collagen Peptides on Global Wrinkles, Skin Elasticity and Appearance in Healthy Female Subjects. Dermatol Ther (Heidelb) 2024; 14:1599-1614. [PMID: 38811471 PMCID: PMC11169317 DOI: 10.1007/s13555-024-01184-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2024] [Accepted: 05/09/2024] [Indexed: 05/31/2024] Open
Abstract
INTRODUCTION With ageing, collagen production slows down, leading to wrinkle appearance and loss of elasticity. Replenishing key structural molecules through oral supplementation is a promising strategy that complements the topical delivery of cosmetic products and creates a holistic skincare regimen. The present study assessed the effectiveness of a food supplement with collagen peptides, vitamins and minerals in improving the quality of the skin and general wellbeing of healthy women. METHODS This was an open-label study of 135 women aged between 45 and 65 years. A 3-month treatment phase followed a 4-week washout phase, with visits scheduled at baseline and after each month of treatment. Subjects received three tablets of Richelet Skin Renewal daily. The primary outcome was change from baseline to month 3 in global wrinkles score by expert grader analysis. Secondary outcomes included changes in skin elasticity and other skin attributes, product assessment via self-perception questionnaires and total antioxidant status. RESULTS A total of 116 subjects completed the study. The mean global wrinkles score indicated a statistically significant decrease from 5.9 at baseline to 5.0 at month 3 (p < 0.0001), with 83.6% of subjects showing an improvement; significant changes were reported at all intermediate visits. The increase in skin elasticity was also statistically significant (R2 score 0.74 at month 3; p < 0.0001). All subjects (100%) demonstrated significant improvements in skin texture, skin tone evenness, skin radiance and overall skin quality at the month 3 visit. CONCLUSIONS The study product achieved statistically significant, noticeable effects on global wrinkles, skin elasticity and a range of skin attributes after 3 months of use in healthy women. These results strengthen the evidence for supplementation of collagen peptides and other micronutrients as an effective component of anti-ageing skincare.
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Affiliation(s)
| | - Lieselotte Krug
- P&G Health Germany GmbH, Sulzbacher Straße 40-65824, Schwalbach am Taunus, Germany
| | | | - Azadeh Safaei
- P&G Health, Route de Saint George 47, Petit-Lancy 1213, Geneva, Switzerland
| | - Sue Aspley
- P&G, 452 Basingstoke Road, Reading, RG2 0QE, UK
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14
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Poleva I, Szomolai E, Hegedus B, Zhukova O. Multicentric observational study of the possible side effects of the COVID-19 vaccine in relation to absorbable thread insertion. J Cutan Aesthet Surg 2024; 17:100-104. [PMID: 38800814 PMCID: PMC11126218 DOI: 10.4103/jcas.jcas_93_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2024] Open
Abstract
Background Coronavirus disease 2019 (COVID-19) vaccination programs in Europe began in December 2020, and as the number of vaccinated people increased, more information emerged about the possible side effects of vaccines. Recently, some reports appeared around the association of adverse reactions following soft-tissue filler injections and the COVID-19 vaccines. This fact raised the concerns of esthetic practitioners regarding the possibility of the association of the COVID-19 vaccine and adverse effects in other esthetic treatments. Many of us wonder if botox injection, biostimulation, or other procedure could trigger the same or other adverse reactions after the COVID-19 vaccination. Many colleagues postpone esthetic treatments, canceling the appointments. Objective The objective of our investigation was to understand if any adverse reactions have been observed in the patients who underwent threads implantation before and after the vaccination. Materials and Methods Four medical centers have collected the data of the patients treated with absorbable threads before the vaccination and after vaccination for COVID-19. The dossiers of 190 patients with a mean age of 50.4 years were evaluated. Three questionnaires were administered 1 week, 1 month, and 3 months after thread implantation. Results There were no adverse reactions in the groups of patients under monitoring. Only one patient presented signs of inflammation and infection, but they are more probably attributable to the contamination during thread insertion. Conclusions No patients treated with absorbable threads developed adverse events in relation to the COVID-19 vaccine. The only case of inflammation is attributable probably to the contamination of the thread during the procedure.
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Affiliation(s)
- Irina Poleva
- Dermatology Department, CGH Compagnie Generale des Hopitaux di Roma, Roma, Italy
| | | | | | - Olga Zhukova
- Dermatology Department, Moscow Clinic and Science Centre of Aesthetic Medicine, Moscow, Russia
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15
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Thomaidou E, Karlafti E, Didagelos M, Megari K, Argiriadou E, Akinosoglou K, Paramythiotis D, Savopoulos C. Acalculous Cholecystitis in COVID-19 Patients: A Narrative Review. Viruses 2024; 16:455. [PMID: 38543820 PMCID: PMC10976146 DOI: 10.3390/v16030455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Revised: 03/11/2024] [Accepted: 03/13/2024] [Indexed: 05/23/2024] Open
Abstract
Acute acalculous cholecystitis (AAC) represents cholecystitis without gallstones, occurring in approximately 5-10% of all cases of acute cholecystitis in adults. Several risk factors have been recognized, while infectious diseases can be a cause of cholecystitis in otherwise healthy people. Coronavirus disease 2019 (COVID-19) is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and has spread worldwide, leading to an unprecedented pandemic. The virus enters cells through the binding of the spike protein to angiotensin-converting enzyme 2 (ACE2) receptors expressed in many human tissues, including the epithelial cells of the gastrointestinal (GI) tract, and this explains the symptoms emanating from the digestive system. Acute cholecystitis has been reported in patients with COVID-19. The purpose of this review is to provide a detailed analysis of the current literature on the pathogenesis, diagnosis, management, and outcomes of AAC in patients with COVID-19.
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Affiliation(s)
- Evanthia Thomaidou
- Department of Anesthesiology and Intensive Care Unit, AHEPA University General Hospital, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece; (E.T.); (M.D.); (E.A.)
| | - Eleni Karlafti
- Emergency Department, AHEPA University General Hospital, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece;
- First Propaedeutic Internal Medicine Department, AHEPA University General Hospital, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece
| | - Matthaios Didagelos
- Department of Anesthesiology and Intensive Care Unit, AHEPA University General Hospital, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece; (E.T.); (M.D.); (E.A.)
- 1st Cardiology Department, AHEPA University General Hospital, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece
| | - Kalliopi Megari
- CITY College, University of York Europe Campus, 54626 Thessaloniki, Greece;
| | - Eleni Argiriadou
- Department of Anesthesiology and Intensive Care Unit, AHEPA University General Hospital, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece; (E.T.); (M.D.); (E.A.)
| | - Karolina Akinosoglou
- Department of Medicine, University General Hospital of Patras, 26504 Rio, Greece;
| | - Daniel Paramythiotis
- First Propaedeutic Department of Surgery, AHEPA University General Hospital, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece;
| | - Christos Savopoulos
- First Propaedeutic Internal Medicine Department, AHEPA University General Hospital, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece
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16
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Lee W, Shah-Desai S, Rho NK, Cho J. Etiology of Delayed Inflammatory Reaction Induced by Hyaluronic Acid Filler. Arch Plast Surg 2024; 51:20-26. [PMID: 38425859 PMCID: PMC10901605 DOI: 10.1055/a-2184-6554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2023] [Accepted: 08/26/2023] [Indexed: 03/02/2024] Open
Abstract
The etiology and pathophysiology of delayed inflammatory reactions caused by hyaluronic acid fillers have not yet been elucidated. Previous studies have suggested that the etiology can be attributed to the hyaluronic acid filler itself, patient's immunological status, infection, and injection technique. Hyaluronic acid fillers are composed of high-molecular weight hyaluronic acids that are chemically cross-linked using substances such as 1,4-butanediol diglycidyl ether (BDDE). The mechanism by which BDDE cross-links the two hyaluronic acid disaccharides is still unclear and it may exist as a fully reacted cross-linker, pendant cross-linker, deactivated cross-linker, and residual cross-linker. The hyaluronic acid filler also contains impurities such as silicone oil and aluminum during the manufacturing process. Impurities can induce a foreign body reaction when the hyaluronic acid filler is injected into the body. Aseptic hyaluronic acid filler injections should be performed while considering the possibility of biofilm formation or delayed inflammatory reaction. Delayed inflammatory reactions tend to occur when patients experience flu-like illnesses; thus, the patient's immunological status plays an important role in delayed inflammatory reactions. Large-bolus hyaluronic acid filler injections can induce foreign body reactions and carry a relatively high risk of granuloma formation.
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Affiliation(s)
- Won Lee
- Yonsei E1 Plastic Surgery Clinic, Scientific Faculty of the Minimal Invasive Plastic Surgery Association, Dongan-ro, Dongan-gu, Anyang, Republic of Korea
| | | | - Nark-Kyoung Rho
- Department of Dermatology, Sungkyunkwan University School of Medicine, Gyeonggi-do, Republic of Korea. Leaders Aesthetic Laser & Cosmetic Surgery Center, Seoul, Republic of Korea
| | - Jeongmok Cho
- Etonne Plastic Surgery Clinic, Scientific Faculty of the Milimal Invasive Plastic Surgery Association, Seoul, Republic of Korea
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17
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Cheng WJ, Cai ZX, Tang XJ. Adverse reactions to cosmetic implants after COVID-19 vaccination: A literature review. J Cosmet Dermatol 2023; 22:3199-3212. [PMID: 37592436 DOI: 10.1111/jocd.15828] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 04/08/2023] [Accepted: 05/09/2023] [Indexed: 08/19/2023]
Abstract
BACKGROUND As the world's population of people vaccinated with the COVID-19 vaccine increases, adverse reactions are increasingly being reported. There have been progressive reports of the effects of COVID-19 vaccination on cosmetic fillers or prostheses, but they have not been reviewed based on their clinical morphologic patterns. This article reviewed the progress of research on adverse reactions to cosmetic implants after COVID-19 vaccination. METHODS We researched the English-language literature up to October 15, 2022, using predefined keywords to identify relevant studies about adverse reactions to cosmetic implants after the COVID-19 vaccination, collecting patient characteristics, implant type, the time interval between vaccination and implantation or injection, time of onset, symptoms, treatments, and outcomes. RESULTS Among the adverse reactions to implants associated with COVID-19 vaccination, we distinguished between (1) injectable fillers and (2) surgical prosthetic implants. The most common adverse reactions were at the site of hyaluronic acid injection and breast prosthesis after Pfizer vaccination, mainly DIRs, and mainly manifested as edema, rash, fever, and capsular contracture. This paper also reported the possible causes, treatments of DIRs, and limitations of current studies. CONCLUSIONS In this article, we attempted to investigate and discuss all the adverse reactions of cosmetic implants related to COVID-19 vaccination in the current literature, to unmask these reactions and make a more accurate assessment of vaccine safety.
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Affiliation(s)
- Wen-Jie Cheng
- Department of Craniomaxillofacial Surgery, Plastic Surgery Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Zi-Xing Cai
- Xiamen University Medical College, Fujian, China
| | - Xiao-Jun Tang
- Department of Craniomaxillofacial Surgery, Plastic Surgery Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
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18
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Liu X, Tian Y, Jiang C, Dong M, Li M, Sun H, Han X, Li F. The impact of SARS-Cov-2 infection on the periocular injection pain and hypersensitive reaction to botulinum toxin type A: results from clinical questionnaires. Front Cell Infect Microbiol 2023; 13:1240303. [PMID: 37731822 PMCID: PMC10508337 DOI: 10.3389/fcimb.2023.1240303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 08/01/2023] [Indexed: 09/22/2023] Open
Abstract
Background The COVID-19 pandemic has brought about significant changes in the medical field, yet the use of botulinum toxin type A has remained uninterrupted. Plastic surgeons must carefully consider the timing of administering botulinum toxin type A to patients who have recovered from COVID-19. Methods A questionnaire survey was conducted among patients who had contracted and recovered from SARS-CoV-2 within a month. The survey aimed to investigate various indicators in patients who had received botulinum toxin A injections at the same site before and after their infection, including pain scores and allergic reactions and the occurrence of complications. Results The pain scores of patients who contracted SARS-CoV-2 infection between 14-21 days post-infection exhibited significant variation from previous injections. However, patients who contracted the infection between 22-28 days post-infection did not exhibit significant variation from previous injections. Furthermore, the incidence of allergic reactions and complications following botulinum toxin injection within one month after contracting the infection did not significantly differ from that observed prior to infection. Conclusion Administering botulinum toxin type A three weeks after COVID-19 recovery is a justifiable and comparatively secure approach.
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Affiliation(s)
- Xiangyu Liu
- Body Sculpture and Fat Transplantation Center, Plastic Surgery Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
| | - Yanli Tian
- ADD+ Medical Esthetic Clinic, Beijing, China
| | - Chanyuan Jiang
- Body Sculpture and Fat Transplantation Center, Plastic Surgery Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
| | - Miao Dong
- Body Sculpture and Fat Transplantation Center, Plastic Surgery Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
| | - Ming Li
- Body Sculpture and Fat Transplantation Center, Plastic Surgery Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
| | - Hefeng Sun
- Body Sculpture and Fat Transplantation Center, Plastic Surgery Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
| | - Xuefeng Han
- Body Sculpture and Fat Transplantation Center, Plastic Surgery Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
| | - Facheng Li
- Body Sculpture and Fat Transplantation Center, Plastic Surgery Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
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19
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Kroumpouzos G, Harris S, Bhargava S, Wortsman X. Complications of fillers in the lips and perioral area: Prevention, assessment, and management focusing on ultrasound guidance. J Plast Reconstr Aesthet Surg 2023; 84:656-669. [PMID: 37002059 DOI: 10.1016/j.bjps.2023.01.048] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 11/30/2022] [Accepted: 01/29/2023] [Indexed: 03/09/2023]
Abstract
An ever-increasing interest in perioral rejuvenation with dermal fillers reflects the esthetic importance of this region. However, filler injections in the lips and perioral area have been associated with various complications. Such complications are classified according to severity (mild, moderate, severe) or by the time of onset: immediate (within 24 h after injection), early (24 h to 4 weeks post-procedure), and late or delayed (>4 weeks after injection). While most complications are mild and manageable, vascular compromise, infections, and the development of delayed-onset nodules may significantly undermine the ultimate esthetic outcome and cause substantial morbidity. These more serious complications often require more invasive treatment modalities. This article details the prevention and management of such adverse events and discusses safe filler injection principles, including safety recommendations for the lips. Lastly, we highlight the use of ultrasound guidance in complication prevention (vascular mapping, filler identification, location, and extent), assessment (identification of intravascular embolus or external vascular compression by the filler implant), and management (real-time imaging of hyaluronidase or other drug injection in the affected area). Esthetic practitioners should be versed in injection anatomy, and the prevention, recognition, and management of filler complications in the perioral area.
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Affiliation(s)
- George Kroumpouzos
- Department of Dermatology, Warren Alpert Medical School at Brown University, Providence, RI, USA.
| | | | - Shashank Bhargava
- Department of Dermatology, R.D. Gardi Medical College and C.R. Gardi Hospital, Ujjain, India.
| | - Ximena Wortsman
- Institute for Diagnostic Imaging and Research of the Skin and Soft Tissues, Santiago, Chile; Department of Dermatology, Faculty of Medicine, Universidad de Chile, Santiago, Chile; Department of Dermatology, School of Medicine, Pontificia Universidad Catolica de Chile, Santiago, Chile.
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20
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Neamatallah T. Delayed inflammatory reaction to hyaluronic acid lip filler after the Pfizer-BioNTech COVID-19 vaccine: A case report. Heliyon 2023; 9:e18274. [PMID: 37539264 PMCID: PMC10395472 DOI: 10.1016/j.heliyon.2023.e18274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2022] [Revised: 07/07/2023] [Accepted: 07/13/2023] [Indexed: 08/05/2023] Open
Abstract
Hypersensitivity reactions can be a side effect to any vaccine, but they are usually rare. The COVID-19 vaccination may cause hypersensitivity, and several cases of delayed hypersensitivity (DH) to hyaluronic acid (HA) dermal filler have been documented. The current report presents a case of a 36-year-old female patient with DH to HA dermal filler after receiving the Pfizer-BioNTech COVID-19 vaccine. Symptoms, including dryness, swelling, and a painless nodule, appeared after the first and second doses of the vaccine. The patient was treated with intralesional hyaluronidase and triamcinolone in the outpatient clinic. Although HA is relatively safe and routinely used in aesthetic medicine, DH reactions must be considered. Therefore, an appropriate patient history should be obtained, and physicians should provide counselling on the potential reactions to avoid these adverse effects.
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21
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López PV, García PT, López-Pitalúa JA, Pinto H. Side effects after hyaluronic acid facial injection in adults during COVID-19 pandemic. J Cosmet Dermatol 2023; 22:1714-1719. [PMID: 37082890 DOI: 10.1111/jocd.15780] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 03/06/2023] [Accepted: 04/05/2023] [Indexed: 04/22/2023]
Abstract
BACKGROUND Different causes may be responsible for delayed inflammatory reactions after hyaluronic acid injections, among them several mechanisms of SARS-CoV-2. AIMS The study's objective was to assess the percentage of adverse reactions after hyaluronic acid injections in a cohort of adult patients with a test for SARS-CoV-2 or vaccinated during the COVID-19 pandemic. PATIENTS/METHODS An observational, retrospective, comparative, multi-center, non-interventional in a real-life setting study was carried out with patients treated with facial injections of hyaluronic acid from May to September 2021, with a test to discard SARS-COV 2 or that had been vaccinated. RESULTS Sixty-three patients were included. Seven (11.1%) were vaccinated patients without a test for SaRS-CoV-2 and 56 (88.9%) with antigenic or PCR screening tests (18 [32.1%] negative and 39 [69.6%] positives for COVID-19). The mean age was 51.3 (SD 12.71; range 23-70), and 57 (90.5%) were female. Twenty-three patients (36.5%) had a history of adverse events with hyaluronic acid injections. During the study, 15 adverse events were reported; 11 patients (73.3%) had a history (p = 0.0018); two patients (13.3%) had been vaccinated; 13 (86.7%) had performed a SARS-CoV2 test (six [46.2%] negatives, and seven [53.8%] with a positive result; p = 0.5969). All adverse study events were resolved, and none had sequelae. CONCLUSION Adverse events after hyaluronic acid facial injections were higher among patients with a history but not among those diagnosed with COVID-19. The new scenario related to COVID-19 infections or vaccinations would require readapting criteria for applying hyaluronic acid injections.
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Affiliation(s)
| | | | | | - Hernán Pinto
- i2e3 Biomedical Research Institute, Barcelona, Spain
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22
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Azzouz S, Lanoue D, Champagne K, Genest G. Delayed hypersensitivity reaction to cosmetic filler following two COVID-19 vaccinations and infection. Allergy Asthma Clin Immunol 2023; 19:31. [PMID: 37076880 PMCID: PMC10115597 DOI: 10.1186/s13223-023-00788-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Accepted: 04/03/2023] [Indexed: 04/21/2023] Open
Abstract
BACKGROUND With ongoing COVID-19 vaccination schedules and the popularity of cosmetic fillers, it is important to examine and record associated adverse reactions to a more general audience of health care professionals. Case reports exist in subspecialty journals outlining reactions after SARS-CoV-2 infection and vaccination. This is one of the first cases published in Canada, and it highlights priorities and challenges faced by physicians in assessing and managing patients presenting with adverse reactions post vaccination. CASE PRESENTATION We present a case of a 43 -year-old women with delayed type 4 hypersensitivity reaction to hyaluronic acid cosmetic filler triggered by COVID-19 mRNA vaccination. We outline the clinical presentation, diagnosis, complications, and treatment of a late inflammatory reaction to hyaluronic acid filler and highlight the treatment priorities for clinicians faced with similar presentations. CONCLUSION The differential diagnosis of delayed onset nodules formation post filler injection is broad and includes redistribution of fillers, inflammatory reaction to biofilm, and delayed hypersensitivity reaction. As result, in order to make the right diagnosis, administer the appropriate treatment and achieve great cosmetic results, we highly recommend seeking expert opinion from dermatologist, plastic surgeon and allergist immunologist in a timely manner.
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Affiliation(s)
- Safaa Azzouz
- Division of Internal Medicine, McGill University Health Centre, Montréal, Québec, Canada.
| | - Derek Lanoue
- Division of Allergy and Immunology, McGill University Health Centre, Montréal, Québec, Canada
| | - Katéri Champagne
- Institut de Médecine du Sommeil, Town of Mount Royal, QC, Canada
| | - Genevieve Genest
- Division of Allergy and Immunology, McGill University Health Centre, Montréal, Québec, Canada
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23
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Braccini F, Fanian F, Garcia P, Delmar H, Loreto F, Benadiba L, Nadra K, Kestemont P. Comparative clinical study for the efficacy and safety of two different hyaluronic acid-based fillers with Tri-Hyal versus Vycross technology: A long-term prospective randomized clinical trial. J Cosmet Dermatol 2023; 22:473-485. [PMID: 35770300 PMCID: PMC10084174 DOI: 10.1111/jocd.15200] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 06/07/2022] [Accepted: 06/23/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Hyaluronic acid-based fillers have an immediate volumizing effect for the treatment of dermal contour deformities and to smooth dermal depressions formed by the loss of volume. A previous study on 2016-2018 has shown the efficacy and safety of the HA-based filler ART FILLER® Volume on the midface only, but not in a comparative manner. METHODS In this context, an 18 months prospective randomized single-blind study of the non-inferiority of ART FILLER® Volume versus the reference product Juvéderm Voluma® was performed on the midface, temple, and jawline, and non-comparative study on the chin. The efficacy and the longevity were evaluated for the selected face areas via dedicated clinical scoring systems after a single filler injection without any re-touch or re-injection. The short- and long-term adverse effects were also recorded. RESULTS The observations confirmed the non-inferiority of ART FILLER® Volume versus the reference product on the different injected areas. For both fillers, the beneficial effects on volumes restoration were maintained 18 months post-injection; however, these effects were diminished among the time. Furthermore, injections of Art Filler® Volume were well tolerated by the subjects and showed less acute side effects compared with the reference product that may be explained by a lower induction of inflammation.
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24
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Li Z, Zhao P, Xu Q, Bi J, Huo R. Delayed Inflammatory Reactions After Hyaluronic Acid Filling of Neck Lines: A Case Report. Clin Cosmet Investig Dermatol 2023; 16:99-102. [PMID: 36686608 PMCID: PMC9849916 DOI: 10.2147/ccid.s394141] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Accepted: 12/23/2022] [Indexed: 01/15/2023]
Abstract
The incidence of adverse events after hyaluronic acid filling is gradually increasing. In addition to acute reactions in the early postoperative period, there have been some cases of delayed inflammatory reactions. However, such events are rarely reported in Asia, which may be due to atypical symptoms, long intervals, and misidentification of the product quality. Herein, we present a case in which erythema of the neck appeared three weeks after hyaluronic acid injection into the neck lines and a delayed inflammatory reaction was diagnosed. Watchful waiting was performed, and the erythema subsided spontaneously after two weeks. This case suggests that in patients with a history of hyaluronic acid injections who develop allergic and inflammatory reactions after an interval, it is important to consider whether the reaction is a delayed inflammatory reaction, and if aggressive intervention is necessary.
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Affiliation(s)
- Zhiyu Li
- Department of Plastic and Aesthetic Surgery, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong Province, People’s Republic of China
| | - Pu Zhao
- Department of Plastic Surgery, Liaocheng Hospital of Traditional Chinese Medicine, Liaocheng, People’s Republic of China
| | - Qing Xu
- Department of Plastic and Aesthetic Surgery, Maternity and Child Health Care of Zaozhuang, Zaozhuang, People’s Republic of China
| | - Jianhai Bi
- Department of Plastic and Aesthetic Surgery, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong Province, People’s Republic of China,Department of Plastic and Aesthetic Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, People’s Republic of China,Medical Science and Technology Innovation Center, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, People’s Republic of China,Correspondence: Jianhai Bi; Ran Huo, Email ;
| | - Ran Huo
- Department of Plastic and Aesthetic Surgery, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong Province, People’s Republic of China,Department of Plastic and Aesthetic Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, People’s Republic of China,Medical Science and Technology Innovation Center, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, People’s Republic of China
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25
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Montaño-Armendáriz N, Zamudio-Cuevas Y, Fernández-Torres J, Martínez-Flores K, Luján-Juárez IA. [Importance of autoimmunity induced by SARS-CoV-2 and development of post-vaccination autoimmune diseases]. REVISTA ALERGIA MÉXICO 2023; 69:78-88. [PMID: 36928248 DOI: 10.29262/ram.v69i2.1153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 10/23/2022] [Indexed: 01/06/2023] Open
Abstract
SARS-CoV-2, a virus belonging to the large family of coronavirus, aroused great interest following the outbreak of this new strain reported in 2019, in Wuhan China. Its clinical spectrum is highly variable, ranging from a self-limited disease to an acute respiratory distress syndrome with systemic clinical manifestations (COVID-19), in which the immune system plays a key role in the pathophysiology of this disease and in its severity; several studies show the prevalence of some autoimmune markers suggesting that they may lead to autoimmune states. The most important strategy worldwide to protect the population was the development of vaccines to induce immunity to severe COVID-19; however, vaccines have also been shown to have the ability to produce autoimmune states in a small percentage of the world's population; nevertheless, the best strategy remains vaccination. The aim of this review is to show the current overview of the mechanisms of SARS-CoV-2-induced autoimmunity and post-vaccination for a better understanding and identification of these in the population. Publications from 2019 to 2022 were reviewed in PubMed as the primary search source.
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Affiliation(s)
| | - Yessica Zamudio-Cuevas
- Laboratorio de Líquido Sinovial, Instituto Nacional de Rehabilitación "Luis Guillermo Ibarra Ibarra", Ciudad de México, México
| | - Javier Fernández-Torres
- Laboratorio de Líquido Sinovial, Instituto Nacional de Rehabilitación "Luis Guillermo Ibarra Ibarra", Ciudad de México, México
| | - Karina Martínez-Flores
- Laboratorio de Líquido Sinovial, Instituto Nacional de Rehabilitación "Luis Guillermo Ibarra Ibarra", Ciudad de México, México
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Chan SLS, Hsieh MKH, Mok JWL, Kong TY. Delayed prosthetic seroma: a localized inflammatory response to COVID vaccination and infection? EUROPEAN JOURNAL OF PLASTIC SURGERY 2023; 46:125-128. [PMID: 36624820 PMCID: PMC9813890 DOI: 10.1007/s00238-022-02031-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Accepted: 12/05/2022] [Indexed: 01/07/2023]
Abstract
We present a patient whom we believe developed a late abdominal mesh collection in response to COVID-19 mRNA vaccination booster and COVID-19 infection. A polypropylene mesh was placed during her right breast reconstruction operation 2 years ago where she underwent a right transverse abdominis rectus muscle (TRAM) free flap. She recovered uneventfully from this operation. This lady, though vaccinated, developed respiratory symptoms and tested positive for COVID-19 infection 3 days after her booster injection. She then noticed right-sided abdominal swelling 3 days after the onset of respiratory symptoms. She only presented 1 month later due to a 7-day history of pain at the site of abdominal swelling. A computed tomography scan confirmed the presence of a seroma, and she underwent ultrasound-guided percutaneous drainage. A COVID Antigen Rapid Test of the fluid returned positive, though the PCR swab returned negative. There have been no published reports of periprosthetic mesh seroma after COVID-19 vaccination or infection to date. We wanted to share our experience so that other surgeons may be aware of this potential presentation given the current ongoing pandemic. Level of evidence: Level V, risk/prognostic.
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Affiliation(s)
- Stephanie Li-shan Chan
- Department of Plastic, Reconstructive and Aesthetic Surgery, KK Women’s and Children’s Hospital, Women’s Tower, 100 Bukit Timah Road, 229899 Singapore, Singapore
| | - Michael Ku Hung Hsieh
- Department of Plastic, Reconstructive and Aesthetic Surgery, KK Women’s and Children’s Hospital, Women’s Tower, 100 Bukit Timah Road, 229899 Singapore, Singapore
| | - James Wan Loong Mok
- Department of Plastic, Reconstructive and Aesthetic Surgery, KK Women’s and Children’s Hospital, Women’s Tower, 100 Bukit Timah Road, 229899 Singapore, Singapore
| | - Tze Yean Kong
- Department of Plastic, Reconstructive and Aesthetic Surgery, KK Women’s and Children’s Hospital, Women’s Tower, 100 Bukit Timah Road, 229899 Singapore, Singapore
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Michel JC, Perenack JD, Chapple AG, Christensen BJ. Are Delayed Dermal Filler Granulomas More Common Since COVID-19? J Oral Maxillofac Surg 2023; 81:42-48. [PMID: 36270386 PMCID: PMC9507785 DOI: 10.1016/j.joms.2022.09.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 08/29/2022] [Accepted: 09/15/2022] [Indexed: 01/06/2023]
Abstract
PURPOSE Granuloma and delayed inflammatory reaction to hyaluronic acid facial esthetic fillers occurs rarely. More recently, these reactions have been reported with increasing frequency and have been associated with COVID-19 infection. The purpose of the study is to determine if delayed filler granulomas are more common after the start of the COVID-19 pandemic. MATERIALS AND METHODS A retrospective cohort study including of all patients treated with dermal filler at 4 offices of a single cosmetic surgery practice between August 1, 2018 and October 31, 2021 was performed. The primary outcome variable was granuloma formation. The primary predictor variable was time period, either pre-COVID (8/1/18 to 2/29/20) or post-COVID (3/1/20 to 10/31/21). Other study variables recorded were age, amounts of dermal fillers used, and types of dermal filler used. Data were analyzed using chi-squared test, t-tests, and logistic regression. RESULTS Over the study period, 3,255 patients receiving 8,067 syringes of filler over 6,800 sessions were reviewed. The average patient age was 46.8 ± 13.7 years and 2,583 sessions were performed in the pre-COVID time period and 4,217 sessions in the post-COVID time period. There were 11 granulomas in 9 subjects receiving filler in the post-COVID time period and 0 granulomas in the pre-COVID time period (0.3% vs 0.0%, respectively, P = .009). Juvederm Vollure was used in 64% of patients who developed granulomas but only accounted for 26% of filler administrations in the post-COVID time period and 28% in the cohort overall (P = .02). CONCLUSIONS Granuloma formation is a rare complication of hyaluronic acid filler injection that appears to be occurring with more frequency following the COVID-19 pandemic. Practitioners who administer dermal fillers should be aware of this complication and its apparent increased incidence.
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Affiliation(s)
- Jonathan C. Michel
- Facial Cosmetic Surgery Fellow, Department of Oral and Maxillofacial Surgery, Louisiana State University Health Sciences Center New Orleans, New Orleans, LA,Address correspondence and reprint requests to Dr Michel: Department of Oral and Maxillofacial Surgery, Louisiana State University Health Sciences Center, School of Dentistry, 1100 Florida Avenue #220, New Orleans, LA 70119
| | - Jon D. Perenack
- Fellowship Director and Associate Clinical Professor, Department of Oral and Maxillofacial Surgery, Louisiana State University Health Sciences Center New Orleans, New Orleans, Louisiana; and Medical and Surgical Director, Williamson Cosmetic Center and Perenack Aesthetic Surgery, Baton Rouge, LA
| | - Andrew G. Chapple
- Assistant Professor, Biostatistics Program, School of Public Health, Louisiana State University Health Sciences Center New Orleans, New Orleans, LA
| | - Brian J. Christensen
- Assistant Professor, Department of Oral & Maxillofacial Surgery, Louisiana State University Health Sciences Center New Orleans, New Orleans, LA
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Late Hypersensitivity Reactions to the BNT162b2 SARS-CoV-2 Vaccine Are Linked to Delayed Skin Sensitization and Prior Exposure to Hyaluronic Acid. Life (Basel) 2022; 12:life12122021. [PMID: 36556386 PMCID: PMC9784938 DOI: 10.3390/life12122021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 11/20/2022] [Accepted: 11/30/2022] [Indexed: 12/12/2022] Open
Abstract
Background: Late hypersensitivity reactions (HSRs) to the BNT162b2-vaccine have raised concerns regarding its safety, particularly as further immunizations are required. The yield of skin testing with the BNT162b2v is unclear, as well as the risk factors and outcomes of re-immunization after late HSRs. Objective: We studied a series of patients with late HSRs to BNT162b2v. Methods: Patients referred to the Sheba medical center from December 2020 to May 2021 with late HSRs to the first dose of BNT162b2 were included. HSRs were defined as late if they appeared or lasted >24 h after inoculation. We compared late HSRs to immediate HSRs that appeared within minutes−2 h after vaccination. Intradermal testing with PEG-containing medication and BNT162b2v was performed. Results: A total of 17 patients that presented with late HSRs (study group) were compared to 34 patients with immediate HSRs (control group). Delayed sensitivity to intradermal testing of the BNT162b2v was observed in 9/17 (53%) of the study group compared to 4/34 (12%) in the control group (p = 0.01). Former exposure to a dermal filler with hyaluronic acid was documented among 7/17 (41%) vs. 2/34 (6%) in the study and control groups, respectively, (p = 0.0038). All patients who presented with late HSRs were advised to receive subsequent doses of the BNT162b2v vaccine with or without concomitant medication, and all were re-immunized successfully. Conclusions: Late HSRs to BNT162b2v were linked with positive responses to intradermal testing with the vaccine and prior exposure to derma fillers with hyaluronic acid. This may elude to an immune mechanism triggered by former exposures. Although further studies are needed, late HSRs to the BNT162b2-vaccine did not prevent patients from receiving subsequent doses of the vaccines.
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Hosseinzadeh A, Ebrahimi K, Shahriarirad R, Dalfardi F. Lower limb lymphedema and cellulitis as a complication of COVID-19 vaccine: A case report. Clin Case Rep 2022; 10:e6317. [PMID: 36540881 PMCID: PMC9755814 DOI: 10.1002/ccr3.6317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 08/21/2022] [Accepted: 08/24/2022] [Indexed: 12/23/2022] Open
Abstract
A 68-year-old man without complications following his first dose of Sinopharm (BBIBP-CorV) COVID-19 vaccine developed left foot and ankle edema, extending to his left leg 3 days after his second dose. Color-Doppler sonography and lymphoscintigraphy showed extensive soft tissue swelling and fat edema in both legs, proposing lymphatic drainage disorder.
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Affiliation(s)
- Ahmad Hosseinzadeh
- Thoracic and Vascular Surgery Research CenterShiraz University of Medical SciencesShirazIran
| | - Kamyar Ebrahimi
- Thoracic and Vascular Surgery Research CenterShiraz University of Medical SciencesShirazIran
- School of MedicineShiraz University of Medical SciencesShirazIran
| | - Reza Shahriarirad
- Thoracic and Vascular Surgery Research CenterShiraz University of Medical SciencesShirazIran
- School of MedicineShiraz University of Medical SciencesShirazIran
| | - Farzad Dalfardi
- Thoracic and Vascular Surgery Research CenterShiraz University of Medical SciencesShirazIran
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Dim‐Jamora KCC, Gulmatico‐Flores Z, Rescober‐Valencia MC, Lacson S, Ingente‐Tablante M, Robredo‐Vitas IG, Ang‐Tiu C, Sy‐Alvarado FMS, Ferrariz TS, Espinoza‐Thaebtharm A. Effect of the COVID-19 vaccine on facial aesthetic injectables and suspension threads among patients treated by the Philippine Dermatological Society (PDS) dermatologists. J Cosmet Dermatol 2022; 21:6562-6563. [PMID: 36200924 PMCID: PMC9874609 DOI: 10.1111/jocd.15417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 09/13/2022] [Accepted: 09/26/2022] [Indexed: 01/28/2023]
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Lee SH, Cho M, Han Y, Woo YR, Cho SH, Lee JD, Kim HS. A case of late-onset granuloma 10 years after illegal filler injection. J Cosmet Dermatol 2022; 21:6515-6517. [PMID: 35971875 DOI: 10.1111/jocd.15304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 07/21/2022] [Accepted: 08/12/2022] [Indexed: 12/27/2022]
Affiliation(s)
- Se Hoon Lee
- Department of Dermatology, Incheon St. Mary's Hospital, The Catholic University of Korea, Seoul, South Korea
| | - Minah Cho
- Department of Dermatology, Incheon St. Mary's Hospital, The Catholic University of Korea, Seoul, South Korea
| | - Yujin Han
- Department of Dermatology, Incheon St. Mary's Hospital, The Catholic University of Korea, Seoul, South Korea
| | - Yu Ri Woo
- Department of Dermatology, Incheon St. Mary's Hospital, The Catholic University of Korea, Seoul, South Korea
| | - Sang Hyun Cho
- Department of Dermatology, Incheon St. Mary's Hospital, The Catholic University of Korea, Seoul, South Korea
| | - Jeong Deuk Lee
- Department of Dermatology, Incheon St. Mary's Hospital, The Catholic University of Korea, Seoul, South Korea
| | - Hei Sung Kim
- Department of Dermatology, Incheon St. Mary's Hospital, The Catholic University of Korea, Seoul, South Korea.,Department of Biomedicine & Health Sciences, The Catholic University of Korea, Seoul, South Korea
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Imen MT. Delayed infectious reactions of dermal filler injections in the face: Causes and management. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2022; 124:101334. [PMID: 36400392 DOI: 10.1016/j.jormas.2022.11.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 11/09/2022] [Accepted: 11/14/2022] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Nowadays, dermal filler injections in the face, are widespread. However, late complications are rarely reported and misunderstood. Moreover, they could be potentially severe, particularly cellulitis which is life-threatening. Reactivation of the biofilm and the hypersensitivity reaction are the main etiopathogenic factors of such unpredictable infections and granuloma reactions. Through four cases of foreign-body cellulitis, this article aims to explain the causality of filler material, and trigger conditions while emphasizes the prompt and adequate solution. MATERIAL AND METHODS This work is a retrospective study and chart review which was granted an exemption by the author's institutional review board (IRB). Four women ranging from 27 to 55 years old, presented with onset symptoms of cellulitis of the face and inflammatory swelling of the lip. The hyaluronic acid filler was injected a long date prior. Trigger conditions caused the hatching of such complications which were solved with medical treatment without any filler dissolution or removal. RESULTS Improvement of the symptoms was remarkable within the three and fifth days of antibiotic therapy. There was no abscess formation or, recurrence for more than one-year follow-up. CONCLUSION The screening for dermal filler deposits must be considered for any inflammatory reaction of the face. Their causality should be discussed as well as the infectious and/or immunologic etiology, ensuring prompt and adequate medical treatment. Thus abscess formation could then not happen, and the resolution of the inflammatory reaction will be obtained. The extraction of filler material or the use of hyaluronidase should not be mandatory and will be done on a case-by-case basis.
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Washrawirul C, Triwatcharikorn J, Phannajit J, Ullman M, Susantitaphong P, Rerknimitr P. Global prevalence and clinical manifestations of cutaneous adverse reactions following COVID-19 vaccination: A systematic review and meta-analysis. J Eur Acad Dermatol Venereol 2022; 36:1947-1968. [PMID: 35666609 PMCID: PMC9348179 DOI: 10.1111/jdv.18294] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 05/18/2022] [Indexed: 01/08/2023]
Abstract
Although vaccination is widely accepted as an effective method of preventing and controlling the COVID-19 pandemic, many people are concerned about possible cutaneous side-effects, which can delay or prevent them from being vaccinated. The objectives of this systematic review were to assess the global prevalence and clinical manifestations of cutaneous adverse reactions following COVID-19 vaccination. PubMed and Scopus databases were searched for articles published from 1 January 2019 to 31 December 2021, and reference lists for each selected article were screened. Case reports, case series, observational studies and randomized controlled trials that provided information on cutaneous adverse reactions following COVID-19 vaccines were included. A total of 300 studies were included in a systematic review of which 32 studies with 946 366 participants were included in the meta-analysis. The pooled prevalence of cutaneous manifestations following COVID-19 vaccination was 3.8% (95% CI, 2.7%-5.3%). COVID-19 vaccines based on the mRNA platform had a higher prevalence than other platforms at 6.9% (95% CI, 3.8%-12.3%). Various cutaneous manifestations have been reported from injection site reactions, which were the most common (72.16%) to uncommon adverse reactions such as delayed inflammatory reactions to tissue filler (0.07%) and flares of pre-existing dermatoses (0.07%). Severe cutaneous reactions such as anaphylaxis have also been reported, but in rare cases (0.05%). In conclusion, cutaneous adverse reactions are common, especially in those receiving mRNA vaccines. Most reactions are mild and are not contraindications to subsequent vaccination except for anaphylaxis, which rarely occurs. COVID-19 vaccination may also be associated with flares of pre-existing dermatoses and delayed inflammatory reactions to tissue filler. Patients with a history of allergies, pre-existing skin conditions or scheduled for filler injections should receive additional precounselling and monitoring. A better understanding of potential side-effects may strengthen public confidence in those wary of new vaccine technologies.
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Affiliation(s)
- C. Washrawirul
- Division of Dermatology, Department of Medicine, Faculty of MedicineChulalongkorn UniversityBangkokThailand
| | - J. Triwatcharikorn
- Division of Dermatology, Department of Medicine, Faculty of MedicineChulalongkorn UniversityBangkokThailand
| | - J. Phannajit
- Division of Nephrology, Department of Medicine, Faculty of MedicineChulalongkorn UniversityBangkokThailand
- Division of Clinical Epidemiology, Department of Medicine, Faculty of MedicineChulalongkorn UniversityBangkokThailand
- King Chulalongkorn Memorial HospitalThai Red Cross SocietyBangkokThailand
- Research Unit for Metabolic Bone Disease in CKD Patients, Faculty of MedicineChulalongkorn UniversityBangkokThailand
| | - M. Ullman
- Department of Research AffairsChulalongkorn UniversityBangkokThailand
| | - P. Susantitaphong
- Division of Nephrology, Department of Medicine, Faculty of MedicineChulalongkorn UniversityBangkokThailand
- King Chulalongkorn Memorial HospitalThai Red Cross SocietyBangkokThailand
- Research Unit for Metabolic Bone Disease in CKD Patients, Faculty of MedicineChulalongkorn UniversityBangkokThailand
| | - P. Rerknimitr
- Division of Dermatology, Department of Medicine, Faculty of MedicineChulalongkorn UniversityBangkokThailand
- Skin and Allergy Research UnitChulalongkorn UniversityBangkokThailand
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Himed S, Gray A, Awethe Z, Libson K, Kaffenberger BH, Korman AM, Trinidad JCL. SARS-CoV-2 Infection and Vaccination Cutaneous Manifestations for the Inpatient Dermatologist. CURRENT DERMATOLOGY REPORTS 2022; 11:252-262. [PMID: 36274753 PMCID: PMC9579541 DOI: 10.1007/s13671-022-00374-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/25/2022] [Indexed: 11/26/2022]
Abstract
Purpose of Review The overall purpose of this review was to characterize and summarize cutaneous eruptions associated with coronavirus disease 2019 (COVID-19) as well as COVID-19 vaccination. Recent Findings Cutaneous eruptions associated with COVID-19 infection have a reported frequency of 1-20%. Increased COVID-19 disease severity has been associated with morbilliform exanthems, urticaria, retiform purpura, and livedo racemosa. Papulovesicular eruptions were associated with a milder COVID-19 disease course. A range of dermatoses have also been reported with COVID-19 vaccination but have rarely prevented subsequent vaccination. Summary Dermatologists should be aware of the associations between COVID-19 disease severity and cutaneous eruptions. Livedo racemosa and retiform purpura are particularly associated with increased disease severity and death. In the setting of COVID-19 vaccination, cutaneous eruptions can largely be managed symptomatically and very rarely do these reactions prevent subsequent vaccination.
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Affiliation(s)
- Sonia Himed
- College of Medicine, University of Cincinnati, Cincinnati, OH USA
| | - Ashley Gray
- Division of Dermatology, Department of Internal Medicine, The Ohio State University, Columbus, OH USA
| | - Zaynah Awethe
- Division of Dermatology, Department of Internal Medicine, The Ohio State University, Columbus, OH USA
| | - Karissa Libson
- Division of Dermatology, Department of Internal Medicine, The Ohio State University, Columbus, OH USA
| | - Benjamin H. Kaffenberger
- Division of Dermatology, Department of Internal Medicine, The Ohio State University, Columbus, OH USA
| | - Abraham M. Korman
- Division of Dermatology, Department of Internal Medicine, The Ohio State University, Columbus, OH USA
| | - John C. L. Trinidad
- Department of Dermatology, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114 USA
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35
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Singh R, Freeman EE. Viruses, Variants, and Vaccines: How COVID-19 Has Changed the Way We Look at Skin. CURRENT DERMATOLOGY REPORTS 2022; 11:289-312. [PMID: 36274754 PMCID: PMC9574791 DOI: 10.1007/s13671-022-00370-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/28/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Rhea Singh
- Department of Dermatology, Massachusetts General Hospital, Harvard Medical School, 50 Staniford St, Boston, MA 02114 USA
- Virginia Commonwealth University School of Medicine, Richmond, VA USA
| | - Esther E. Freeman
- Department of Dermatology, Massachusetts General Hospital, Harvard Medical School, 50 Staniford St, Boston, MA 02114 USA
- Medical Practice Evaluation Center, Mongan Institute, Massachusetts General Hospital, Boston, MA USA
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36
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López Pérez V. [Translated article] COVID-19 and Dermal Fillers: Should We Really Be Concerned? ACTAS DERMO-SIFILIOGRAFICAS 2022; 113:T888-T894. [PMID: 35952917 PMCID: PMC9359628 DOI: 10.1016/j.ad.2022.08.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 05/22/2022] [Indexed: 11/21/2022] Open
Abstract
SARS-CoV-2 has caused millions of infections and deaths worldwide and case numbers continue to rise. Besides the effect of the virus on key organs - leading to respiratory illness, anosmia, diarrhea, and fever and other complications - delayed inflammatory reactions to hyaluronic acid dermal fillers, mainly in the face, have also been reported to occur after confirmed SARS-CoV-2 infections and in vaccinated individuals. While delayed inflammatory reactions tend to be self-limiting, they should be diagnosed and treated with corticosteroids, hyaluronidase, and/or antibiotics when necessary. The inflammation is generally not severe, yet these complications are classified as serious adverse events by the US Food and Drug Administration. They appear to be delayed type IV hypersensitivity reactions triggered by the immune system in the presence of SARS-CoV-2 or other viruses, such as those causing influenza, although the underlying mechanisms have not been fully elucidated. Because the longevity of dermal fillers is increasing, while the pandemic continues to evolve and new vaccines are under development, the long-term effects on hyaluronic acid fillers and other bioimplant materials should be studied. Physicians must also be encouraged to report these reactions, however mild, to ensure accurate records.
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Affiliation(s)
- V López Pérez
- Servicio de Anestesiología y Reanimación, Hospital Universitario 12 de Octubre, Madrid, Spain; Médico Estético, AG BIOMEDIC CLINIC, Madrid, Spain.
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Aryanian Z, Ehsani A, Razavi Z, Hamzelou S, Mohseni Afshar Z, Hatami P. The COVID-19 pandemic and its impact on esthetic dermatology. J Cosmet Dermatol 2022; 21:6557-6561. [PMID: 36106524 PMCID: PMC9538429 DOI: 10.1111/jocd.15386] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 09/12/2022] [Indexed: 01/06/2023]
Abstract
In general, the world population interest has increased for maintaining youthfulness and having better appearance since this leads to a better mental wellbeing and self-estimate. The coronavirus disease 2019 (COVID-19) pandemic has revolutionized every field of medicine. As every specialty has been affected by limitations caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), this branch of medicine has also needed certain precautions for safer practice in the COVID era. With the global vaccination program against COVID-19, reports of some cutaneous reactions in patients have been undergone various esthetic procedures including filler or botox injection would be increasingly demonstrated. Although the end of pandemic was announced, the necessity of continuing COVID vaccination in future mandates gathering data regarding safety of vaccines. Herein, we presented a comprehensive review on various aspects of association between esthetic medicine or cosmetic dermatology and COVID-19.
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Affiliation(s)
- Zeinab Aryanian
- Autoimmune Bullous Diseases Research Center, Razi HospitalTehran University of Medical SciencesTehranIran,Department of DermatologyBabol University of Medical SciencesBabolIran
| | - Amirhooshang Ehsani
- Autoimmune Bullous Diseases Research Center, Razi HospitalTehran University of Medical SciencesTehranIran,Department of Dermatology, School of Medicine, Razi HospitalTehran University of Medical SciencesTehranIran
| | - Zahra Razavi
- Autoimmune Bullous Diseases Research Center, Razi HospitalTehran University of Medical SciencesTehranIran,Department of Dermatology, School of Medicine, Razi HospitalTehran University of Medical SciencesTehranIran
| | - Shahin Hamzelou
- Department of Dermatology, School of Medicine, Razi HospitalTehran University of Medical SciencesTehranIran
| | - Zeinab Mohseni Afshar
- Clinical Research Development Center, Imam Reza HospitalKermanshah University of Medical SciencesKermanshahIran
| | - Parvaneh Hatami
- Autoimmune Bullous Diseases Research Center, Razi HospitalTehran University of Medical SciencesTehranIran
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Mahdiabadi S, Rezaei N. Anaphylaxis and allergic reactions to COVID-19 vaccines: A narrative review of characteristics and potential obstacles on achieving herd immunity. Health Sci Rep 2022; 5:e787. [PMID: 36032518 PMCID: PMC9401640 DOI: 10.1002/hsr2.787] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 07/29/2022] [Accepted: 08/01/2022] [Indexed: 12/24/2022] Open
Abstract
Background and Aims Coronavirus disease 2019 (COVID-19) is a highly contagious infection, and new variants of its causative virus continue to emerge all around the world. Meanwhile, mass vaccination represents a highly effective measure to reduce the disease burden. Not only do vaccines immunize individuals, but they also protect the entire population through achieving herd immunity. They are composed of various ingredients, some of which may induce hypersensitivity reactions, namely anaphylaxis and cutaneous allergic reactions. This review aims to provide an explicit overview of the pathophysiology, suspected responsible components, and management of COVID-19 vaccine-induced allergic reactions, and their effect on acquiring herd immunity. Methods To perform this narrative review, a comprehensive literature search based on our selected terms was conducted in online databases of PubMed/Medline and Google Scholar for finding the relevant studies published from 2019 to 2022. Results COVID-19 vaccines introduce several advantages that outweigh their potential risks, such as allergic reactions. Allergic reactions are mainly attributed to polyethylene glycol and polysorbate excipients that can provoke IgE-mediated reactions and hypersensitivity reactions. These reactions should be managed properly to avoid having serious sequelae. Conclusion It is of great importance to immediately recognize and manage vaccine hypersensitivity reactions, especially anaphylaxis, to avoid allergic patients being excluded from the vaccination program, and more importantly, to stop the spreading of unfounded vaccine hesitancy leading to delayed herd immunity.
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Affiliation(s)
- Sara Mahdiabadi
- School of MedicineTehran University of Medical SciencesTehranIran
- Network of Immunity in Infection, Malignancy and Autoimmunity (NIIMA), Universal Scientific Education and Research Network (USERN), Children's Medical CenterTehranIran
- Research Center for Immunodeficiencies, Pediatrics Center of Excellence, Children's Medical CenterTehran University of Medical SciencesTehranIran
| | - Nima Rezaei
- Network of Immunity in Infection, Malignancy and Autoimmunity (NIIMA), Universal Scientific Education and Research Network (USERN), Children's Medical CenterTehranIran
- Research Center for Immunodeficiencies, Pediatrics Center of Excellence, Children's Medical CenterTehran University of Medical SciencesTehranIran
- Department of Immunology, School of MedicineTehran University of Medical SciencesTehranIran
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Chan SLS, Mok JWL. Late Seroma in Breast Implants: A Coronavirus Disease 2019 Phenomenon? Arch Plast Surg 2022; 49:611-613. [PMID: 36159375 PMCID: PMC9507605 DOI: 10.1055/s-0042-1756295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Accepted: 07/07/2022] [Indexed: 10/31/2022] Open
Abstract
The coronavirus disease 2019 (COVID-19) pandemic has been challenging in all aspects of the medical field with new clinical presentations constantly arising. Plastic surgeons are not immune to this and need to be aware of their implications. There has been a recent report of late periprosthetic seroma (breast implant) as a clinical manifestation of COVID-19 infection. To our knowledge, this phenomenon has not been further reported. We present a 53-year-old immunocompromised lady who developed late seroma after COVID-19 infection. She eventually required explantation of the implant and is awaiting autologous reconstruction. It is likely that we will increasingly continue to see this phenomenon of implant complications as a result of COVID-19 infection and should be watchful, especially regarding potential immunocompromised patients.
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Affiliation(s)
- Stephanie L S Chan
- Department of Plastic, Reconstructive and Aesthetic Surgery, KK Women's and Children's Hospital, Singapore
| | - James Wan Loong Mok
- Department of Plastic, Reconstructive and Aesthetic Surgery, KK Women's and Children's Hospital, Singapore
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40
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Safir A, Samuelov L, Sprecher E, Daniely D, Artzi O. Association between BNT162b2 vaccination and the development of delayed inflammatory reactions to hyaluronic acid-based dermal fillers - A nationwide survey. J Cosmet Dermatol 2022; 21:4107-4113. [PMID: 35861599 PMCID: PMC9350399 DOI: 10.1111/jocd.15260] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 06/29/2022] [Accepted: 07/19/2022] [Indexed: 12/02/2022]
Abstract
Background Delayed inflammatory reactions (DIRs) to hyaluronic acid (HA)‐based dermal fillers following COVID‐19 vaccination has been reported in a few anecdotal reports and small series of cases. Aim To evaluate the clinical characteristics, incidence and management options relevant to BNT162b2 vaccination‐associated DIR – A nationwide survey was conducted. Methods An online self‐administered survey was sent to physicians who actively practice tissue filler injections. The data acquired included demographic and clinical characteristics of relevant DIR cases. Results Out of 262 responders, 20 cases with DIR following the vaccination were reported. 35% and 65% occurred shortly after the first and second vaccination dose, respectively. Overall, 65% of the DIRs appeared ≤5 days after vaccine administration and most DIRs resolved within 21 days. The filler's volume (P = .016) was associated with higher DIR severity, and the same tendency was noted among some filler types and locations of injection. Medical intervention was provided in 12 (60%) cases. Conclusion DIR associated with BNT162b2 vaccination is rare and tends to resolve spontaneously or with short‐term medical intervention.
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Affiliation(s)
- Ari Safir
- Division of Dermatology, , Tel Aviv Medical Center, Tel Aviv, Israel
| | - Liat Samuelov
- Division of Dermatology, , Tel Aviv Medical Center, Tel Aviv, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Eli Sprecher
- Division of Dermatology, , Tel Aviv Medical Center, Tel Aviv, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Danny Daniely
- Division of Dermatology, , Tel Aviv Medical Center, Tel Aviv, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Ofir Artzi
- Division of Dermatology, , Tel Aviv Medical Center, Tel Aviv, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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41
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Orbital Sarcoidosis Masquerading as Late Postoperative Blepharoplasty Complication: A Case Report. Ophthalmic Plast Reconstr Surg 2022; 38:e113-e116. [DOI: 10.1097/iop.0000000000002160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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42
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Abstract
BACKGROUND Delayed-onset reactions are increasingly relevant given the growing use of hyaluronic acid dermal fillers. There is poor understanding of the phenomenon's etiology and incidence. OBJECTIVE To highlight differences between the dermal filler products with an emphasis on delayed-onset reaction incidence, pathogenesis, prevention, and treatment. METHODS A literature review was performed for delayed-onset reactions following hyaluronic acid dermal filler injection using PubMeb and Embase. Articles were included based on relevance, quality, and the predetermined definition of "delayed-onset reaction" (>30 days post injection). A total of 28 studies were included in the data analysis. RESULTS A total of 13,136 subjects from 28 studies treated with 15 filler types were included in the analysis. VYC-15L dermal filler injections carried the highest risk of delayed reaction with a mean incidence of 3.83% ( n = 46/1,202), followed by VYC-20L (0.92%) and VYC-17.5L (0.88%). The mean incidence of delayed reactions among all filler types was 1.13%. CONCLUSION Incidence of delayed reaction to hyaluronic fillers ranges from 0% to 3.83% (mean = 1.13%) and varies by filler type. The exact etiology of these delayed reactions remains disputed. Future studies should report reaction description, precise timeline, and posttreatment immunologic history to better delineate the incidence of delayed-onset hypersensitivity reactions.
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Affiliation(s)
- Ryan E Kokoska
- All authors are affiliated with the Department of Dermatology, Indiana University School of Medicine, Indianapolis, Indiana
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43
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Ding YW, Wang ZY, Ren ZW, Zhang XW, Wei DX. Advances in modified hyaluronic acid-based hydrogels for skin wound healing. Biomater Sci 2022; 10:3393-3409. [PMID: 35575243 DOI: 10.1039/d2bm00397j] [Citation(s) in RCA: 68] [Impact Index Per Article: 22.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2025]
Abstract
Hyaluronic acid (HA) is a natural linear anionic polysaccharide with many unique characteristics such as excellent biocompatibility and biodegradability, native biofunctionality, hydrophilicity, and non-immunoreactivity. HA plays crucial roles in numerous biological processes, including the inflammatory response, cell adhesion, migration, proliferation, differentiation, angiogenesis, and tissue regeneration. All these properties and biological functions of HA make it an appealing material for the synthesis of biomedical hydrogels for skin wound healing. Since HA is not able to be gelate alone, it must be processed and functionalized through chemical modifications and crosslinking to generate versatile HA-based hydrogels. In recent years, different physical and chemical crosslinking strategies for HA-based hydrogels have been developed and designed, such as radical polymerization, Schiff-base crosslinking, enzymatic crosslinking, and dynamic covalent crosslinking, and they have broad and promising applications in skin wound healing and tissue engineering. In this review, we focus on chemical modification and crosslinking strategies for HA-based hydrogels, aiming to provide an overview of the latest advances in the development of HA-based hydrogels for skin wound healing. We summarize and propose feasible measures for the application of HA-based hydrogels for skin treatment, and discuss future application trends, which may ultimately promote HA-based hydrogels as a promising biomaterial for clinical applications.
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Affiliation(s)
- Yan-Wen Ding
- Key Laboratory of Resource Biology and Biotechnology in Western China, Ministry of Education, School of Medicine, Department of life sciences and medicine, Northwest University, Xi'an, China.
| | - Ze-Yu Wang
- Key Laboratory of Resource Biology and Biotechnology in Western China, Ministry of Education, School of Medicine, Department of life sciences and medicine, Northwest University, Xi'an, China.
| | - Zi-Wei Ren
- Key Laboratory of Resource Biology and Biotechnology in Western China, Ministry of Education, School of Medicine, Department of life sciences and medicine, Northwest University, Xi'an, China.
| | - Xu-Wei Zhang
- Key Laboratory of Resource Biology and Biotechnology in Western China, Ministry of Education, School of Medicine, Department of life sciences and medicine, Northwest University, Xi'an, China.
| | - Dai-Xu Wei
- Key Laboratory of Resource Biology and Biotechnology in Western China, Ministry of Education, School of Medicine, Department of life sciences and medicine, Northwest University, Xi'an, China.
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Dong C, Yu Z, Quan X, Wei S, Wang J, Ma X. No Differences in Wound Healing and Scar Formation Were Observed in Patients With Different COVID-19 Vaccination Intervals. Front Public Health 2022; 10:883113. [PMID: 35719612 PMCID: PMC9198238 DOI: 10.3389/fpubh.2022.883113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 04/29/2022] [Indexed: 11/20/2022] Open
Abstract
Background Safety concerns are one of the most common reasons for COVID-19 vaccination refusal. In the field of plastic and reconstructive surgery, whether COVID-19 vaccination influences wound healing and scar formation is worthy of special attention. Methods In this study, patients with adult trauma with subcutaneous sutures placed by a single plastic surgeon in a single center were included. The vaccination interval was defined as the interval between the last dose of the COVID-19 vaccine and when surgical sutures were introduced. The patients were categorized by vaccination interval into three groups of <1, 1–3, and ≥3 months. Wound healing and scar formation were rated according to the Wound Assessment Inventory (WAI) and Patient and Observer Scar Assessment Scale (POSAS) in the groups at 7 days and after a 3-month follow-up. Results All total and individual scores of WAI and POSAS were not significantly different among the groups. Conclusion No differences in wound healing and scar formation were observed in patients with different COVID-19 vaccination intervals. Thus, it is not necessary to postpone COVID-19 vaccination, as the vaccine does not affect wound healing and scar formation in patients undergoing surgery. This study aimed to eliminate concerns and hesitancy in receiving the COVID-19 vaccine.
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Affiliation(s)
- Chen Dong
- Department of Plastic Surgery, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Zhou Yu
- Department of Plastic Surgery, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Xin Quan
- Department of Plastic Surgery, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Siming Wei
- Department of Plastic Surgery, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Jiayang Wang
- Department of Plastic Surgery, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Xianjie Ma
- Department of Plastic Surgery, Xijing Hospital, Fourth Military Medical University, Xi'an, China
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45
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COVID y rellenos faciales ¿realmente debemos preocuparnos? ACTAS DERMO-SIFILIOGRAFICAS 2022; 113:888-894. [PMID: 35659611 PMCID: PMC9159960 DOI: 10.1016/j.ad.2022.05.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 05/01/2022] [Accepted: 05/22/2022] [Indexed: 12/24/2022] Open
Abstract
La pandemia por COVID ha causado hoy en día millones de afectados, continuando su aumento a nivel mundial. Junto con la afectación los órganos diana clave (aparato respiratorio, anosmia, diarrea, fiebre, etc.), se han descrito reacciones inmunológicas tardías en los rellenos dérmicos por ácido hialurónico (AH), fundamentalmente a nivel facial. Estas alteraciones aparecen tanto en pacientes positivos para el virus, independientemente de la sintomatología sistémica, como en pacientes que han recibido vacunación frente al SARS-CoV-2. Aunque las reacciones suelen ser autolimitadas y autoresolutivas, es importante saber diagnosticarlas y en ocasiones establecer tratamiento con corticoides, hialuronidasa y/o antibióticos. Aunque no son graves, la Administración de Alimentos y Medicamentos de los Estados Unidos (FDA) las ha clasificado como evento adverso serio. Los mecanismos que originan están reacciones no están completamente dilucidados. Parece que son reacciones de hipersensibilidad retardada tipo IV, favorecidas por estímulos inmunológicos que se activan en presencia de la COVID o de otros virus como la gripe. Sin embargo, dado que los rellenos presentan cada vez mayor durabilidad y a que la pandemia continúa su curso, existiendo nuevas vacunas en desarrollo, es esencial la realización de estudios que describan la evolución a largo plazo tanto de los rellenos de AH, como de otros bioimplantes. Así mismo, es esencial alentar a los médicos de que reporten este tipo de reacciones, aunque no revistan gravedad con el objetivo de poder realizar un registro fidedigno de ellas.
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46
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Treatment of Delayed-onset Inflammatory Reactions to Hyaluronic Acid Filler: An Algorithmic Approach. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2022; 10:e4362. [PMID: 35747256 PMCID: PMC9208893 DOI: 10.1097/gox.0000000000004362] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 04/11/2022] [Indexed: 02/08/2023]
Abstract
Hyaluronic acid fillers are one of the most widely used and versatile fillers worldwide. Although traditionally regarded as immunologically inert, many currently available products have been substantially modified to improve longevity and to optimize properties for specific indications. Such modifications, either alone or in combination with other factors (such as the immune status of the patient, immune-triggering events, and bacterial contamination), may lead to the development of late-onset inflammatory nodules in some patients. This article discusses the clinical presentation of late-onset adverse inflammatory reactions to hyaluronic acid injections, describes their likely triggers, and presents the author's treatment algorithm for successful resolution.
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Alijotas-Reig J, García-GImenez V, Velthuis PJ, Niessen FB, Decates TS. Inflammatory immune-mediated adverse reactions induced by COVID-19 vaccines in previously injected patients with soft tissue fillers: a case-series of 20 patients. J Cosmet Dermatol 2022; 21:3181-3187. [PMID: 35621234 PMCID: PMC9347616 DOI: 10.1111/jocd.15117] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 04/20/2022] [Accepted: 05/24/2022] [Indexed: 11/28/2022]
Abstract
Background Adverse events (AE) after COVID‐19 vaccines, particularly, but not solely, with those messenger RNA (mRNA)‐based vaccines, have rarely been reported in patients previously treated with dermal fillers (DF). Objective To evaluate the morphology, clinical characteristics, the timing of presentation, and outcomes of inflammatory AE appeared in patients injected with DF, after anti‐COVID‐19 vaccination. Methods Descriptive study of a case series of 20 consecutive patients collected after the occurrence of AE in previously filled areas post COVID‐19 vaccination. Results From January 2021 to July 2021, we analyzed 20 AE reactions triggered by COVID‐19 vaccines in the previously mentioned cohort. They were vaccinated with Pfizer/Biontech (11; 55%), Moderna (5; 25%), Astra‐Zeneca (3; 15%), and Sputnik (1; 5%). The most common manifestations were oedema/swelling, angioedema, erythema, skin induration, and granuloma. Less common reactions included myalgia and lymphadenopathy. In 13/20 (65%) cases, the AE appeared after the first dose of vaccine. These inflammatory AE appeared more rapidly after the second dose than after the first one. In 13/20 (65%) cases, the symptomatology subsided with anti‐inflammatory/antihistaminic drugs, while spontaneously in 3/20 (15%). The manifestations are ongoing.in the remaining four cases (20%). Conclusion Although probably rare, both RNA‐based and adenovirus‐based anti‐COVID‐19 vaccines can cause inflammatory bouts in patients previously treated with DF. In these cases, caution should be paid on subsequent vaccine doses, considering a tailored risk/benefit for any case before next vaccination.
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Affiliation(s)
- Jaume Alijotas-Reig
- Systemic Autoimmune Disease Unit, Service of Internal Medicine, Vall d'Hebron University Hospital and Department of Medicine. Faculty of Medicine. Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Victor García-GImenez
- Europe Medical Centre, Sociedad Española de Medicina y Cirugía Cosmética, Barcelona, Spain
| | - Peter J Velthuis
- Department of Dermatology, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Frank B Niessen
- Department of Plastic Surgery, Amsterdam UMC, Vrije Universiteit, Amsterdam, the Netherlands
| | - Tom S Decates
- Department of Dermatology, Erasmus Medical Center, Rotterdam, the Netherlands
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48
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Jeon HB, Yoon JH, Lim NK. Midface Infection after COVID-19 Vaccination in a Patient with Calcium Hydroxylapatite Dermal Filler: A Case Report and Literature Review. Arch Plast Surg 2022; 49:310-314. [PMID: 35832142 PMCID: PMC9142264 DOI: 10.1055/s-0042-1748643] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
The emergence of vaccines for coronavirus disease 2019 (COVID-19) raises risk of possible adverse events from interaction between the vaccines and facial aesthetic care. A 47-year-old female with no medical comorbidities visited our emergency room due to midface painful swelling after 3 hours following receiving the second dose of the messenger RNA BNT162b2 COVID-19 vaccine. About 14 years ago, she underwent nonsurgical augmentation on the nasojugal groove with a calcium hydroxylapatite dermal filler. We performed incision and drainage under general anesthesia on the next day. During operation, yellowish pus-like materials bulged out. After an operation, we performed a combination therapy with antibiotics and methylprednisolone. Her symptoms improved day by day after surgery, and then a complete recovery was achieved at 3 weeks after the treatment. In conclusion, providers of aesthetic procedures are to be aware of the potential risks of such vaccines for patients who already had or seek to receive dermal filler injections.
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Affiliation(s)
- Hong Bae Jeon
- Department of Plastic and Reconstructive Surgery, Dankook University Hospital, Cheonan, Chungnam, Republic of Korea
| | - Jae Hee Yoon
- Department of Plastic and Reconstructive Surgery, Dankook University Hospital, Cheonan, Chungnam, Republic of Korea
| | - Nam Kyu Lim
- Department of Plastic and Reconstructive Surgery, Dankook University Hospital, Cheonan, Chungnam, Republic of Korea
- Department of Plastic and Reconstructive Surgery, Dankook University College of Medicine, Cheonan, Chungnam, Republic of Korea
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49
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Kalantari Y, Aryanian Z, Mirahmadi SMS, Alilou S, Hatami P, Goodarzi A. A systematic review on COVID-19 vaccination and cosmetic filler reactions: A focus on case studies and original articles. J Cosmet Dermatol 2022; 21. [PMID: 35534886 PMCID: PMC9348142 DOI: 10.1111/jocd.15071] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 03/02/2022] [Accepted: 05/05/2022] [Indexed: 12/18/2022]
Abstract
Background Tissue fillers are among the most popular cosmetic procedures performed and notably, cases of filler reactions after COVID‐19 vaccination have been reported. Objective The objective was to determine the characteristics of patients with filler reaction after COVID‐19 vaccination and address several considerations that have to be taken into practice. Methods A PRISMA compliant systematic search was conducted in Scopus, Web of Science, and PubMed/MEDLINE databases for articles published from inception up to October 21, 2021. Results Out of 106 initially retrieved articles, four of them were included in our study, and a total number of 13 cases were analyzed. In this study, we found that all of the patients who developed delayed‐type reaction (DTR) following COVID‐19 vaccination were middle‐aged women without any known history of allergy to foods or drugs. All patients had a history of hyaluronic acid (HA) filler injection in their head and neck and demonstrated symptoms particularly swelling, from <1 day up to 10 days after the first or second doses of vaccines. Lisinopril, hyaluronidase, and corticosteroids seemed to have good results in management. Conclusion Although rare, DTR to fillers after COVID‐19 vaccination can happen. Physicians should be aware of the pathogenesis and management of this phenomenon.
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Affiliation(s)
- Yasamin Kalantari
- Department of Dermatology, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran.,Autoimmune Bullous Diseases Research Cente, Tehran University of Medical Sciences, Tehran, Iran
| | - Zeinab Aryanian
- Autoimmune Bullous Diseases Research Cente, Tehran University of Medical Sciences, Tehran, Iran.,Department of Dermatology, Babol University of Medical Sciences, Babol, Iran
| | | | - Sanam Alilou
- Student Research Committee, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Parvaneh Hatami
- Autoimmune Bullous Diseases Research Cente, Tehran University of Medical Sciences, Tehran, Iran
| | - Azadeh Goodarzi
- Rasool Akram Medical Complex Clinical Research Development Center (RCRDC), School of Medicine, Iran University of Medical Sciences, Tehran, Iran.,Skin and Stem Cell Research Center, Tehran University of Medical Sciences, Tehran, Iran
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50
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Rivers JK. Incidence and Treatment of Delayed-onset Nodules After VYC Filler Injections to 2139 Patients at a Single Canadian Clinic. J Cosmet Dermatol 2022; 21:2379-2386. [PMID: 35451214 PMCID: PMC9321104 DOI: 10.1111/jocd.15013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Revised: 03/17/2022] [Accepted: 04/18/2022] [Indexed: 11/29/2022]
Abstract
Background Data suggest that hyaluronic acid (HA) fillers using VYC technology have a higher incidence of delayed‐onset nodule development at facial injection sites than earlier HA products. Objective To assess the incidence of delayed‐onset nodules with VYC products based on a single experienced injector. Methods and Materials Patients with delayed‐onset nodules after injections with VYC‐20L, VYC‐17.5L, and VYC‐15L were identified by retrospective chart review. Results Since 2010, 2139 patients received injections from the same physician with combinations of VYC‐20L (57.6% of patients; 2.4 syringes/patient), VYC‐17.5L (23.9%; 1.5), or VYC‐15L (18.5%; 1.5). Seven female patients (mean age, 62 years) developed delayed‐onset nodules for an overall incidence of 0.33%. A potential inflammatory trigger (reported by 6 patients) occurred 1–168 days prior to nodule development. Nodule biopsy in 1 patient confirmed a foreign‐body granuloma. The most effective treatment incorporated prednisone with or without hyaluronidase, and in 2 patients, nodules resolved spontaneously. The incidence of delayed‐onset nodules was not associated with injection technique or amount of product used. Conclusion VYC‐associated incidence of delayed‐onset nodules (0.33%) was lower than earlier estimates from previous studies. In the current analysis, VYC‐15L had a rate of delayed reactions comparable with non‐VYC products.
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Affiliation(s)
- Jason K Rivers
- Pacific Derm and The, Department of Dermatology and Skin Science, University of British Columbia, Vancouver, BC, Canada
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