Exenatide-Induced Eosinophil-Rich Granulomatous Panniculitis

Exenatide‐induced granulomatous panniculitis associated with poly(d,l‐lactide‐co‐glycolide)

“…6 Neither of these two cases identified the foreign material, 2,6 but the injected substance's histopathologic appearance was finally captured in 2015. 7 In this case, similar findings on histopathology were identified as in the previous reports, but the authors were able to additionally obtain images of nonpolarizable structures representing PLGA microspheres from exenatide injections. 7 More recently, in a 2018 documented case of exenatide-induced panniculitis, the PLGA microspheres were discovered to be highlighted by Patients should be properly educated regarding the condition, and while in many instances the injection-site reactions will spontaneously resolve, it is possible for the nodules to persist, in which case serial intralesional triamcinolone has been found to be a potential treatment option.…”

Eosinophilic Panniculitis Following the Subcutaneous Injection of Exenatide Extended-Release

“…In these cases, the nodule occurred at the injection site. The histopathologic features revealed fat necrosis with eosinophils and mixed cell infiltration, similar to our case [6][7][8][9] .…”

“…Shan and Guo 6 speculated that the eosino-philic reaction after exenatide extended-release injection might be associated with a lack of the enzyme that hydrolyzes PLG to lactic acid and glycolic acid. Moreover, previous reports identified the histopathologic appearance of the microspheres of PLG in exenatide-induced eosinophil rich granulomatous panniculitis 7,8 . Injection-site reactions in exenatide extended-release users were observed more frequently (17.1%) compared to exenatide (12.7%) and insulin glargine (1.8%) users.…”

Persistent injection site nodules from exenatide: Successful treatment with intralesional triamcinolone

“…However, rarer, atypical persistent nodules, panniculitis, and even morphealike changes of the skin have been reported with various subcutaneous injected medications, and prescribing physicians need to be aware of this. 5 , 6 , 7 , 8 , 9 , 10 As the number of subcutaneously injected medications expands, we suspect the number of more atypical, persistent cutaneous reactions will follow. Proper patient education is imperative, along with prompt cessation of the drug.…”

“… 1 , 4 A handful of cases have also identified eosinophil-rich granulomatous panniculitis at the exenatide injection site, along with more persistent, nonresolving nodules. 5 , 6 , 7 , 8 For these rarer, persistent nodules, hospitalization and surgical intervention have been reported. 8 We report a case of persistent exenatide extended release panniculitis nodules successfully treated with serial intralesional triamcinolone injections.…”