Management of complications of vitamin E injections into the face

Liquid vitamin E injection for cosmetic facial rejuvenation: A disaster report of lipogranuloma

“…2,4,6 Also, histopathology results were reported only in some cases and have shown vacuoles in variable sizes, resulting in a Swiss cheeselike appearance in most cases. 2,[4][5][6]9,10 Vitamin E can be used for a wide variety of cosmetic and also clinical reasons. 11 It is useful for facial rejuvenation by retarding or reversing cutaneous signs of aging due to its antioxidant nature.…”

“…There is no exact algorithmic approach for the treatment of complications due to the injections. 5 These patients may develop psychological problems following significant inflammatory reactions in the face, and this can lead to abandoning treatment and social isolation. 13 F I G U R E 1 Vitamin E injection-associated Lipogranuloma A prolonged course of broad-spectrum antibiotics, systemic and intralesional corticosteroids are the main steps of the treatment.…”

“…3 Lipogranuloma is an inflammatory condition that may occur after exogenous lipid or oil-like substances injection into the skin.Related lesions usually have round-to-ovoid, vacuole-like cavities with variable sizes in the dermis, which causes a Swiss cheese-like appearance. 4,5 Vitamin E is an oil-soluble vitamin that needs oil vehicles such as peanut oil or soya oil that are responsible for adverse effects caused by vitamin E injection. The most common adverse reactions related to vitamin E injection included lipogranuloma, sclerodermoid reaction, subcutaneous infiltration, subcutaneous nodules, persistent edema, deformation, and ulceration at the site of injection.…”

“…The most common adverse reactions related to vitamin E injection included lipogranuloma, sclerodermoid reaction, subcutaneous infiltration, subcutaneous nodules, persistent edema, deformation, and ulceration at the site of injection. 2,[4][5][6] Rarely, these reactions can extend and progress in an uncontrolled manner to life-threatening systemic conditions including hepatosplenomegaly, pulmonary fibrosis, 7 acute kidney injuries, disseminated lipogranuloma, and sudden death. 8 Herein, we report a 50-year-old woman who had a liquid vitamin E injection for cosmetic facial rejuvenation and development of…”

Peligros de la mesoterapia no autorizada, reporte de caso

“…11 El tratamiento en estos casos casi siempre es muy desalentador, ya que no existe un enfoque algorítmico definido para el tratamiento de las complicaciones debidas a la mesoterapia con productos no autorizados; existen muy pocos reportes de casos de un tratamiento exitoso, uno de ellos recomienda el uso de corticosteroides sistémicos y antibióticos de espectro extendido junto con esteroide intralesional, clindamicina y 5-fluorouracilo en combinación. 12,13 Existe una serie de casos, en los cuales los autores basados en su experiencia e informes anteriores de lipogranulomas de genitales externos, proponen un algoritmo terapéutico para pacientes con lipogranuloma de sustancias oleosas inyectadas para aumento de tejidos de la siguiente manera: primero un antibiótico sistémico de amplio espectro (cefalosporinas) durante 10 días, seguido de glucocorticosteroides sistémicos en una dosis de 0,5 a 0,7 mg/kg con disminución de la dosis dentro de las próximas 6 a 8 semanas; y por último y solo en caso de resolución incompleta o recurrencia, la aplicación intralesional de glucocorticoides una vez al mes hasta seis sesiones. 14…”