与聚丙烯酰胺真皮填充剂相关的迟发性免疫介导不良反应：临床发现、管理及随访
Delayed immune-mediated adverse effects related to polyacrylamide dermal fillers: clinical findings, management, and follow-up.
作者信息
Alijotas-Reig Jaume, Garcia-Gimenez Victor, Miró-Mur Francesc, Vilardell-Tarrés Miquel
机构信息
Department of Internal Medicine I, Vall d'Hebron University Hospital, Barcelona, Spain.
出版信息
Dermatol Surg. 2009 Feb;35 Suppl 1:360-6. doi: 10.1111/j.1524-4725.2008.01041.x.
BACKGROUND
It has been thought that polyacrylamide (PA) injections do not have inflammatory side effects. Recent evidence shows that local and regional delayed adverse effects may appear with its use.
OBJECTIVE
To evaluate the clinical complaints and follow-up of patients with delayed immune-mediated adverse effects related to PA injections.
METHODS
Prospective, case-series study of 10 patients with delayed adverse effects related to PA injections. Only patients with intermediate or delayed adverse effects related to polyacrylamide injection were included. Patients with immediate side effects were excluded. Patients underwent clinical management, follow-up, and when possible, blood tests and biopsy.
RESULTS
Average latency period to onset of symptoms was 10 months (range 2-36). Tender, inflammatory nodules--granulomas--with pseudo-abscesses were commonly seen. Laboratory abnormalities were found in all analyzed cases. After 20.1 months average follow-up, five patients were in remission, two had recurrent bouts, and three were lost to follow-up, one of them in remission.
CONCLUSION
Although it happens infrequently, local and regional delayed and recurrent granulomatous reactions may complicate PA gel injections.
背景
一直以来人们认为聚丙烯酰胺（PA）注射没有炎症副作用。最近有证据表明，使用PA可能会出现局部和区域性延迟不良反应。
目的
评估与PA注射相关的延迟性免疫介导不良反应患者的临床症状及随访情况。
方法
对10例与PA注射相关的延迟不良反应患者进行前瞻性病例系列研究。仅纳入与聚丙烯酰胺注射相关的中度或延迟不良反应患者。排除有即刻副作用的患者。患者接受临床处理、随访，并在可能的情况下进行血液检查和活检。
结果
症状出现的平均潜伏期为10个月（范围2 - 36个月）。常见有压痛性炎性结节——肉芽肿——伴假性脓肿。所有分析病例均发现实验室异常。平均随访20.1个月后，5例患者病情缓解，2例复发，3例失访，其中1例处于缓解状态。
结论
尽管这种情况很少发生，但局部和区域性延迟及复发性肉芽肿反应可能会使PA凝胶注射出现并发症。
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