Department of Internal Medicine I, Vall d'Hebron University Hospital, Barcelona, Spain.
Dermatology. 2009;219(4):303-8. doi: 10.1159/000243804. Epub 2009 Oct 1.
It has been thought that poly-L-lactic acid (PLLA) injections do not have inflammatory side effects. Recent evidence shows that local/regional/systemic delayed adverse effects may appear with its use.
To evaluate the clinical complaints, treatment response and long-term follow-up of non-HIV patients with delayed immune-mediated adverse effects related to PLLA injections.
Prospective, case series study of 10 patients with delayed adverse effects related to PLLA injections. The inclusion criterion was defined as the onset at least 6 months after PLLA use, with 1 or more of the following clinical signs: oedema, skin induration, swelling/tender nodules with or without discharge of pus or filler material. Several systemic manifestations were also included. Patients with immediate side effects were excluded. Patients underwent clinical management and long-term follow-up.
The average latency period to the onset of symptoms was 19.2 months (range: 6-60). Tender, inflammatory nodules and facial oedema were commonly seen. One case presented a systemic granulomatous disorder as a complication. After 50.2 months of average follow-up (range: 38-78), 5 patients are in remission, 4 have recurrent bouts and the last case has been lost to follow-up.
Although infrequently, local and/or regional and/or systemic delayed and recurrent granulomatous reactions may complicate PLLA gel injections.
人们曾认为聚左旋乳酸（PLLA）注射不会产生炎症性副作用。但最近的证据表明，其使用后可能会出现局部/区域/全身迟发性不良反应。
评估与 PLLA 注射相关的非 HIV 患者迟发性免疫介导的不良反应的临床主诉、治疗反应和长期随访情况。
对 10 例与 PLLA 注射相关的迟发性不良反应患者进行前瞻性、病例系列研究。纳入标准定义为 PLLA 使用后至少 6 个月发病，且具有以下 1 种或多种临床体征：水肿、皮肤硬结、肿胀/触痛结节，伴或不伴脓液或填充物排出。还包括几种全身表现。排除有即刻副作用的患者。患者接受临床管理和长期随访。
症状出现的平均潜伏期为 19.2 个月（范围：6-60）。常见的是触痛性炎性结节和面部水肿。1 例出现全身性肉芽肿性疾病并发症。在平均 50.2 个月（范围：38-78）的随访后，5 例患者缓解，4 例复发，最后 1 例失访。
尽管不太常见，但 PLLA 凝胶注射后可能会出现局部和/或区域和/或全身迟发性和复发性肉芽肿性反应。
