Assistant Professor, Department of Diagnostic Sciences and Oral Medicine, Division of Oral and Maxillofacial Pathology, UTHSC College of Dentistry, Memphis, TN, USA.
Assistant Clinical Professor, Department of Oral Medicine, Infection and Immunity, Harvard School of Dental Medicine, Boston, MA, USA; Associate Pathologist, Center for Oral Pathology, StrataDx, Lexington, MA, USA.
Oral Surg Oral Med Oral Pathol Oral Radiol. 2014 Jan;117(1):105-10. doi: 10.1016/j.oooo.2013.10.008. Epub 2013 Oct 23.
We report intraoral granulomatous foreign body reactions in patients treated with calcium hydroxylapatite (CHA) or poly-l-lactic acid (PLA).
Clinical and histopathologic data were obtained from 25 patients who developed orofacial nodules or swelling after dermal filler injections.
All 25 patients were women aged 35 to 78 years (median, 55 years). All had a history of injection of CHA (n = 13) or PLA (n = 12) to the lips, nasolabial area, or mental area. Two patients developed cutaneous nodules at the sites of injections; all others presented with intraoral nodules (labial/buccal or vestibular mucosa) distant from the site of injections, suggestive of filler migration. Five of 21 cases presented with pain. Histopathologically, CHA presented as a diffuse mass of mauve-gray or beige, nonrefractile spherules, and PLA as rice- or spindle-shaped, geometric, refractile bodies within circumscribed nodules.
Cutaneous injections of CHA and PLA fillers may induce granulomatous reactions presenting as intraoral nodules distant from the injection sites.
报告接受羟基磷灰石钙（CHA）或聚左旋乳酸（PLA）治疗的患者发生口腔内肉芽肿性异物反应的情况。
从 25 名因真皮填充剂注射后出现面部或口腔结节或肿胀而就诊的患者中获取了临床和组织病理学数据。
25 名患者均为女性，年龄 35 至 78 岁（中位数 55 岁）。所有患者均有 CHA（n=13）或 PLA（n=12）注射唇部、鼻唇沟或颏部的病史。2 名患者在注射部位出现皮肤结节，其余患者均表现为远离注射部位的口腔内结节（唇/颊或颊侧前庭黏膜），提示填充物迁移。21 例中有 5 例出现疼痛。组织病理学上，CHA 表现为弥漫性淡紫色-灰色或米色、非折射性的小球体，PLA 则表现为边界清楚的结节内呈稻穗或梭形、几何形、折射性的物质。
皮肤注射 CHA 和 PLA 填充物可能会引起肉芽肿反应，表现为远离注射部位的口腔内结节。
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