Cassiano Daniel, Miyuki Iida Tatiana, Lúcia Recio Ana, Yarak Samira
Department of Dermatology, Universidade Federal de São Paulo, São Paulo, Brazil.
Private Office, São Paulo, Brazil.
J Cosmet Dermatol. 2020 Mar;19(3):582-584. doi: 10.1111/jocd.13287. Epub 2020 Jan 11.
Vascular compromise is a rare but serious complication of dermal filler injection. Vessel occlusion tends to have a more immediate onset of symptoms. We report a case of skin necrosis that started with pain, erythema and edema two days after hyaluronic acid filler on the forehead of a 57-year-old woman. The patient was treated with less than 24 hours the onset of symptoms, leaving discreet scar. The current theories that explain skin necrosis caused by HA fillers include angiospasm and embolization. The frontal region has many anastomoses, the embolized proximal vessel initially did not lead to symptoms. However, the HA inside the artery may have traveled over time and reached a terminal distal branch, which generated localized skin damage and pain. The urgent treatment of arterial occlusion and thromboembolism caused by HA injection is intralesional high-dose hyaluronidase.
血管损伤是真皮填充剂注射罕见但严重的并发症。血管闭塞往往症状出现更为迅速。我们报告一例皮肤坏死病例，一名57岁女性在前额注射透明质酸填充剂两天后开始出现疼痛、红斑和水肿。患者在症状出现后不到24小时接受治疗，仅留下轻微疤痕。目前解释透明质酸填充剂引起皮肤坏死的理论包括血管痉挛和栓塞。额部有许多吻合支，栓塞的近端血管最初并未导致症状。然而，动脉内的透明质酸可能随时间推移移动并到达终末远端分支，从而造成局部皮肤损伤和疼痛。透明质酸注射引起的动脉闭塞和血栓栓塞的紧急治疗方法是病灶内注射高剂量透明质酸酶。
