Granuloma annulare after Botulonium toxin A injection: A rare association.

BACKGROUND

Botulinum toxin is generally considered safe and has been used in constantly expanded cosmetic and therapeutic indications. However, long-term side effects such as granulomatous reactions have been associated with this drug.

AIMS

We aim to evaluate a rare reaction to Botulonium toxin A injection.

PATIENTS/METHODS: A 44-year-old woman, developed annular plaques eleven months after botulinum toxin A injection for the correction treatment of wrinklesglabellar rhytides.

RESULTS

Histopathological examination revealed granuloma annulare formation. Clinical and biological investigations were negative, ruling out the hypothesis of systemic sarcoidosis. Triamcinolone acetonide injection was followed by a regression of the plaques.

CONCLUSION

There are previous reports in the literature of sarcoidal and foreign body granuloma at the sites of injection of botulinum toxin A injection. To our knowledge this is the first report of granuloma annulare occurrence after botulinum toxin A injection.