Li Yingzi, Zheng Qiaoyuan, Lin Jinhao, Su Xueshang, Zhuang Jun, Wei Qingqian, Hu Jintian
From the Cosmetic Injection Center, Plastic Surgery Hospital, Chinese Academy of Medical Sciences, Beijing, People's Republic of China.
College of Clinical Medicine, Fudan University, Shanghai, People's Republic of China.
Plast Reconstr Surg Glob Open. 2024 May 24;12(5):e5845. doi: 10.1097/GOX.0000000000005845. eCollection 2024 May.
Botulinum toxin type A (BTA) is becoming more and more prevalent as an injection agent in cosmetic surgery. However, there is an increasing amount of cases reporting unexpected adverse reactions related to BTA injection. BTA can invoke many kinds of hypersensitive reactions, some of which can be delayed-type or even fatal; hence, it is of crucial importance to pay close attention to atypical and early symptoms that may indicate the presence of BTA allergy in patients.
In this study, we reported three cases of mild and unexpected BTA-related hypersensitive reaction with a symptom of nonpruritic erythema on the chest that happened after BTA treatment of upper facial wrinkles and proposed several suggestions based on our practical experience and literature review.
Two patients' symptoms were alleviated spontaneously, and one patient's were alleviated after taking oral corticosteroid. According to our literature review, we believe that these incidences indicate a kind of unreported allergic reaction relevant to botulinum toxin.
We suggest clinicians consider warily patients' subsequent BTA injection schedule if any suspicious reaction occurs after treatment. We suggest that patients who experience nonpruritic erythema after botulinum toxin injection should suspend subsequent injection plans for at least 3 months to prevent more severe consequences.
A型肉毒杆菌毒素（BTA）作为一种注射剂在整容手术中越来越普遍。然而，越来越多的病例报告了与BTA注射相关的意外不良反应。BTA可引发多种过敏反应，其中一些可能是迟发型甚至是致命的；因此，密切关注可能表明患者存在BTA过敏的非典型和早期症状至关重要。
在本研究中，我们报告了3例在BTA治疗上睑皱纹后出现胸部非瘙痒性红斑症状的轻度意外BTA相关过敏反应病例，并根据我们的实践经验和文献综述提出了一些建议。
2例患者症状自发缓解，1例患者在口服皮质类固醇后症状缓解。根据我们的文献综述，我们认为这些事件表明了一种与肉毒杆菌毒素相关的未报告的过敏反应。
我们建议临床医生在治疗后若出现任何可疑反应，应谨慎考虑患者后续的BTA注射计划。我们建议肉毒杆菌毒素注射后出现非瘙痒性红斑的患者应至少暂停后续注射计划3个月，以防止更严重的后果。
