Ianhez Mayra, Miot Hélio A, Caetano Lívia Vn, de Paula Henrique Moura, Freire Giselle Gs, Torres Pedro Pts
From the Department of Dermatology, Cório Clínica, Goiânia - GO, Brazil.
Department of Dermatology, Universidade Federal de Goiás, Goiânia GO, Brazil.
Indian J Dermatol. 2024 Jul-Aug;69(4):328-332. doi: 10.4103/ijd.ijd_56_24. Epub 2024 Aug 19.
Sarcoidosis and complications related to fillers have been reported following the COVID-19 vaccination. Additionally, cutaneous sarcoidosis has been observed around polymethyl methacrylate (PMMA) injection sites. Foreign-body reactions to PMMA can occur simultaneously with systemic sarcoidosis, suggesting a shared pathogenic mechanism between both conditions. To report a case of sarcoidosis and PMMA granulomas following COVID-19 vaccination (ChAdOx11), successfully treated with tofacitinib. We present a 59-year-old woman who developed systemic sarcoidosis and a granulomatous reaction to PMMA filler following the COVID-19 vaccination (ChAdOx11). Notably, both PMMA and the vaccine were potential triggers for sarcoidosis. Treatment with tofacitinib produced marked improvement in both the cutaneous and pulmonary involvement of sarcoidosis and the granulomatous reaction to PMMA. This successful outcome suggests tofacitinib, a pan-JAK inhibitor, an alternative treatment for cutaneous and systemic sarcoidosis, as well as a potential therapy for granulomatous complications of dermal fillers, such as PMMA.
据报道，接种新冠病毒疫苗后出现了结节病以及与填充剂相关的并发症。此外，在聚甲基丙烯酸甲酯（PMMA）注射部位周围观察到了皮肤结节病。对PMMA的异物反应可与系统性结节病同时发生，提示这两种情况之间存在共同的致病机制。报告1例接种新冠病毒疫苗（ChAdOx11）后出现结节病和PMMA肉芽肿且成功接受托法替布治疗的病例。我们介绍了一名59岁女性，其在接种新冠病毒疫苗（ChAdOx11）后出现了系统性结节病以及对PMMA填充剂的肉芽肿反应。值得注意的是，PMMA和疫苗都是结节病的潜在触发因素。托法替布治疗使结节病的皮肤和肺部受累情况以及对PMMA的肉芽肿反应均有显著改善。这一成功结果表明，泛JAK抑制剂托法替布可作为皮肤和系统性结节病的替代治疗方法，以及治疗如PMMA等真皮填充剂肉芽肿并发症的潜在疗法。
