Fu Jingqiu, Luo Wen, Wang Ping, Wu Weiwei, Lu Jiejie
Department of Dermatology, Affiliated Dermatology Hospital of Hainan Medical University, The Fifth People's Hospital of Hainan Province, Haikou, Hainan, People's Republic of China.
Hainan Medical University, Haikou, Hainan, People's Republic of China.
Clin Cosmet Investig Dermatol. 2025 May 17;18:1199-1206. doi: 10.2147/CCID.S522469. eCollection 2025.
Foreign body granuloma (FBG) formation is linked to chronic persistent cutaneous inflammation, representing a severe delayed complication characterized histologically by infiltration of multinucleated giant cells and aggregation of lymphocytes. In filler-induced FBG following cosmetic injections, implanted materials represent a key driver of sustained inflammatory responses. Achieving complete resolution remains challenging, with current therapeutic outcomes for FBG being suboptimal. Emerging evidence suggests that Janus kinase (JAK) inhibitors may constitute a promising therapeutic strategy for refractory granulomatous conditions.
This case report describes the successful management of FBG using JAK inhibitors and synthesizes existing literature to evaluate the efficacy, safety, and potential mechanisms of abrocitinib in treating filler-induced cutaneous FBG.
We present a case of post-filler FBG that presents with multiple smooth-surfaced, hemispherical lesions (3-5 mm in diameter) distributed across the entire facial region. The patient was treated with oral abrocitinib (100 mg daily) and prednisone (30 mg daily, tapered over 9 weeks). Clinical outcomes were assessed weekly for 13 weeks through serial clinical photography, dermoscopy, reflectance confocal microscopy, and multispectral imaging. Adverse events, including rash exacerbation, vomiting, dizziness, and fever, were systematically monitored. A comprehensive literature review was conducted to elucidate JAK inhibitors' therapeutic rationale in filler-associated FBG.
The patient achieved complete granuloma resolution within 13 weeks following failed corticosteroid monotherapy. No treatment-related adverse effects were observed during the one-month follow-up period, supporting the favorable safety profile of this therapeutic approach.
This report provides preliminary evidence for JAK inhibitors' efficacy in managing refractory filler-induced FBG. Large-scale controlled trials are warranted to validate long-term safety and therapeutic benefits.
异物肉芽肿（FBG）的形成与慢性持续性皮肤炎症有关，是一种严重的迟发性并发症，组织学特征为多核巨细胞浸润和淋巴细胞聚集。在美容注射后填充剂诱导的FBG中，植入材料是持续炎症反应的关键驱动因素。实现完全消退仍然具有挑战性，目前FBG的治疗效果并不理想。新出现的证据表明，Janus激酶（JAK）抑制剂可能是治疗难治性肉芽肿性疾病的一种有前景的治疗策略。
本病例报告描述了使用JAK抑制剂成功治疗FBG的过程，并综合现有文献评估阿布昔替尼治疗填充剂诱导的皮肤FBG的疗效、安全性和潜在机制。
我们报告一例填充剂注射后FBG病例，患者面部出现多个表面光滑的半球形皮损（直径3 - 5毫米）。患者接受口服阿布昔替尼（每日100毫克）和泼尼松（每日30毫克，9周内逐渐减量）治疗。通过连续临床摄影、皮肤镜检查、反射式共聚焦显微镜检查和多光谱成像，每周评估13周的临床结果。系统监测不良事件，包括皮疹加重、呕吐、头晕和发热。进行了全面的文献综述，以阐明JAK抑制剂在填充剂相关FBG中的治疗原理。
在皮质类固醇单药治疗失败后，患者在13周内肉芽肿完全消退。在为期1个月的随访期内未观察到与治疗相关的不良反应，支持了这种治疗方法良好的安全性。
本报告为JAK抑制剂治疗难治性填充剂诱导的FBG的疗效提供了初步证据。有必要进行大规模对照试验以验证其长期安全性和治疗益处。
