Sawaguchi Risa, Kondoh Shoji, Kinjo Yuto, Yuzuriha Shunsuke
Division of Plastic and Aesthetic Surgery, Ina Central Hospital, Ina, Japan.
Department of Plastic and Reconstructive Surgery, Shinshu University School of Medicine, Matsumoto, Japan.
Aesthetic Plast Surg. 2025 Sep 4. doi: 10.1007/s00266-025-05185-0.
No studies in Japan have investigated delayed-onset inflammatory nodules as an adverse event following hyaluronic acid (HA) injections. Our institution, located in a rural area with no nearby aesthetic clinics, allows for comprehensive follow-up of HA-treated patients. This study analyzed complications from 673 cases over 6 years, focusing on delayed-onset inflammatory nodules.
A retrospective review of medical records was conducted for patients treated with AbbVie-Allergan HA products between January 2018 and December 2023. Adverse events were categorized as acute complications or delayed-onset inflammatory nodules. Statistical analysis assessed product type, time to onset, patient history, and treatment approaches.
One acute allergic reaction and seven cases (1.07%) of delayed-onset inflammatory nodules were identified. Volbella was involved in 4 cases, Volift in 1 case, Voluma in 1 case, and Ultra Plus in 1 case. Statistical analysis revealed a significantly higher incidence with Volbella (p = 0.0484). The average onset was 144 days, with no seasonal pattern. Among affected patients, three had a history of non-HA-related allergies, and one had a preceding infection. Treatments included oral antibiotics (2 cases), oral antihistamines (5 cases), topical steroids (3 cases), hyaluronidase injections (4 cases), oral steroids (2 cases), and surgical intervention (1 case).
Delayed-onset inflammatory nodules occurred in approximately 1% of cases, with Volbella showing the highest incidence. Patients with allergies or prior infections may have an increased risk. Comprehensive informed consent should emphasize potential delayed complications to ensure patient understanding.
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在日本，尚无研究将迟发性炎性结节作为透明质酸（HA）注射后的不良事件进行调查。我们的机构位于农村地区，附近没有美容诊所，因此能够对接受HA治疗的患者进行全面随访。本研究分析了6年期间673例患者的并发症，重点关注迟发性炎性结节。
对2018年1月至2023年12月期间接受艾伯维-艾尔建HA产品治疗的患者的病历进行回顾性分析。不良事件分为急性并发症或迟发性炎性结节。统计分析评估了产品类型、发病时间、患者病史和治疗方法。
确定了1例急性过敏反应和7例（1.07%）迟发性炎性结节。其中，4例涉及Volbella，1例涉及Volift，1例涉及Voluma，1例涉及Ultra Plus。统计分析显示，Volbella的发病率显著更高（p = 0.0484）。平均发病时间为144天，无季节性规律。在受影响的患者中，3例有非HA相关过敏史，1例有先前感染史。治疗方法包括口服抗生素（2例）、口服抗组胺药（5例）、外用类固醇（3例）、透明质酸酶注射（4例）、口服类固醇（2例）和手术干预（1例）。
迟发性炎性结节的发生率约为1%，其中Volbella的发生率最高。有过敏或先前感染史的患者可能风险增加。全面的知情同意应强调潜在的延迟并发症，以确保患者理解。
证据级别IV：本刊要求作者为每篇文章指定证据级别。有关这些循证医学评级的完整描述，请参阅目录或作者在线指南www.springer.com/00266 。
