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A continuous increase in the popularity of esthetic procedures with the use of substances as HA has been observed for many years, which might be contributing to an increase in the number of adverse events. The autoimmune/inflammatory syndrome induced by adjuvants (ASIA) can be provoked by hyaluronic acid (HA), which belongs to substances meeting th...
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Citations
... other therapies that have been reported include the injection of 5-Fluorouracil, the systemic use of allopurinol, cyclosporine and steroids, as well as hyperbaric therapy (4,5). However, as a result of the extended degradation cycle of certain filling materials and the adjuvant effect stemming from unique material properties and immune factors, recurrent swelling and other immune-mediated reactivation of inflammatory response can be induced by triggering events, such as infections, vaccines, and similar factors (6). Consequently, these granuloma disorders present significant treatment challenges, necessitating the development of more efficient and targeted therapeutic approaches. ...
... on the other hand, according to the 'adjuvant effect' pathogenesis theory (18), it is believed that the filler is not directly recognized as an antigen, but rather it enhances the activity and function of immune cells such as t lymphocytes. this, in turn, strengthens the local innate and acquired immune responses, making them more sensitive to external factors such as infection, temperature changes, and vaccines (6). as a result, symptoms are repeatedly stimulated and aggravated. ...
Background
Granuloma formation is an uncommon and persistent skin inflammatory condition caused by the injection of dermal fillers. The exact cause of this reaction is not well understood, but it may be associated with irritating components or abnormal immune function. Treating granulomas can be difficult. However, recent research has shown that Janus kinase (JAK) inhibitors hold promise as a potential therapy for refractory granulomatous diseases.
Objectives
The aim was to evaluate the efficacy and safety of tofacitinib as a treatment for granulomas secondary to filler injection and the possible mechanisms were discussed and summarized.
Methods
This study focuses on three cases of patients who experienced granuloma formation after receiving filler injections and were subsequently treated with tofacitinib. The efficacy and safety of the treatment were evaluated using parameters such as photographs and monitoring for any adverse reactions. In addition, a literature review was conducted to explore the underlying mechanisms and potential effects of tofacitinib.
Results
All three cases recovered from swelling and nodules without side effects through the off-label use of oral tofacitinib. Existing data review reveals some approaches for cutaneous granulomatous disorders like inhibiting macrophage activation and downregulation of the JAK–STAT pathway.
Conclusion
This report emphasizes the effectiveness of JAK inhibitors in treating granulomas caused by filler injections. Recent advancements in understanding the underlying mechanisms of granulomatous reactions have paved the way for JAK inhibitors to be regarded as a promising treatment choice. However, further research is necessary to fully assess the safety and long-term effectiveness of using tofacitinib for granuloma treatment.
