Cutaneous Hypersensitivity Reaction to Injectable Hyaluronic Acid Gel

Background: Injectable hyaluronic acid gel is a non-animal biomaterial used for soft tissue augmentation.

Objective: The dermal implantation of this naturally occurring polysaccharide is reported to be well tolerated by patients, with a longer duration in tissue than bovine collagen without any major local or systemic side effects. We report a case of an acute hypersensitivity reaction in a woman after her third injection for improvement of melolabial fold wrinkles.

Methods: An adverse granulomatous-like response to the intradermal injection of a modified hyaluronic acid gel is described.

Results: The patient developed indurated and erythematous papulocystic nodules in the melolabial folds bilaterally at the sites of injection.

Conclusion: Injectable hyaluronic acid gel can be associated with severe allergic reactions and patients should be warned of this possible treatment side effect.