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Landau M, Klein J, Leizgold FR, Kroumpouzos G. Rare and novel complications of botulinum neurotoxin type A and dermal filler injections. Clin Dermatol 2024:S0738-081X(24)00107-X. [PMID: 38914174 DOI: 10.1016/j.clindermatol.2024.06.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/26/2024]
Abstract
Botulinum neurotoxin type A (BoNTA) and filler injection procedures usually provide predicted outcomes with a low incidence of complications. Most of the complications after these procedures have been extensively discussed. In this study, we report on these injectables' less well-known, recently reported, and novel complications and attempt to clarify the underlying mechanisms. Counterfeit or mishandled BoNTA has been associated with botulism. BoNTA has been linked to uncommon complications, including morphea-like lesions, nontuberculous mycobacterial infections, vascular occlusion, and pseudoaneurysm of the superficial temporal artery. Unusual complications from filler injection include nonscarring alopecia, intraoral necrosis, nontuberculous mycobacterial infections, xanthelasma-like reactions, intracranial perforation, and pneumosinus dilatans. Post-BoNTA injection nodules and filler infection from bone destruction due to cocaine use are new complications. These complications pose a challenge for diagnosis and treatment. This publication aims to assist in promptly identifying and managing these rare and novel complications when necessary.
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Affiliation(s)
| | - Jerome Klein
- Jules Stein Eye Institute, UCLA Medical Center, Los Angeles, California, USA
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Ou Y, Liu D, Feng J, Xu X, Lin T, Zhang Y, Luo L, Wu M, Cui Y. Subcutaneous infection caused by Mycobacterium abscessus following botulinum toxin injections: A case report and literature review. J Cosmet Dermatol 2024; 23:1527-1532. [PMID: 38178368 DOI: 10.1111/jocd.16170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2023] [Revised: 11/30/2023] [Accepted: 12/27/2023] [Indexed: 01/06/2024]
Abstract
BACKGROUND The rapid development of cosmetic injections has led to an increased incidence of nontuberculous mycobacterial (NTM) infection. PATIENTS AND METHODS Here, we presented a case of cutaneous Mycobacterium abscessus infection subsequent to botulinum toxin injection for treating masseter hypertrophy, and reviewed the literature on skin and soft tissue infections caused by NTM after cosmetic injections. RESULTS AND CONCLUSIONS The patient underwent surgical excision and regular antibiotic therapy and has had nearly 2 months of follow-up without any signs of infection. The diagnosis and treatment of NTM infection have always been challenging, and further research is needed to standardize and guide the treatment.
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MESH Headings
- Adult
- Female
- Humans
- Anti-Bacterial Agents/administration & dosage
- Anti-Bacterial Agents/adverse effects
- Anti-Bacterial Agents/therapeutic use
- Botulinum Toxins, Type A/adverse effects
- Botulinum Toxins, Type A/administration & dosage
- Cosmetic Techniques/adverse effects
- Hypertrophy
- Masseter Muscle/abnormalities
- Mycobacterium abscessus/isolation & purification
- Mycobacterium Infections, Nontuberculous/drug therapy
- Mycobacterium Infections, Nontuberculous/diagnosis
- Mycobacterium Infections, Nontuberculous/etiology
- Mycobacterium Infections, Nontuberculous/microbiology
- Skin Diseases, Bacterial/diagnosis
- Skin Diseases, Bacterial/microbiology
- Skin Diseases, Bacterial/drug therapy
- Skin Diseases, Bacterial/etiology
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Affiliation(s)
- Yanting Ou
- Department of Plastic Surgery, Peking University Shenzhen Hospital, Shenzhen, China
- Medical College, Shantou University, Shantou, China
| | - Dandan Liu
- Department of Plastic Surgery, Peking University Shenzhen Hospital, Shenzhen, China
| | - Jun Feng
- Department of Plastic Surgery, Peking University Shenzhen Hospital, Shenzhen, China
| | - Xiangwen Xu
- Department of Plastic Surgery, Peking University Shenzhen Hospital, Shenzhen, China
| | - Tingyin Lin
- Department of Plastic Surgery, Peking University Shenzhen Hospital, Shenzhen, China
- Medical College, Shantou University, Shantou, China
| | - Yihan Zhang
- Department of Plastic Surgery, Peking University Shenzhen Hospital, Shenzhen, China
- Medical College, Shantou University, Shantou, China
| | - Lin Luo
- Department of Plastic Surgery, Peking University Shenzhen Hospital, Shenzhen, China
| | - Mengfan Wu
- Department of Plastic Surgery, Peking University Shenzhen Hospital, Shenzhen, China
| | - Yongyan Cui
- Department of Plastic Surgery, Peking University Shenzhen Hospital, Shenzhen, China
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Shen H, Zhang Q, Peng L, Ma W, Guo J. Cutaneous Mycobacterium Abscessus Infection Following Plastic Surgery: Three Case Reports. Clin Cosmet Investig Dermatol 2024; 17:637-647. [PMID: 38505806 PMCID: PMC10949168 DOI: 10.2147/ccid.s445175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Accepted: 03/06/2024] [Indexed: 03/21/2024]
Abstract
Aim Mycobacterium abscessus is ubiquitous in the environment and seldom causes infections in immunocompetent individuals. However, skin and soft tissue infections caused by M. abscessus have been reported in recent years. Additionally, the cutaneous infections or outbreaks post cosmetic surgery caused by M. abscessus have been increasing due to the popularity of plastic surgery. The main modes of transmission are through contaminated saline, disinfectants, or surgery equipment, as well as close contact between patients. This article describes three patients who were admitted to our hospital between November 2019 and October 2020. They presented with long-term non-healing wounds caused by M. abscessus infection after undergoing plastic surgery. Symptoms presented by the three patients included swelling, ulceration, secretion, and pain. After identification of M. abscessus with Ziehl-Neelsen staining and MALDI-TOF MS system, the patients were treated with surgical debridement and clarithromycin. Conclusion It is important to note that a long-term wound that does not heal, especially after plastic surgery, should raise suspicion for M. abscessus infection. The infection mechanism in these three patients may have been due to exposure to surgical equipment that was not properly sterilized or due to poor sterile technique by the plastic surgeon. To prevent such infections, it is important to ensure proper sterilization of surgical equipment and saline.
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Affiliation(s)
- Hongwei Shen
- Clinical Laboratory, Shenzhen Hospital of Southern Medical University, Shenzhen, Guangdong, People’s Republic of China
| | - Qiaomin Zhang
- Clinical Laboratory, Shenzhen Hospital of Southern Medical University, Shenzhen, Guangdong, People’s Republic of China
| | - Liang Peng
- Department of Burns and Plastic Surgery, Shenzhen Hospital of Southern Medical University, Shenzhen, Guangdong, People’s Republic of China
| | - Wen Ma
- Clinical Laboratory, Shenzhen Hospital of Southern Medical University, Shenzhen, Guangdong, People’s Republic of China
| | - Jingdong Guo
- Department of Burns and Plastic Surgery, Shenzhen Hospital of Southern Medical University, Shenzhen, Guangdong, People’s Republic of China
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Ninosu N, Vogelmann R, Géraud C, Olsavszky V. Abscessed Mycobacterium fortuitum infection of the face after autologous fat transfer. J Dtsch Dermatol Ges 2024; 22:453-456. [PMID: 38185788 DOI: 10.1111/ddg.15321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Accepted: 11/03/2023] [Indexed: 01/09/2024]
Affiliation(s)
- Nadia Ninosu
- Department of Dermatology, Venereology, and Allergology, University Medical Center and Medical Faculty Mannheim, Heidelberg University, and Center of Excellence in Dermatology, Mannheim, Germany
| | - Roger Vogelmann
- Second Department of Internal Medicine, University Medical Center Mannheim and Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Cyrill Géraud
- Department of Dermatology, Venereology, and Allergology, University Medical Center and Medical Faculty Mannheim, Heidelberg University, and Center of Excellence in Dermatology, Mannheim, Germany
- Section of Clinical and Molecular Dermatology, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- European Center for Angioscience, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Victor Olsavszky
- Department of Dermatology, Venereology, and Allergology, University Medical Center and Medical Faculty Mannheim, Heidelberg University, and Center of Excellence in Dermatology, Mannheim, Germany
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Ninosu N, Vogelmann R, Géraud C, Olsavszky V. Abszedierte Mycobacterium-fortuitum-Infektion im Gesicht nach Eigenfettinjektion: Abscessed Mycobacterium fortuitum infection of the face after autologous fat transfer. J Dtsch Dermatol Ges 2024; 22:453-456. [PMID: 38450989 DOI: 10.1111/ddg.15321_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Accepted: 11/03/2023] [Indexed: 03/08/2024]
Affiliation(s)
- Nadia Ninosu
- Klinik für Dermatologie, Venerologie und Allergologie, Universitätsmedizin Mannheim, Medizinische Fakultät Mannheim der Universität Heidelberg, Mannheim, und Exzellenzzentrum für Dermatologie, Mannheim
| | - Roger Vogelmann
- II. Medizinische Klinik, Universitätsklinikum Mannheim, Universitätsmedizin Mannheim, Medizinische Fakultät Mannheim der Universität Heidelberg, Mannheim
| | - Cyrill Géraud
- Klinik für Dermatologie, Venerologie und Allergologie, Universitätsmedizin Mannheim, Medizinische Fakultät Mannheim der Universität Heidelberg, Mannheim, und Exzellenzzentrum für Dermatologie, Mannheim
- Sektion Klinische und Molekulare Dermatologie, Universitätsmedizin Mannheim, Medizinische Fakultät Mannheim der Universität Heidelberg, Mannheim
- European Center for Angioscience, Medizinische Fakultät Mannheim der Universität Heidelberg, Mannheim
| | - Victor Olsavszky
- Klinik für Dermatologie, Venerologie und Allergologie, Universitätsmedizin Mannheim, Medizinische Fakultät Mannheim der Universität Heidelberg, Mannheim, und Exzellenzzentrum für Dermatologie, Mannheim
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