Ann Dermatol.  2016 Dec;28(6):753-756. 10.5021/ad.2016.28.6.753.

Late-Onset Complication of Fillers: Paraffinoma of the Lower Eyelids Clinically Mimicking Xanthelasma

• Kim MW
• Park HS
• Yoon HS
• Cho S

• KMID: 2368127
• DOI: http://doi.org/10.5021/ad.2016.28.6.753

Abstract

Injectable poly-L-lactic acid (PLLA) is world-famous filler used in lipoatrophy and facial rejuvenation because of its collagen neogenesis effect which leads to gradual volume restoration. Until recently, quite a number of unwanted adverse events of PLLA have been reported. However, to the best of our knowledge, paraffinoma as a complication of PLLA has never been reported. We herein describe the first case of paraffinoma after Sculptra® injection and propose its possible mechanism.

Keyword

Dermal fillers; Foreign-body granuloma; Lipogranuloma; Paraffinoma; Poly-L-lactic acid

MeSH Terms

Collagen
Dermal Fillers
Eyelids*
Granuloma, Foreign-Body
Rejuvenation
Collagen
Dermal Fillers

Figure

• 

  Fig. 1 A physical examination of the patient shows relatively well-demarcated yellowish plaque lesions in both the lower eyelids, and the lesion on the right side was more prominent.

• 

  Fig. 2 (A) A hematoxylin and eosin-stained section shows a diffuse inflammatory reaction with a Swiss cheese appearance and 4 reactive lymphoid follicles throughout the middle and deep dermis down to the muscle layer (×40). (B) Numerous epithelioid cells, a foreign body-type giant cell, and vacuolated histiocytes both scattered individually and in aggregates forming a Swiss cheese pattern are seen along with a lymphoid follicle (H&E, ×200). (C) Variably sized vacuoles, which correspond to lipid removed with tissue processing, as well as numerous foamy histiocytes, lymphocytes, and hyalinized collagen fibrils are seen (H&E, ×400).

• 

  Fig. 3 After 3 months of 100% trichloroacetic acid peel treatment, the lesions show partial improvement.

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