Delayed hypersensitivity reaction to hyaluronic acid dermal filler following influenza-like illness

Figures & data

Figure 1 Sites of reaction.

Table 1 The injected fillers, number of injections, and time to onset

Patient number	Patient age	Injected product(s)	Number of treatments in the 4 years prior to onset of symptoms	Time to onset of symptoms (months after final treatment)	Treatment(s) received
1	32	Teosyal Deep Lines Belotero Intense Belotero Volume	4	4	Prednisolone Hyaluronidase
2	31	Teosyal Deep Lines Juvederm Volbella Belotero Balance	3	2	Prednisolone
3	29	Teosyal Puresense Juvederm Volift	2	10	Prednisolone
4	22	Juvederm Volbella Teosyal Kiss	2	4	Prednisolone
5	40	Juvederm Volbella Juvederm Voluma Juvederm Volift	6	6	Prednisolone Hyaluronidase
6	65	Teosyal	2	4	Methyl Prednisolone
7	57	Hylaform Surgiderm	8	7	Methyl Prednisolone
8	63	Juvederm Volbella Belotero Balance	5	9	Prednisolone Hyaluronidase
9	41	Juvederm Volbella Juvederm Voluma Juvederm Volift	3	3	Prednisolone Hyaluronidase
10	25	Restylane Volyme Restylane Defyne Belotero Intense	4	5	Prednisolone
11	34	Juvederm Voluma	6	3	Methyl Prednisolone
12	45	Belotero Balance	4	5	Methyl Prednisolone
13	23	Belotero Balance	2	6	Methyl Prednisolone
14	61	Restylane Refyne Restylane Defyne	6	4	Methyl Prednisolone

Table 2 Number of injections in each anatomical site of each kind of filler

Site of injection	Brand of filler	Number of injections in each site
Tear trough	Juvederm Volbella	6
	Belotero Balance	4
	Teosyal Puresense	2
Lip	Teosyal Kiss	1
	Belotero intense	2
	Juvederm Volbella	2
Cheeks	Juvederm Voluma	6
	Restylane Refyne	3
	Restylane Defyne	1
	Belotero Volume	1
Nasolabial folds	Restylane Refyne	2
	Belotero Balance	2
Chin	Juvederm Voluma	3
	Teosyal Deep Lines	3
Nose	Juvedrem Volift	2
	Restylane Refyne	1

Figure 2 Patient 1 and patient 2: sites of reaction before (left) and two weeks after (right) treatment.