Correspondence |

Adverse Reaction to Cutaneous Injection of Contents From a Vitamin E Liquid–Containing Capsule

Silvina Pugliese, BS; Ron Yaar, MD, PhD; Najla Al-Dawsari, MD; Lynne J. Goldberg, MD; Amit Garg, MD
Arch Dermatol. 2010;146(4):454-455. doi:10.1001/archdermatol.2010.30.
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Mesotherapy, or the transcutaneous injection of compounds for local treatment of a medical condition or for cosmesis, is an emerging trend in skin rejuvenation. Despite the relative paucity of published clinical trials assessing the efficacy of mesotherapy for cosmesis,1 mesotherapy is performed by both licensed and unlicensed practitioners in the United States and abroad. Little has been discussed regarding adverse reactions to vitamins administered transcutaneously for cosmesis. We report herein an adverse cutaneous reaction to injection of the contents of a vitamin E capsule, and we describe its course and histologic correlates.

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Figure 2.

Histologic findings prior to treatment. A and B, Hematoxylin-eosin–stained sections demonstrate irregular spaces throughout the reticular dermis, apoptotic cells, basophilic cellular debris, and a mild neutrophilic panniculitis (original magnifications ×4 [A] and ×20 [B]). C, Periodic acid–Schiff (PAS)-stained sections demonstrate PAS-positive lipomembrane-like structures present throughout the reticular dermis (original magnification ×40).

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Figure 1.

Clinical appearance before treatment. Facial edema (A) and erythema and induration at injection sites at the glabella (B) and along the nasolabial fold (C).

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