Casuistic chain: COVID-19, inflammatory response to hyaluronic acid-based filler and xanthelasma

ABSTRACT

The pandemic of a new coronavirus infection has posed many challenges and questions for medicine. Dermatologists, in particular, have encountered a wide variety of cutaneous manifestations of this infection. Apart from a fairly broad coverage of various rashes and features of the course of many chronic dermatoses, only sporadic descriptions of inflammatory reactions to cosmetic fillers are available. Objec-tives. An extremely rare complication is described an inflammatory reaction to the injection of a hyaluronic acid-based filler, which, in turn, led to the occurrence of xanthelasma at the sites of filler localization during the recovery period after COVID-19. Material and methods. A patient presented with yellow lesions in the nasolacrimal sulcus area following the resolution of an inflammatory response to the injection of a hyaluronic acid-based filler during the recovery period after a COVID-19 infection. Results. The diagnosis was confirmed by ultrasound of the face skin and soft tissues, and the optimal therapy regimen was determined. Conclusion. In the global medical practice, only single cases of xanthelasma and xanthelasma-like reactions after the filler injection are report-ed. In a scientific first, the pathogenetic chain including COVID-19, filler inflammatory response, and xanthelasma is described. The patho-genesis of this complication is also of particular interest and needs further study. Although extremely rare, physicians should be aware of this complication and its treatment options.