A study of the microbiological profile of filler-induced skin necrosis

Clin Exp Dermatol. 2021 Jul;46(5):901-905. doi: 10.1111/ced.14653. Epub 2021 May 3.

Abstract

Skin necrosis is one of the most severe complications following filler injections, and can result in permanent aesthetic defects. Although an increasing number of studies have addressed the management of dermal filler complications, no study has described the spectrum of microbial pathogens. The aim of this study was to delineate the bacterial profile and prognostic factors of filler-related skin necrosis by reviewing the clinical and microbiological features of these patients. A retrospective medical record review of patients undergoing treatment for skin necrosis induced by fillers was conducted. In total, 10 cases were identified, with injection sites being the nasolabial fold (70%; n = 7), nasal dorsum (20%; n = 2) and nasal tip (10%; n = 1). Reviewing the culture results, the true culture-positive rate was found to be 50% after cases of contamination were excluded. To avoid permanent sequelae, all physicians should be aware of possible secondary infections when treating filler-induced skin necrosis.

MeSH terms

  • Adult
  • Anti-Bacterial Agents / standards
  • Anti-Bacterial Agents / therapeutic use
  • Culture Techniques / methods
  • Culture Techniques / statistics & numerical data
  • Dermal Fillers / administration & dosage
  • Dermal Fillers / adverse effects*
  • Female
  • Gram-Negative Bacteria / growth & development
  • Gram-Negative Bacteria / isolation & purification
  • Humans
  • Injection Site Reaction / microbiology
  • Injection Site Reaction / pathology
  • Middle Aged
  • Nasolabial Fold / microbiology
  • Nasolabial Fold / pathology
  • Necrosis / chemically induced*
  • Necrosis / diagnosis
  • Necrosis / microbiology*
  • Necrosis / therapy
  • Nose / microbiology
  • Nose / pathology
  • Prognosis
  • Re-Epithelialization / physiology
  • Retrospective Studies
  • Severity of Illness Index
  • Skin Diseases / etiology*
  • Skin Diseases / pathology

Substances

  • Anti-Bacterial Agents
  • Dermal Fillers