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Reversible Alopecia with Localized Scalp Necrosis After Accidental Embolization of the Parietal Artery with Hyaluronic Acid.
Aesthetic Plastic Surgery ( IF 2.0 ) Pub Date : 2017-03-28 , DOI: 10.1007/s00266-017-0841-z
Qing Yang 1 , Lihong Qiu 1 , Chenggang Yi 1 , Ping Xue 1 , Zhou Yu 1 , Xianjie Ma 1 , Yingjun Su 1 , Shuzhong Guo 1
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Hyaluronic acid (HA) filler injection is widely used for soft-tissue augmentation. Complications associated with HA filling are not uncommon; however, HA-induced alopecia is a rarely reported complication that could result in severe secondary psychological trauma. The etiology, clinical traits, treatment strategies, outcomes, and possible reversibility of HA-induced alopecia have not been characterized. Here, we report a case in which bilateral temple injections of 6.5 mL of HA led to persistent pain over the left scalp for several days. Although the pain was relieved at day 9 after 600 U of hyaluronidase were injected in the left temple, the patient developed localized alopecia at the left temporoparietal region with central skin necrosis at day 15. After topical applications of recombinant bovine basic fibroblast growth factor gel and 2% minoxidil spay, the necrotic skin wound was healed at day 42. Hair regrowth and normal hair density were restored at day 74. Analyses of Doppler ultrasound examinations and histopathology of the skin biopsy suggested that mild ischemia of the left temporoparietal region led to reversible alopecia, while the permanent hair loss in the left parietal area was associated with severe skin ischemia. Therefore, the key to treatment would be to focus on the effective correction of severe ischemia-induced skin necrosis to prevent permanent hair loss. Level of Evidence V This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

中文翻译:

透明质酸意外栓塞顶动脉后可逆性脱发伴局部头皮坏死。

透明质酸(HA)填充剂注射剂广泛用于软组织增强。与HA填充相关的并发症并不少见。然而,HA引起的脱发是很少报道的并发症,可能导致严重的继发性心理创伤。HA引起的脱发的病因,临床特征,治疗策略,结局和可能的可逆性尚未得到表征。在这里,我们报道了一种情况,其中双侧太阳穴注射6.5毫升的HA导致左头皮持续几天疼痛。尽管在左侧太阳穴中注射600 U透明质酸酶后第9天疼痛得到缓解,但患者在第15天出现了左侧颞顶叶区域的局部脱发,并伴有中央皮肤坏死。局部应用重组牛碱性成纤维细胞生长因子凝胶和2%米诺地尔喷洒后,坏死的皮肤伤口在第42天愈合。毛发再生长和正常的头发密度在第74天恢复。多普勒超声检查分析和皮肤活检组织病理学分析提示左颞顶区轻度缺血导致可逆性脱发,而左顶区永久性脱发与严重的皮肤缺血有关。因此,治疗的关键将集中于有效纠正严重的缺血性皮肤坏死,以防止永久性脱发。证据等级V本期刊要求作者为每篇文章分配一定程度的证据。有关这些循证医学评分的完整说明,
更新日期:2019-11-01
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