Foreign body reaction triggered by cytotoxic T lymphocyte-associated protein 4 blockade 25 years after dermal filler injection

Abstract

Foreign body reactions are regularly seen as a late complication of cosmetic treatment with synthetic dermal fillers. Often this foreign body reaction is triggered by a systemic infection, but other systemic triggers are reported in literature as well. In this case report, we present a female patient in her 60s who was treated with ipilimumab for metastatic melanoma. After two courses of treatment she developed painless facial nodules. A foreign body reaction to dermal fillers was suspected because patient had received cosmetic treatment with dermal fillers 25 years before. This was confirmed by excision and histological examination. In the absence of other known triggers, this case report revealed immunotherapy (ipilimumab) and subsequent activation of the adaptive immune-system, as potential trigger of foreign body reactions to dermal fillers. Immunotherapy is increasingly used as anti-cancer treatment for an increasing number of tumour types. Furthermore, synthetic dermal fillers were frequently used in the past. Therefore physicians should be aware of this late-occurring complication of synthetic filler treatment in patients that develop skin lesions during treatment with immunotherapy. This article is protected by copyright. All rights reserved.