Prof. Dr. Owczarczyk-Saczonek Agnieszka
Head of Dept of Dermatology, Sexually Transmitted Diseases and Clinical Immunology
The University of Warmia and Mazury in Olsztyn
SERIOUS ADVERSE REACTIONS AFTER AESTHETIC MEDICINE PROCEDURES
Author: Agnieszka Owczarczyk-Saczonek
The most common adverse reactions can be observed immediately after aesthetic procedures and are usually associated with tissue traumatization: hematoma, bruising, swelling or in the case of hyaluronic acid (HA) vascular occlusion. Whereas delayed hypersensitivity reactions are observed more often after 1 week to years after treatment. In some cases the product, subject to natural hyaluronidase enzyme, releases low molecular weight HA, or is poorly purified (containing bacterial DNA) which become antigens, thus provoking delayed reactions. Recently ASIA syndrome (the autoimmune/inflammatory syndrome) induced by adjuvants was established. HA, as an adjuvant, enhances antigen specific immune response, induces inflammatory cytokines release and interacts with Toll-like receptors and inflammasome. This reaction leads to innate and adaptive immune response (polyclonal activation of B cells, effect on cellular immunity). Therefore, the long-term observation and monitoring of the patient, as well as the choice of a solution approved by FDA or EMA are of the utmost importance.
In cases of botulinum procedures, BoNT is immunogenic and stimulates the production of neutralizing anti-drug antibodies, especially with repeated administration, resulting in secondary lack of response. The substance administered is not a pure toxin, but it contains neurotoxin-associated complexing proteins (NAPs), excipients for stabilization, and buffer systems. Antibodies produced against NAPs are non-neutralizing antibodies and do not affect neurotoxin activity.
The lecture presents own cases of immune disorders provoked by HA, BoNT and platelet-rich plasma.
Agnieszka Owczarczyk-Saczonek is assistant professor, the Head of the Department of Dermatology, Sexually Transmitted Diseases and Clinical Immunology at The University of Warmia and Mazury in Olsztyn. She was appointed as the consultant in dermatology and venereology of Warmian-Masurian Voivodeship in 2013. Moreover she is a member of the Polish Society of Dermatology, a member of the Association of Aesthetic Dermatology, and a member of the European Academy of Dermatology and Venereology.
Dermatology, Metabolic diseases, Aesthetic Dermatology