Objectives: Report of a case, granuloma secondary to the application of PCL a biostimulator
the importance of knowing that we are injecting will guide us in the treatment to be carried out to reverse adverse effects
Introduction: Polycaprolactone (PCL) is a biodegradable aliphatic polyester, the polymer is frequently used and has its medical indications such as volume replacement and collagen biostimulator, it belongs to the group of semi-permanent injectables. PCL is degraded by hydrolysis of its ester linkages under normal conditions; measured by different enzymes that are capable of hydrolyzing products and breaking their hydrogen bonding structure. Today we know that this material is combined with carboxymethylcellulose 70% of the material and 30% PCL, which this osmotic carbohydrate serves as a vehicle for the PCL
Materials / method: Case report
A 48-year-old female patient comes to our clinic, referring that she had been placed with PCL with another dermatologist. A clinical history is started and data is collected to initiate ideal management, as the patient had more than 3 months of application of PCL, she refers that from the beginning of the product, when it was placed, she noticed a few days later that it was stiff, very little mobile, At 6 weeks after product placement, it begins with total deformation, inflammation and increased volume of the PCL placement sites.
Results: General data is taken, for which we decide and due to evolution time we suspect a reaction to the product and the generation of collagen worsened the situation. Therefore, we started under the protocol Biopsy of the area and extraction of little material; which is made by Dra. Rebeca Palacio; retinologist and Dr. Juan Biguerias, surgeon and esthetician; due to the proximity to risk areas for compromising the orbit, corrugator muscle, and proximity to the temporal nerve. Extracted material is sent to the pathology laboratory for study and a photographic count is taken
Conclusion: They send us a pathology report showing the following:
Report: Epithelioid histiocytes, multinucleated giant cells; foreign body, lymphocyte collar and abundant fibrosis at the site of placement
The management of a patient with this deformity is not so easy, it is a challenge for every dermatologist, aesthetic doctor, plastic surgeon, for which, given the data revealed by the biopsy, we started with 5ml collagenase on each side injected intralesionally with a 25G dermal cannula with technique of subinscision.
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