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      COVID y rellenos faciales ¿realmente debemos preocuparnos? Translated title: [[Translated article]]COVID-19 and Dermal Fillers: Should We Really Be Concerned?

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          Abstract

          La pandemia por COVID ha causado a día de hoy millones de afectados, continuando actualmente su aumento a nivel mundial. Junto con la afectación los órganos diana clave (aparato respiratorio, anosmia, diarrea, fiebre, etc), se han descrito reacciones inmunológicas tardías en los rellenos dérmicos por ácido hialurónico, fundamentalmente a nivel facial. Estas alteraciones aparecen tanto en pacientes positivos para el virus, independientemente de la sintomatología sistémica, como en pacientes que han recibido vacunación frente al SARS-CoV-2. Aunque las reacciones suelen ser autolimitadas y autoresolutivas, es importante saber diagnosticarlas y en ocasiones establecer tratamiento con corticoides, hialuronidasa y/o antibióticos. Aunque no son graves, la FDA las ha clasificado como evento adverso serio. Los mecanismos que originan están reacciones no están completamente dilucidados. Parece que son reacciones de hipersensibilidad retardada tipo IV, favorecidas por estímulos inmológicos que se activan en presencia del COVID o de otros virus como la gripe. Sin embargo, dado que los rellenos presentan cada vez mayor durabilidad y a que la pandemia continúa su curso, existiendo nuevas vacunas en desarrollo, es esencial la realización de estudios que describan la evolución a largo plazo tanto de los rellenos de AH, como de otros bioimplantes. Así mismo, es esencial alentar a los médicos de que reporten este tipo de reacciones, aunque no revistan gravedad con el objetivo de poder realizar un registro fidedigno de ellas.

          Translated abstract

          SARS-CoV-2 has caused millions of infections and deaths worldwide and case numbers continue to rise. Besides the effect of the virus on key organs — leading to respiratory illness, anosmia, diarrhea, and fever and other complications — delayed inflammatory reactions to hyaluronic acid dermal fillers, mainly in the face, have also been reported to occur after confirmed SARS-CoV-2 infections and in vaccinated individuals. While delayed inflammatory reactions tend to be self-limiting, they should be diagnosed and treated with corticosteroids, hyaluronidase, and/or antibiotics when necessary. The inflammation is generally not severe, yet these complications are classified as serious adverse events by the US Food and Drug Administration. They appear to be delayed type IV hypersensitivity reactions triggered by the immune system in the presence of SARS-CoV-2 or other viruses, such as those causing influenza, although the underlying mechanisms have not been fully elucidated. Because the longevity of dermal fillers is increasing, while the pandemic continues to evolve and new vaccines are under development, the long-term effects on hyaluronic acid fillers and other bioimplant materials should be studied. Physicians must also be encouraged to report these reactions, however mild, to ensure accurate records.

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          Author and article information

          Journal
          Actas Dermosifiliogr
          Actas Dermosifiliogr
          Actas Dermo-Sifiliograficas
          AEDV. Published by Elsevier España, S.L.U.
          0001-7310
          1578-2190
          8 August 2022
          8 August 2022
          Affiliations
          [0005]Servicio de Dermatología, Hospital Universitario 12 de Octubre, Madrid, España; AG BIOMEDIC CLINIC, Madrid, España
          Author notes
          [* ]Autor de correspondencia
          Article
          S0001-7310(22)00715-3
          10.1016/j.ad.2022.08.013
          9359628
          3ef4bc3b-032e-499c-9dec-3ae79b15ecf3
          © 2022 AEDV. Published by Elsevier España, S.L.U.

          Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.

          History
          : 24 February 2022
          : 22 May 2022
          Categories
          Revisión

          covid-19,sars-cov-2,ácido hialurónico,reacción imnunológica tardía,inflamación,ace2,hyaluronic acid,delayed immune reaction,angiotensin-converting enzyme 2,ace2 enzyme

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