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Autoimmune Autoinflammatory Syndrome Induced by Adjuvants (ASIA) After Injection of Foreign Materials for Cosmetic Purposes: Retrospective Analysis of 1027 Cases

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Abstract

Background

The injection of illicit, non-regulated foreign materials may trigger an autoimmune autoinflammatory syndrome induced by adjuvants (ASIA).

Methods

A retrospective review of health records was performed to identify patients’ epidemiological and clinical characteristics. The issues analyzed were age and gender of cases, occupation, the person who administered the substance, anatomical site, type and volume of the injected substance, time from injection to the onset of symptoms, chief complaint, measures taken to alleviate symptoms, local complications, systemic manifestations, and imaging method to aid in diagnosis.

Results

More than 70% of patients were female and dedicated to household activities; the mean age was 44 years for females and 40.7 years for males. One-quarter of patients reported some comorbidity. The most commonly reported substance was mineral oil, whereas the most frequent anatomical site was the gluteal region with volumes around one liter. Signs and symptoms occurred almost exclusively at a local level, pain (40%) and swelling (18%) being the predominant manifestations with a peak incidence after three years. Treatment was mainly medical; surgery, primarily en bloc resection, was performed in 20% of patients.

Conclusions

A myriad of substances may induce autoimmune autoinflammatory syndrome induced by adjuvants (ASIA) when injected for cosmetic purposes. Since effective treatments are scarce, public policies should be enforced to alert the community and limit the consequences of this healthcare problem.

Level of Evidence V

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Data Availability

The data underlying this article cannot be shared publicly in order to protect the privacy of individuals that participated in the study. The data will be shared on reasonable request to the corresponding author.

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Authors and Affiliations

  1. General Surgery Department, Mexico’s General Hospital (Hospital General de México), Mexico City, Mexico

    Beatriz Hatsue Kushida-Contreras

  2. National Autonomous University of Mexico (Universidad Nacional Autónoma de México, UNAM), Mexico City, Mexico

    Brenda Gómez-Calva & Bruno Mendoza-Ramírez

  3. Plastic and Reconstructive Surgery Department, Mexico’s Children’s Hospital (Hospital Infantil de México “Federico Gómez”), Mexico City, Mexico

    Miguel Angel Gaxiola-García

Authors
  1. Beatriz Hatsue Kushida-Contreras
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Correspondence to Miguel Angel Gaxiola-García.

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Human and Animal Rights

The appropriate Ethics Committee approved the study protocol. Anonymity and confidentiality were preserved. The research was conducted according to the World Medical Association Declaration of Helsinki. IRB approval number DI/21/104/03/12. For this type of study informed consent is not required.

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Kushida-Contreras, B.H., Gómez-Calva, B., Mendoza-Ramírez, B. et al. Autoimmune Autoinflammatory Syndrome Induced by Adjuvants (ASIA) After Injection of Foreign Materials for Cosmetic Purposes: Retrospective Analysis of 1027 Cases. Aesth Plast Surg 48, 491–500 (2024). https://doi.org/10.1007/s00266-023-03670-y

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