Abstract
The popularity of nonsurgical, minimally invasive cosmetic treatments has increased drastically in recent years, with lip augmentation being one of the most common. Dermatologists play an important role in the delivery of safe, evidence-based options for lip augmentation, including lip filler. Many types of filler are available to patients, and their safety profiles have been studied extensively. Adverse effects, if they do occur, are generally mild and self-limited; however, fewer data exist describing the adverse effects of fillers, particularly hyaluronic acid (HA) dermal fillers, in patients with a history of autoimmune disease. This report presents a case of a granulomatous delayed hypersensitivity reaction to HA filler in a patient with ankylosing spondylitis, which was subsequently successfully treated with hyaluronidase. As complications of cosmetic procedures affect patients' quality of life, this case highlights the importance of recognizing similar reactions to HA filler and the efficacy of hyaluronidase as a treatment option when they occur.