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American Journal of Dermatopathology:
doi: 10.1097/DAD.0b013e3181f9f549
Extraordinary Case Report

Granulomatous Reaction After Injection of a New Resorbable Filler Novabel

Moulonguet, Isabelle MD*; de Goursac, Catherine MD†; Plantier, Françoise MD*

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Abstract

A new resorbable filler, Novabel, became commercially available in January 2010 in France. A 52-year-old general practitioner injected 0.1 cm3 of a 1 cm3 alginate solution (Novabel) into the deep dermis of her left arm to test it before using it on her patients. Ten days later, she observed a small pink nodule at the injection site forming secondary a bluish papule. A biopsy was performed 2 months after the injection. Histopathology showed a granulomatous reaction involving the deep dermis and the subcutaneous fat. The inflammatory reaction surrounded a nonpolarizing exogenous material consisting of slightly bluish deposits of variable size and shape, some of which were well delineated, others with a blurred or spiky perimeter, frequently showing retraction in a clear vacuole. The papule regressed, resolving completely 5 months after the injection. Novabel is a totally new type of aesthetic injectable resorbable filler consisting of a purified polysaccharide, alginate, which is extracted from crusted brown algae. No side effects have been reported to date and we describe here a first granulomatous reaction after filler injection which has a distinctive appearance in keeping with the histopathological findings.

© 2011 Lippincott Williams & Wilkins, Inc.

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