Abstract:

We present a case of a 46-year-old female that presented for complications after self-injections of fat dissolving chemical purchased from an online retailer. Two weeks after the home based procedure, the patient noted erythematous painful dermal nodules had developed at the injection sites of the face, neck, and arms. After two months, she presented to her local emergency department on multiple occasions, was initiated on three different oral antibiotics with no noticeable benefit. The patient was then referred to dermatology for evaluation. Upon further history, the patient reported new nodules were developing at locations not previously injected. This raised concern for possible underlying infectious etiology, so two biopsies were performed for histopathologic evaluation and culture. After one week, tissue and wound cultures were negative, while biopsy histopathology revealed deep granulomatous inflammation with focal acute and chronic inflammation and zones of necrosis, raising concerns for atypical fungal or mycobacterial infection not cultured on initial medium. Repeat cultures were performed and are pending The use of phosphatidylcholine-containing products was originally thought to be a critical component in facial contouring and aesthetics. While their use has begun to fall out of favor amongst physician practitioners, many of these products are now available over the counter or without prescription. In addition to the complications associated with conducting medical procedures outside of a clean or sterile environment, cosmetic products placed by an untrained hand may result in a poor outcome.

Financial Disclosure:
No current or relevant financial relationships exist.

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Willis Lyford, MD