{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T01:11:52Z","timestamp":1787015512441,"version":"build-2736575974"},"reference-count":15,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2019,11,28]],"date-time":"2019-11-28T00:00:00Z","timestamp":1574899200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acad Dermatol Venereol"],"published-print":{"date-parts":[[2020,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      Granulomatous foreign body reactions (\n                      <jats:styled-content style=\"fixed-case\">GFBR<\/jats:styled-content>\n                      ) have been reported after injection with almost every soft tissue fillers, more commonly with non\u2010biodegradable ones. Such granulomatosis is rare but can cause significant discomfort owing to their aesthetic and functional repercussions.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>\n                      To determine whether immunomodulation with low doses of methotrexate is effective in the treatment of\n                      <jats:styled-content style=\"fixed-case\">GFBR<\/jats:styled-content>\n                      to filler material.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Clinical case series of four patients with severe, treatment\u2010resistant\n                      <jats:styled-content style=\"fixed-case\">GFBR<\/jats:styled-content>\n                      to non\u2010biodegradable fillers in the Department of Dermatology of Bordeaux University Hospital, Bordeaux, France, successfully treated with oral or subcutaneous methotrexate, 10\u201315\u00a0mg weekly during 6\u00a0months. Adverse events were monitored throughout the treatment once weekly the first month then once monthly the remaining 5\u00a0months.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Four women with a mean age of 73.7\u00a0years (66\u201385\u00a0years) and nodularity of the face were included and treated up to 6\u00a0months. Histological findings were consistent with\n                      <jats:styled-content style=\"fixed-case\">GFBR<\/jats:styled-content>\n                      to liquid injectable silicone in 2 cases, polymethylmethacrylate in 1 case and hydroxyethylmethacrylate in the last case. The delay after injection of the filler material was from 17 to 30\u00a0years. In one patient, inflammatory lesions followed dental care. After 6\u00a0months of treatment with 10\u201315\u00a0mg once weekly, all patients were cleared. Three patients developed a mild hepatic cytolysis (grade 1 or 2). Methotrexate could be maintained in those 3 cases and was discontinuated after 6\u00a0months in all cases. Two patients developed recurrence of lesions, 28 and 9\u00a0months, respectively, after treatment stops, requiring reintroduction of treatment. The two other patients remained cleared after 6\u00a0months of follow\u2010up.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      Low doses of methotrexate appear to offer a low\u2010risk therapeutic alternative in resistant and severe\n                      <jats:styled-content style=\"fixed-case\">GFBR<\/jats:styled-content>\n                      to fillers. A prospective study with long\u2010term follow\u2010up is required to confirm these preliminary observations.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jdv.16027","type":"journal-article","created":{"date-parts":[[2019,10,25]],"date-time":"2019-10-25T04:14:05Z","timestamp":1571976845000},"page":"817-820","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":25,"title":["Management of granulomatous foreign body reaction to fillers with methotrexate"],"prefix":"10.1111","volume":"34","author":[{"given":"M.","family":"Broly","sequence":"first","affiliation":[{"name":"Department of Dermatology Centre Hospitalier Universitaire de Bordeaux H\u00f4pital Saint\u2010Andr\u00e9 Bordeaux France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Marie","sequence":"additional","affiliation":[{"name":"Department of Dermatology Centre Hospitalier de P\u00e9rigueux P\u00e9rigueux 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