{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T18:15:23Z","timestamp":1772993723884,"version":"3.50.1"},"reference-count":26,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,10,15]],"date-time":"2025-10-15T00:00:00Z","timestamp":1760486400000},"content-version":"vor","delay-in-days":287,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Case Reports in Dermatological Medicine"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Botulinum toxin type A is widely used for aesthetic purposes and is generally considered safe. However, rare complications such as nodule formation at injection sites can occur, posing diagnostic and therapeutic challenges.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>To describe a case report of patients developing inflammatory nodules after incobotulinum toxin A injections, review the differential diagnoses, and discuss appropriate management strategies based on clinical outcomes and literature.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients\/Methods<\/jats:title>\n                    <jats:p>We report three cases of healthy female patients (ages 35\u201340) who presented with localized nodules approximately 1\u2009cm in diameter following a full\u2010face treatment with Inco botulinum toxin A for treatment of rhytides. Nodules appeared at the frontal injection sites immediately after treatment and were evaluated through clinical examination and ultrasound imaging. Only one patient received empirical anti\u2010inflammatory and antibiotic therapy; the others were managed conservatively with observation alone.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>All cases resolved spontaneously in one and 2\u2009months, with no scarring or pigmentation changes. Although histopathological confirmation was not performed, the benign clinical course and absence of systemic symptoms suggest a transient inflammatory or hypersensitivity reaction rather than infectious or granulomatous pathology. Literature review supports a multifactorial aetiology, including immune\u2010mediated, foreign\u2010body, and rare infectious causes. Early identification and conservative management are often sufficient, though persistent or atypical cases may warrant biopsy and targeted therapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Nodule formation following incobotulinum toxin A injection is an uncommon but important clinical entity. Awareness of its presentation and natural course can prevent unnecessary interventions. Further research is needed to define diagnostic algorithms and management guidelines.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1155\/crdm\/9921924","type":"journal-article","created":{"date-parts":[[2025,10,16]],"date-time":"2025-10-16T03:33:41Z","timestamp":1760585621000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Toxin\u2010Induced Nodules: A Clinically Distinct Complication With Implications for Aesthetic Practice"],"prefix":"10.1155","volume":"2025","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3830-4918","authenticated-orcid":false,"given":"Desiree","family":"Castelanich","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3908-3440","authenticated-orcid":false,"given":"Luis Alberto","family":"Parra","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-4036-7365","authenticated-orcid":false,"given":"Juan Sebastian","family":"Rodriguez Cabrales","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eugenia","family":"Cure","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-0098-4835","authenticated-orcid":false,"given":"Eliana","family":"Garces","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9141-1328","authenticated-orcid":false,"given":"Andrea Marcela","family":"Parra","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,10,15]]},"reference":[{"key":"e_1_2_10_1_2","unstructured":"ISAPS Global Survey 2023."},{"key":"e_1_2_10_2_2","doi-asserted-by":"publisher","DOI":"10.1002\/der2.70023"},{"key":"e_1_2_10_3_2","doi-asserted-by":"publisher","DOI":"10.1093\/asj\/sjac228"},{"key":"e_1_2_10_4_2","doi-asserted-by":"publisher","DOI":"10.1111\/jocd.14160"},{"key":"e_1_2_10_5_2","doi-asserted-by":"publisher","DOI":"10.1111\/jocd.13667"},{"key":"e_1_2_10_6_2","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.10175"},{"key":"e_1_2_10_7_2","doi-asserted-by":"publisher","DOI":"10.1097\/scs.0000000000009790"},{"key":"e_1_2_10_8_2","doi-asserted-by":"publisher","DOI":"10.1080\/14764172.2019.1690663"},{"key":"e_1_2_10_9_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00105-015-3651-8"},{"key":"e_1_2_10_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.clindermatol.2024.06.023"},{"key":"e_1_2_10_11_2","doi-asserted-by":"publisher","DOI":"10.1093\/asj\/sju105"},{"key":"e_1_2_10_12_2","doi-asserted-by":"publisher","DOI":"10.1177\/1090820x14532648"},{"key":"e_1_2_10_13_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1524-4725.2008.34223.x"},{"key":"e_1_2_10_14_2","doi-asserted-by":"publisher","DOI":"10.1055\/s-2005-836609"},{"key":"e_1_2_10_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/s0151-9638(06)70842-0"},{"key":"e_1_2_10_16_2","doi-asserted-by":"publisher","DOI":"10.3109\/14764172.2013.795089"},{"key":"e_1_2_10_17_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00105-015-3651-8"},{"key":"e_1_2_10_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2013.04.060"},{"key":"e_1_2_10_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaip.2019.12.010"},{"key":"e_1_2_10_20_2","unstructured":"SouzaC. L. NascimentoG. G. andCastellanC. C. Reactional Nodule Caused by the Use of Botulinum Toxin and Resulting in Atrophic Scars 2023."},{"key":"e_1_2_10_21_2","doi-asserted-by":"publisher","DOI":"10.25259\/jsstd_52_2022"},{"key":"e_1_2_10_22_2","doi-asserted-by":"publisher","DOI":"10.1097\/md.0000000000019355"},{"key":"e_1_2_10_23_2","doi-asserted-by":"publisher","DOI":"10.1111\/cup.12903"},{"key":"e_1_2_10_24_2","doi-asserted-by":"publisher","DOI":"10.1111\/ajd.13406"},{"key":"e_1_2_10_25_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jdcr.2019.09.017"},{"key":"e_1_2_10_26_2","doi-asserted-by":"publisher","DOI":"10.1111\/jocd.16170"}],"container-title":["Case Reports in Dermatological Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1155\/crdm\/9921924","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1155\/crdm\/9921924","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1155\/crdm\/9921924","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T14:53:59Z","timestamp":1772981639000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1155\/crdm\/9921924"}},"subtitle":[],"editor":[{"given":"Ioannis D.","family":"Bassukas","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2025,1]]},"references-count":26,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2025,1]]}},"alternative-id":["10.1155\/crdm\/9921924"],"URL":"https:\/\/doi.org\/10.1155\/crdm\/9921924","archive":["Portico"],"relation":{},"ISSN":["2090-6463","2090-6471"],"issn-type":[{"value":"2090-6463","type":"print"},{"value":"2090-6471","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1]]},"assertion":[{"value":"2025-06-17","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-09-30","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-10-15","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"9921924"}}