The combination of PMMA and collagen was the first combination therapy to become available. Granulomatous reactions are a well known complication of this combination treatment, as reported in a large case series (Lemperle et al. 1998, 2003) and in various case reports (Alcalay et al. 2003; Hoffmann et al. 1999; Lombardi et al; 2004; Reisberger et al. 2003; Requena et al. 2001; Rudolph et al. 1999).
The retrospective case series, published in 1998 by Lemperle, is based on 515 questionnaires from 290 patients treated between 1993 and 1994. Immediately after PMMA implantation, swelling, redness, and itching was reported. Late reactions such as erythema, transparency, unevenness, and dislocation have also been documented. Longer-lasting redness after Artecoll implantation was reported in 6.1% of reported cases in 1993 and in 0.5% of reported cases in 1994. The overall complication rate in 1994 was 3 % (6 out of 201
patients). In addition, an acute allergic reaction was reported in one woman. Based on data from the manufacturer, the rate of granulomatous reaction was given as 1 in 1000 patients. Nodules did arise 6 months to 2 years after treatment. Again, as this data relies on spontaneous reports, underreporting is likely to have occurred.
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Rosacea and Eczema are two skin conditions that are fairly commonly found throughout the world. Each of them is characterized by different features, and can be both discomfiting as well as result in undesirable appearance features. In a nutshell, theyre problems that many would want to deal with.