Foreign Body Granulomatous Reaction Associated with Off-Label Exosome Injection for Skin Rejuvenation

다국어 초록 (Multilingual Abstract)

Skin boosters, including hyaluronic acid and mesenchymal stem cell–derived exosomes, are widely used biological materials intended to restore the decreased function of the skin associated with aging. Despite their popularity in cosmetic practices, little is known about the safety of such materials. Herein, we present three cases of foreign body reactions following intradermal injections of skin boosters primarily composed of human adipose tissue–derived mesenchymal stem cell (ASC)-exosomes and hyaluronic acid. Biopsies in all cases revealed foreign body granulomatous inflammation. Treatment with corticosteroid, cyclosporine or antibiotics showed little response.
Although ASC-exosomes are commonly used as skin boosters, no exosomes have been approved for injectable use.
Clinicians should be aware that granulomatous foreign body reactions can occur after off-label and unauthorized intradermal injection of exosome-containing products and should exercise caution.