Sarcoidosis is a systemic granulomatous disease with skin involvement in 10% to 25% of cases. This skin condition has been associated with previous trauma, including the use of skin fillers. We present the case of a patient with an erythematous plaque on the nasal dorsum with 12 months of evolution and a history of previous facial fillings with polymethylmethacrylate and hyaluronic acid. Skin biopsy showed a granulomatous inflammatory process with an epithelioid pattern and multinucleated giant cells, characteristic of cutaneous sarcoidosis. Sarcoidosis can occasionally manifest without systemic involvement and may be associated with the previous use of long-term tissue fillers.

Keywords: Hyaluronic acid; Dermatology; Polymethyl methacrylate; Dermal fillers; Sarcoidosis

A 76-year-old woman presented with facial edema and nodules in the front glabellar region and nasal dorsum that clinically resembled leonine facies. A facial ultrasound showed deposits of permanent facial filler with a "snowstorm" aspect characteristic of silicone oil, and an anatomopathological examination suggested a granulomatous reaction to the exogenous substance. Permanent fillers, such as silicone, behave like foreign bodies and cause a chronic granulomatous reaction. Although dermal fillers have been increasingly used, there is still no consensus on the management of their complications. In the present case, a good response to dapsone was observed.

Keywords: Silicones; Dermal Fillers; Granulomatous Disease, Chronic; Foreign-Body Reaction.