Proper injection of poly-l-lactic acid has a role in avoiding development of subcutaneous papules. We evaluated the safety and efficacy of our injection technique ("cross-fanning") and compared it to 4 previous studies. Forty patients were evaluated for adverse events (bruising, edema, erythema, subcutaneous papules) and satisfaction. Papule incidence was compared with the other studies. The in...

A 12-year-old girl was seen for a 2-month history of multiple asymptomatic lesions on the face. She denied applying any topical products and there were no accompanying systemic symptoms. Physical examination revealed multiple, confluent, infiltrated, yellowish papules in the central facial region (perioral, perinasal, and palpebral) (Figure 1). No similar lesions were observed elsewhere on the ...

From the Division of Dermatology, Department of Internal Medicine, Baylor University Medical Center, Dallas, Texas. Corresponding author: Jennifer Clay Cather, MD, 5310 Harvest Hill Road, Suite 260, Dallas, Texas 75230. seen on the oral mucous membrane (Figure 2). The patient was otherwise well, although on further questioning he stated that he felt less energetic than usual. He reported no rec...