Aggravation of Relapsing Polychondritis due to the Infection and Its Manifestation on a Nasal Tip Graft
A 48-year-old woman initially presented in September 2009 with complaints of painful swelling and erythematous changes in the upper and lower lips, both ear auricles and the nasal tip for the previous three days (). She had undergone a filler injection procedure for cosmetic reasons on the both lips at an illegal cosmetic hair shop (not by a medical doctor) seven days previously. The cause of lip infection may be the filler materials which may be not sterilized and not qualified on Korea Food and Drug Administration. There were no other symptoms like fever, chills, arthralgias, dyspnea or voice changes and no specific lab findings (). She had a medical history of relapsing polychondritis and a surgical history of undergoing a surgical operation that was performed by a plastic surgeon for the tip of her nose. The nose-tip surgery had been done by using the right conchal cartilage for augmentation. After she underwent the operation, the nasal tip turned red whenever polychondritis symptoms-color changes of both ear auricles and arthralgia-developed. This case shows that grafted cartilage can also be affected like other cartilages. The symptoms improved a few days after she received methotraxate (2.5 mg, twice a day) and methylpredisolone (8 mg, twice a day) (). We used the medication for seven days. Four weeks after discharge, the swelling and erythematous changes of the nasal tip and the other cartilage resolved.