Sex: F
Vaccine: COVID19, UNK, UNK, UNK, UNK, UNK, UNK
Symptoms: Vascular occlusion
Clinical narrative: Six days post treatment with two painful nodules at both injection sites with localized redness; Two firm nodules at injection sites had re-appeared and were swollen and red; Two firm nodules at injection sites had re-appeared and were swollen and red; Experienced some swelling of the site over the next couple of days; Reporter initial diagnosis was hypersensitivity reaction, but couldn't rule out occlusion; Reporter initial diagnosis was hypersensitivity reaction, but couldn't rule out occlusion; This is a spontaneous report received from contactable reporter(s) (Other HCP). Other Case identifier(s): GL-062222-15728.  A female patient received BNT162b2 (BNT162B2), on 13Mar2021 as dose 1, single (Batch/Lot number: unknown), on 07Apr2021 as dose 2 , single (Batch/Lot number: unknown) and on 01Dec2021 as dose 3 (booster), single (Batch/Lot number: unknown) for covid-19 immunization; methylprednisolone (MEDROL), (Batch/Lot number: unknown); hyaluronic acid (RESTYLANE), since 10May2022 (Batch/Lot number: unknown) at 0.2 mL; Vorhyaluronidase alfa (HYLENEX), first regimen since 16May2022 (Batch/Lot number: unknown) at unk [total of 80 units of Hylenex at both sites], second regimen since 17May2021 (Batch/Lot number: unknown) at unk [40 more units of Hylenex the next day] and third regimen since 18May2022 (Batch/Lot number: unknown) at unk [40 more units (Hylenex)]; triamcinolone acetonide (KENALOG [TRIAMCINOLONE ACETONIDE]), first regimen since 18May2022 (Batch/Lot number: unknown) and second regimen since 24May2022 (Batch/Lot number: unknown); prednisone (PREDNISONE), since 24May2022 (Batch/Lot number: unknown); diphenhydramine hydrochloride (BENADRYL), (Batch/Lot number: unknown). The patient's relevant medical history and concomitant medications were not reported. The following information was reported: VACCINATION SITE DISCOLOURATION (non-serious), outcome "unknown", described as "Six days post treatment with two painful nodules at both injection sites with localized redness"; VACCINATION SITE ERYTHEMA (non-serious), VACCINATION SITE SWELLING (non-serious), outcome "unknown" and all described as "Two firm nodules at injection sites had re-appeared and were swollen and red"; SWELLING (non-serious), outcome "unknown", described as "Experienced some swelling of the site over the next couple of days"; HYPERSENSITIVITY (non-serious), VASCULAR OCCLUSION (non-serious), outcome "unknown" and all described as "Reporter initial diagnosis was hypersensitivity reaction, but couldn't rule out occlusion". The action taken for methylprednisolone, hyaluronic acid, Vorhyaluronidase alfa, triamcinolone acetonide, prednisone and diphenhydramine hydrochloride was unknown.  Addition information: Provider reported a possible inflammatory reaction using Restylane Kysse in an off label area. Patient was treated with 0.2mL of Restylane KYSSE split into two injections sites in her glabella on 10May2022. Patient experienced some swelling of the site over the next couple of days and was seen back in the office six days post treatment with two painful nodules at both injection sites with localized redness. Patient was injected with a total of 80 units of Hylenex at both sites on 16May2022. Patient began nightly with Benadryl and Medrol Pack. Patient was injected with 40 more units of Hylenex the next day (17May2021), and then injected again with another 40 more units (Hylenex) on 18May2022 and kenalog-3. On 19May2022, patient showed improvement. On 24May2022, patient injection site still present and patient was injected with Kenalog-3 and given a prednisone taper. On 24May2022, patient site still present and appeared to be returning. On 01Jun2022, patient showed substantial improvement- through it was resolving. Patient came into office today and two firm nodules at injection sites had re-appeared and were swollen and red. 14Jun2022. Reporter initial diagnosis was hypersensitivity reaction, but couldn't rule out occlusion. Not sure why the nodule has returned when it had seemed to be resolving following Hylenex and TAC.  Follow-up attempts are completed. No further information is expected.