Oral angiotensin-converting enzyme inhibitors for treatment of delayed inflammatory reaction to dermal hyaluronic acid fillers following COVID-19 vaccination-a model for inhibition of angiotensin II–induced cutaneous inflammation

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We present 4 cases of delayed inflammatory reaction (DIR) to facial dermal hyaluronic acid filler rapidly following vaccination for COVID-19. All DIRs occurred after a hyaluronic acid filler had been placed more than 1 year before vaccination. All patients responded rapidly to therapy with a low dose of oral lisinopril, an angiotensin-converting enzyme inhibitor (ACE-I), which decreases the cutaneous filler-related inflammatory reaction and edema by a novel proposed mechanism.