Chronic Ulcer as a Complication of Gold Needle Implantation

초록

An 85-year-old woman presented with a chronic ulcer on her nasal tip (Figure 1). She reported that she had undergone repeated gold needle implantations for facial skin rejuvenation, which were performed by an unlicensed acupuncturist and by herself several years previously. On clinical examination of the nasal ulcer, there were no signs of infection; however, irregular granulation tissue was observed. A scar lesion was found on the left nasolabial fold, which had resulted from an ulcer that developed 5 years previously. Radiographs showed numerous gold needle fragments in her face, with increased densities at the nasal tip and left nasolabial area, which correlated with the clinical symptoms (Figures 2 and 3). A punch biopsy was performed to rule out possible malignancy such as skin cancer or Marjolin's ulcer. Histological examination of the biopsy specimen revealed the presence of irregular granulation tissue. After several sharp debridement procedures, the ulcer healed completely and a scar was formed. Gold needle implantation is used as an alternative method for facial rejuvenation in Asian countries.1 Gold is known to be stable, easy to process, and induces no adverse reactions. Moreover, gold is believed to promote angiogenesis and is hence reported to lead to skin rejuvenation.2 However, the safety of this procedure has not yet been proven and gold needle fragments may complicate radiographic assessment.3–5 Thus, I believe that this procedure should be performed carefully and only by well-trained practitioners to prevent the complications observed in the present case.

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