Seguridad oncológica de la toxina botulínica y los rellenos de ácido hialurónico en dermatología: implicaciones, respuestas inflamatorias y posibles asociaciones con procesos malignos
DOI:
https://doi.org/10.5281/zenodo.22326405Palabras clave:
supervivencia oncológica, inmunología, farmacovigilancia, medicina estética, seguridad clínicaResumen
La expansión de los procedimientos dermatológicos mínimamente invasivos y el aumento de supervivientes de cáncer han intensificado el interés por la seguridad oncológica de la toxina botulínica tipo A y los rellenos dérmicos de ácido hialurónico. El objetivo fue analizar sistemáticamente la evidencia clínica y mecanística sobre eventos adversos, respuestas inflamatorias tardías y posibles asociaciones con carcinogénesis o progresión tumoral. Se efectuó una revisión sistemática documental basada en PRISMA 2020, con búsqueda principal en PubMed/MEDLINE, actualización bibliográfica hasta septiembre de 2026 y consulta de documentos científicos y regulatorios verificables. La evidencia mostró un perfil de seguridad favorable para ambas intervenciones, con eventos predominantemente locales y transitorios; las reacciones inflamatorias tardías por ácido hialurónico fueron infrecuentes y presentaron estimaciones variables según metodología y tecnología del producto. No se identificó evidencia clínica consistente de aumento de incidencia de cáncer, recurrencia tumoral o transformación maligna atribuible a estos procedimientos. El hialuronano endógeno participa en el microambiente tumoral, pero este mecanismo no demuestra carcinogenicidad del ácido hialurónico reticulado. En pacientes oncológicos, la indicación requiere valoración individual del estado inmunológico, hematológico, terapéutico y tisular.
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