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Eingun James Song, MD, FAAD, Co-Chief Medical Officer and Director of Clinical Research at Frontier Dermatology in Seattle, WA, agrees

In all three cases, the temporal relationship between injection and symptom onset was clear, with symptoms appearing within 24 hours and peaking at 48-72 hours

Water reactivates all the chemical processes that lyophilization halted

Any change in appearance, including crystallization, precipitation, or color change, indicates that the medication should not be used and should be returned to the pharmacy for proper disposal

His first injection, which he administered last week, went off without a hitch

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