Analysis of nine cases of oral foreign body granuloma related to biomaterials

Foreign bodies can penetrate the interior of soft and, sometimes, hard, tissues in various ways, including through openwounds, lacerations and traumatic accidents. However over the years, evidence of links between the use of dental materialsand lately, significant involvement of aesthetic filler materials as foreign bodies in the oral and perioral region have beenreported. Foreign body granulomas (FBGs) may develop from this exogenous material, histopathologically characterizedby the presence of chronic inflammation and a high amount of macrophages. This study presents nine FBG cases affectingthe oral and perioral regions, and carries out a literature review on the main clinical, histopathological and materialcharacteristics used in dental and dermatological procedures related to the appearance of this type of granuloma.

A Case of Lepromatous Leprosy Mimicking Foreign Body Granuloma / 대한피부과학회지

No abstract available.

A Protruding Nodule after Filler Injection / 대한피부과학회지

No abstract available.

Foreign Body Granuloma after Filler Injection Treated with Liposuction / 대한피부과학회지

No abstract available.

A comparative overview of histopathology of granulomatous lesions of skin

Granulomatous lesions of the skin and subcutaneous tissue are common in India. They are known as “Dermal Granulomas”. In present study following types of Dermal Granulomas were included – Leprosy, Cutaneous Tuberculosis, Syphilis, Fungal, Actinomycosis, Foreign body Granuloma, Granuloma annulare and Sarcoidosis. Histopathology remains a time tested tool for establishing a correct diagnosis. Clinical lesions often reveal surprising underlying pathology. Hence carrying out skin biopsies and microscopic study with routine haematoxylin and eosin (H&E) as well as special stains are must in these disorders so that the type and aetiological agent of the granuloma are properly identified. Besides, follow-up biopsies after the commencement of treatment help in evaluation of the response to therapy. Methods: 52 cases were studied over a period of 2 and a half years. Specimens were collected from the patients of skin, surgery and ENT department. A brief clinical history with age presenting symptoms and signs were recorded. Routine investigations like ESR were performed. Comparison of our study was done with others around the country. Results: Most common type of dermal granuloma was leprosy (59.6%) followed by cutaneous tuberculosis (21.1%), Foreign Body (5.7%), Granuloma Annulare (5.7%), Fungal (5.7%), Actinomycosis (1.9%) and Sarcoidosis (1.9%). Dermal granulomas were most common between the age group of 31 – 50 years. In leprosy and cutaneous tuberculosis, males were affected more as compared to females. Conclusion: Leprosywas most common than other dermal granuloma. Most common type of leprosy and tuberculosis were lepromatous leprosy and lupus vulgaris respectively.

Leuprolide Acetate-induced Foreign Body Granuloma in a Patient with Prostate Cancer / 대한피부과학회지

Leuprolide acetate is an established luteinizing hormone-releasing hormone (LHRH) agonist used as a first-line treatment in advanced prostate cancer. An 80-year-old man presented with a localized erythematous patch with an indurated plaque and nodule and pustules on the left upper arm. The patient had been treated for metastatic prostate cancer with subcutaneous injections of leuprolide acetate 18 months previously. Histopathologic findings revealed granulomas with multinucleated giant cells from the dermis to the subcutaneous fat layer. The granuloma contained numerous round vacuoles. Cultures from the tissue for bacteria, fungi, and mycobacteria were all negative. The diagnosis of leuprolide acetate-induced foreign body granuloma was made by clinicopathologic findings. Various theories on the mechanism of local reactions to leuprolide have been suggested. The formation of granulomas may be related to the poly (lactic-co-glycolic acid) polymers or leuprolide itself. The depth of injection could have also contributed; therefore, intramuscular injection is recommended to minimize granuloma formation. To the best of our knowledge, there has been no reported case of leuprolide-induced foreign body granuloma in a patient with prostate cancer in the Korean literature. Dermatologists need to know that leuprolide acetate depot injection may cause a granulomatous reaction.

Leuprolide Acetate-induced Foreign Body Granuloma in a Patient with Prostate Cancer / 대한피부과학회지

Leuprolide acetate is an established luteinizing hormone-releasing hormone (LHRH) agonist used as a first-line treatment in advanced prostate cancer. An 80-year-old man presented with a localized erythematous patch with an indurated plaque and nodule and pustules on the left upper arm. The patient had been treated for metastatic prostate cancer with subcutaneous injections of leuprolide acetate 18 months previously. Histopathologic findings revealed granulomas with multinucleated giant cells from the dermis to the subcutaneous fat layer. The granuloma contained numerous round vacuoles. Cultures from the tissue for bacteria, fungi, and mycobacteria were all negative. The diagnosis of leuprolide acetate-induced foreign body granuloma was made by clinicopathologic findings. Various theories on the mechanism of local reactions to leuprolide have been suggested. The formation of granulomas may be related to the poly (lactic-co-glycolic acid) polymers or leuprolide itself. The depth of injection could have also contributed; therefore, intramuscular injection is recommended to minimize granuloma formation. To the best of our knowledge, there has been no reported case of leuprolide-induced foreign body granuloma in a patient with prostate cancer in the Korean literature. Dermatologists need to know that leuprolide acetate depot injection may cause a granulomatous reaction.

Multiple Foreign Body Granuloma due to Lipolytic Mesotherapy / 대한피부과학회지

No abstract available.

Late-Onset Complication of Fillers: Paraffinoma of the Lower Eyelids Clinically Mimicking Xanthelasma

Injectable poly-L-lactic acid (PLLA) is world-famous filler used in lipoatrophy and facial rejuvenation because of its collagen neogenesis effect which leads to gradual volume restoration. Until recently, quite a number of unwanted adverse events of PLLA have been reported. However, to the best of our knowledge, paraffinoma as a complication of PLLA has never been reported. We herein describe the first case of paraffinoma after Sculptra® injection and propose its possible mechanism.

A Case of Foreign Body Granuloma Caused by Subcutaneous Injection of Leuprorelin Acetate / 대한피부과학회지

Leuprorelin acetate is a synthetic analog of luteinizing hormone-releasing hormone (LHRH). Recently, hormone-dependent tumors (prostate cancer and breast cancer) have been treated without surgery using this LHRH agonist. A 74-year-old man presented with a subcutaneous tumor in the abdomen. He had received a subcutaneous injection of depot leuprorelin acetate 2 months previously and radiotherapy for prostate cancer. The subcutaneous tumor was totally excised. Histopathologic findings revealed necrosis of fat tissue, many granulomatous nodules composed of giant cells with vacuoles in the dermis and subcutis, and inflammatory cell infiltrates, including mainly lymphohistiocytes. A diagnosis of foreign body granuloma due to depot injection of leuprorelin acetate was made. He revisited our hospital after 1 month with a subcutaneous tumor on his Lt. upper arm. He had received a subcutaneous injection of leuprorelin acetate 1 week ago on that site. We treated it with intralesional triamcinolone injection. Here, we report a case of granulomatous reaction due to leuprorelin acetate injection, which produced subcutaneous nodules.

Complicação tardia de preenchimento cutâneo após facelift: relato de caso / Late complication of cutaneous filling after a facelift: a case report

Os autores apresentam o caso de uma paciente submetida 7 anos após aplicação de polimetilmetacrilato (PMMA) a um facelift com implante de prótese mentoniana, o qual evoluiu com granuloma por corpo estranho em região distante da aplicação do preenchimento. Após quase um ano de tratamento, a paciente evoluiu com resolução do caso.

The authors present the case of a patient who underwent a facelift with a chin implant 7 years after polymethylmethacrylate (PMMA) implantation, which evolved with foreign body granuloma in a region distant from the filling application. After nearly a year of treatment, the patient evolved with resolution of the granuloma.

Nonspecific Computed Tomography Presentation of Gossypiboma.

A gossypiboma also known as ‘textiloma’ or ‘cottonoid’ is a term used to describe a foreign object (nonabsorbable surgical material), that is left behind in a body cavity during an operation. The manifestations and complications of gossypiboma are so variable that diagnosis may be difficult and patient morbidity is thus significant. Moreover, such foreign bodies can often mimic tumors or abscesses. Here we discuss a case of pelvic gossypiboma that presented as a mass in the pelvis associated with abdominal pain in a post ovarian cystectomy case. The diagnosis was suggested on computed tomography (CT). The diagnosis was confirmed on surgery and the gossypiboma was retrieved successfully.

Pseudovesiculação, infiltração e esclerose cutânea: exuberância clínica do granuloma por silicone / Pseudo-vesiculation, infiltration, and sclerosis: clinical exuberance of silicone granuloma

O aumento da frequência de procedimentos chamados "estéticos" tem apresentado diversas complicações. Muitas vezes realizados por profissionais não habilitados, usando materiais de origem desconhecida ou não autorizados pelas Agências de Vigilância Sanitária, estas intervenções podem trazer grande morbidade física e/ou psicossocial. Por imprudência ou negligência se tem observado aumento significativo de efeitos adversos gerando sequelas estéticas graves e de complexa resolução. Quando as reações são agudas não há maiores dificuldades para o diagnóstico, mas os efeitos tardios podem ser menos específicos, retardando a correta intervenção terapêutica. A despeito das restrições do uso do silicone líquido, ainda se observa sua utilização para preenchimento cutâneo. Descrever-se-á uma paciente que apresentou manifestações exuberantes e tardias pelo uso de silicone líquido no preenchimento dos glúteos. O objetivo do relato é alertar a possibilidade do granuloma por silicone, em lesões infiltradas em áreas de preenchimento, mesmo após longa data do procedimento...

Chronic maxillary sinusitis caused by root canal overfilling of Calcipex II

This is a case report of chronic maxillary sinusitis caused by root canal overfilling of Calcipex II (Techno-Dent). A 60 year-old male complained of dull pain in the right maxillary molar area after complicated endodontic treatment using Calcipex II paste and was finally diagnosed with a chronic maxillary sinusitis through a clinical and radiological observation. In the biopsy examination, the periapical granuloma contained a lot of dark and translucent Calcipex II granules which were not stained with hematoxylin and eosin. They were usually engulfed by macrophages but rarely resorbed, resulting in scattering and migrating into antral mucosa. Most of the Calcipex II granules were also accumulated in the cytoplasms of secretory columnar epithelial cells, and small amount of Calcipex II granules were gradually secreted into sinus lumen by exocytosis. However, chronic granulomatous inflammation occurred without the additional recruitment of polymorphonuclear leukocytes (PMNs) and lymphocytes, and many macrophages which engulfed the Calcipex II granules were finally destroyed in the processes of cellular apoptosis. It is presumed that Calcipex II granules are likely to have a causative role to induce the granulomatous foreign body inflammation in the periapical region, and subsequently to exacerbate the chronic maxillary sinusitis in this study.

Ocular Swelling after Forehead Fat Graft

BACKGROUND: Facial fat grafting is a common cosmetic surgery for facial contouring. Although it is considered a very safe procedure, there are several reports about complications after fat grafting. Eye complications are very rare, but do exist. The author has treated cases of eyelid swelling after forehead fat grafting with conservative or surgical treatment. METHODS: From February 2010 to April 2014, the author treated five women (mean age, 35 years; range 28-52), who developed eyelid swelling (both, n=3; unilateral, n=2) approximately 2 weeks after forehead fat grafting. Symptoms included pain, foreign body sensation, recurrent swelling and redness, unilateral or bilateral ptosis, and palpable lumps. Three were acute cases treated within 1 month, and the other two were chronic cases, which occurred 4 and 28 months after the fat graft. RESULTS: Conservative treatment (Lasix, antibiotics, steroids) was used for two patients. The other three patients were treated with direct fat extraction or lump excision through the double eyelid crease line. Histological examination identified the excised specimens as lipocysts or liopogranulomas. All patients fully recovered, despite transient ptosis for several days immediately after the operation. CONCLUSIONS: Eyelid swelling after forehead fat graft can be successfully treated with either conservative or surgical treatment. Although few studies have reported eyelid swelling after fat grafting, this complication may become more common, in the future, as facial fat grafting becomes more popular. This treatment modality should be helpful to the plastic surgeons faced with these unpleasant complications.

Facial Foreign Body Granulomas Caused by Filler Injection and Barbed Thread-lifting / 대한피부과학회지

No abstract available.

A Case of Multiple Foreign Body Granuloma due to Mesotherapy / 대한피부과학회지

No abstract available.

Complications from Cosmetic Procedures Performed by Non-Professionals: A Case Analysis and Review of Treatments / 대한피부과학회지

BACKGROUND: As the desire to maintain a youthful appearance escalates nationwide, the numbers of patients presenting with complications subsequent to cosmetic treatments performed by non-professionals are increasing. OBJECTIVE: The purpose of this study was to overview complications from cosmetic therapeutic attempts by non-professionals, and to discuss their management from a dermatologist's point of view. METHODS: During the period January 1st, 2011 to December 31st, 2013, a total of 24 patients who visited the Severance Hospital at Yonsei University for complications that developed after cosmetic treatments by oriental doctors, non-medical personnel, and general practitioners were enrolled in this study. Patient clinical characteristics, past history, diagnosis, biopsy results, and treatment information were collected. RESULTS: The most common complication was a granulomatous foreign body reaction (n=15, 62.5%), followed by skin necrosis (n=8, 33.3%), and misdiagnosis and malpractice by non-professionals (n=5, 20.8%). Three patients had more than 2 complications combined. Patients with granulomatous foreign body reactions were usually managed with conservative treatments or excisions, while those with skin necrosis were managed with debridement and secondary intention healing. CONCLUSION: As the number of cosmetic therapeutic attempts made by non-professionals increases, dermatologists need to understand the potential complications that can arise following these procedures, and should take an active role in managing the patients.

Granuloma Developed Following Injection for Chemical Castration Treatment in Paedophilia / 대한피부과학회지

No abstract available.

MRI Findings of Intramuscular Foreign Body Injection: A Case Report

There are various types of foreign body reactions, such as inflammation, edema, fluid collection, hematoma, infection, abscess and granulomas. There are various imaging findings according to types of foreign bodies and depending on the lapse of time. Therefore, correct diagnosis of a foreign body reaction is difficult and easily confused with soft tissue neoplasm. The MRI is ideal for the detection of foreign bodies regardless of radiolucency or acoustic impedance. It is especially very useful in the evaluation of the surrounding tissue reaction. The authors report a case of a 26-year-old female patient with both forearm swelling due to self-injection of a mixture of powdered tablets and saline. The lesion shows numerous internal T1 and T2 dark signal intensity micro-spots with surrounding fluid collection, which are diagnosed as foreign bodies with surrounding inflammatory changes during an operation.