The efficacy of St John's wort oil macerates on intractable skin lesions of patients with idiopathic granulomatous mastitis: preliminary results.

OBJECTIVE: St John's wort (SJW, Hypericum perforatum) has a long history of medicinal use, mainly for its antidepressive effects and for wound healing. However, to the best of our knowledge, this is the first clinical study evaluating the effects of topical SJW oil macerates on the intractable skin lesions of idiopathic granulomatous mastitis (IGM). METHOD: SJW oil massage (twice daily for two minutes) was recommended between 2016 and 2019, only for patients with persistent or intractable skin lesions, after complete regression of granulomatous mass with two cycles of high-dose oral steroid and empiric antibiotics. Skin lesions were assessed and graded, before and after treatment, as clear, mild, moderate and severe. A questionnaire was also completed for each patient at the end of the six-week treatment. RESULTS: A total of 21 patients with persistent IGM lesions used SJW oil after completion of the standard treatment protocol. All patients were women, and the mean age was 36.6 years. Hyperaemia (100%), scaling (61%), induration (52%) and ulcers (28%) were the predominant skin lesions. Distribution of the lesions according to the degree of severity were graded mild, moderate and severe, and seen in 35%, 41% and 23% of the patients, respectively. When compared with pre-treatment scores, there were very significant regressions (clear: 76.4%, mild: 17.6%, moderate: 3.9%, severe: 1.9%; p<0.001 for each). The overall success rate (total clearance or decrease/decline in lesions) of treatment was 94%. CONCLUSION: SJW oil massage seems to be very effective in patients with IGM-related persistent skin lesions.

Reacción granulomatosa difusa en mamas tras inyección de silicona fluida: a propósito de un caso / Diffuse granulomatous reaction in the breasts after fluid silicone injection: a case report

El uso de silicona fluida para el aumento mamario tuvo su auge entre los años cuarenta y setenta del siglo XX. Debido a su alta tasa de complicaciones, su utilización fue finalmente prohibida por la FDA a principios de los años noventa. Presentamos el caso de una mujer con múltiples nódulos mamarios y mastodinia de repetición secundarias a la inyección de silicona fluida en ambas mamas. Las inyecciones de silicona fueron realizadas en su país de origen con objetivo estético. Se realizó estudio mediante resonancia magnética de la mama, que demostró distribución difusa de la silicona en todo el espesor mamario y en especial bajo el complejo aréola-pezón (CAP). Se procedió a la realización de una mastectomía subcutánea bilateral incluyendo el CAP. Intraoperatoriamente se objetivó afectación difusa del espesor muscular del pectoral mayor, además de la ya conocida afectación de todo el parénquima glandular

The use of fluid silicone for breast augmentation reached a peak between the 1940s and 1970s. Due to the high rate of complications, its use was finally banned by the FDA in the early 1990s. We present the case of a woman with multiple mammary nodules and recurrent mastodynia due to the injection of fluid silicone in both breasts. The silicone injections were performed in her country of origin for cosmetic reasons. Magnetic resonance imaging of the breast showed diffuse distribution of the silicone throughout the breast thickness and especially under the nipple-areola complex (NAC). A bilateral subcutaneous mastectomy was performed, including the NAC. Intraoperatively, diffuse muscular thickness of the pectoralis major was affected, in addition to the well-known involvement of the entire glandular parenchyma

Idiopathic granulomatous mastitis associated with risperidone-induced hyperprolactinemia.

Idiopathic granulomatous mastitis (IGM) is a rare inflammatory breast disease. The etiology and treatment options of IGM remain controversial. Previous case reports have suggested that hyperprolactinemia may be associated with IGM. In the present report, we describe the first case of IGM associated with risperidone-induced hyperprolactinemia.