Silicone granuloma

Silicone granulomas are a skin condition that occur as a reaction to liquid silicones, and are characterized by the formation of nodules.^[1]: 46

Silicone granuloma
Snowball like hyperechogenic axillary lymph nodes in a woman with silicone implants removed due to complications
Specialty	Dermatology

Formation of a granuloma is a common tissue response to a range of foreign bodies. Silicone can be directly injected into tissue as part of a cosmetic procedure or it can leak from silicone implants. The formation and consequences of silicon-induced granulomas is not well described or understood. The extent of damage that they cause is controversial.^[2]

Localization

• Lymph node: Granulomatous lymphadenitis^[3][4]
• Skin: Granulomatous dermatitis^[5][6][7]
• Penis^[8]
• Breast: Granulomatous mastitis^[9][10]
• Face: Granulomatous facial reaction ^[11]

Effects

Silicone-induced granuloma can be associated with fever,^[12] calcitriol-mediated hypercalcemia,^[13] reactive amyloidosis.^[14][15][16]

Treatment

Treatment of silicone granulomas and removal of unwanted silicone have historically been very challenging. Anti-inflammatory agents (e.g., oral corticosteroids, allopurinol, colchicine, isotretinoin, cyclosporine, imiquimod, antibiotics) may help treat the granulomatous inflammation,^[17] but do not address or remove the underlying source silicone material. Surgical excision allows for removal of the underlying source of inflammation, but is often deferred due to associated scarring.^[18]

More recently, a case of successful removal of injected silicone using microcoring technology was reported, providing a potential scar-less option for its removal.^[18]

Gallery

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See also

• Granuloma
• Skin lesion

References

1. James, William D.; Berger, Timothy G.; et al. (2006). Andrews' Diseases of the Skin: clinical Dermatology. Saunders Elsevier. ISBN 978-0-7216-2921-6.
2. Ellis, L. Z.; Cohen, J. L.; High, W (2012). "Granulomatous reaction to silicone injection". The Journal of Clinical and Aesthetic Dermatology. 5 (7): 44–7. PMC 3396457. PMID 22798975.
3. Péoc'h, M; Duprez, D; Grice, G; Fabre-Bocquentin, B; Gressin, R; Pasquier, B (2000). "Silicone lymphadenopathy mimicking a lymphoma in a patient with a metatarsophalangeal joint prosthesis". Journal of Clinical Pathology. 53 (7): 549–51. doi:10.1136/jcp.53.7.549. PMC 1731232. PMID 10961180.
4. García Callejo, F. J.; Calvo González, J; Agustí Martínez, J; Bécares Martínez, C; Monzó Gandía, R; Marco Algarra, J (2013). "Neck lymphadenitis due to silicone granuloma after mammary implants". Acta Otorrinolaringológica Española. 64 (3): 217–22. doi:10.1016/j.otorri.2012.12.003. PMID 23499209.
5. Rieder, E; Desai, S; Mundi, J. P.; Boyd, K. P.; Patel, R. R.; Ramachandran, S; Franks Jr, A. G. (2013). "Granulomatous dermatitis related to silicone implant". Dermatology Online Journal. 19 (12): 20708. doi:10.5070/D31912020708. PMID 24364999.
6. El-Charnoubi, W. A.; Foged Henriksen, T; Joergen Elberg, J (2011). "Cutaneous silicone granuloma mimicking breast cancer after ruptured breast implant". Case Reports in Dermatological Medicine. 2011: 1–3. doi:10.1155/2011/129138. PMC 3505939. PMID 23198167.
7. Schwartzfarb, E. M.; Hametti, J. M.; Romanelli, P; Ricotti, C (2008). "Foreign body granuloma formation secondary to silicone injection". Dermatology Online Journal. 14 (7): 20. doi:10.5070/D37JX780XV. PMID 18718204.
8. Inn, F. X.; Imran, F. H.; Ali, M. F.; Ih, R; z, Z (2012). "Penile augmentation with resultant foreign material granuloma and sequalae". The Malaysian Journal of Medical Sciences. 19 (4): 81–3. PMC 3629684. PMID 23613653.
9. El-Charnoubi, W. A.; Foged Henriksen, T; Joergen Elberg, J (2011). "Cutaneous silicone granuloma mimicking breast cancer after ruptured breast implant". Case Reports in Dermatological Medicine. 2011: 1–3. doi:10.1155/2011/129138. PMC 3505939. PMID 23198167.
10. Symmers, W. S. (1968). "Silicone mastitis in "topless" waitresses and some other varieties of foreign-body mastitis". British Medical Journal. 3 (5609): 19–22. doi:10.1136/bmj.3.5609.8-a. PMC 1989508. PMID 5690841.
11. Poveda, R; Bagán, J. V.; Murillo, J; Jiménez, Y (2006). "Granulomatous facial reaction to injected cosmetic fillers--a presentation of five cases". Medicina Oral, Patologia Oral y Cirugia Bucal. 11 (1): E1–5. PMID 16388285.
12. Blum, A; Abboud, W; Shajrawi, I; Tatour, I (2007). "Prolonged fever due to silicone granulomatosis". The Israel Medical Association Journal. 9 (2): 121–2. PMID 17348488.
13. Agrawal, N; Altiner, S; Mezitis, N. H.; Helbig, S (2013). "Silicone-induced granuloma after injection for cosmetic purposes: A rare entity of calcitriol-mediated hypercalcemia". Case Reports in Medicine. 2013: 1–3. doi:10.1155/2013/807292. PMC 3864076. PMID 24363673.
14. d'Ythurbide, G; Kerrou, K; Brocheriou, I; Hertig, A (2012). "Reactive amyloidosis complicated by end-stage renal disease 28 years after liquid silicone injection in the buttocks". BMJ Case Reports. 2012: bcr2012006803. doi:10.1136/bcr-2012-006803. PMC 4543521. PMID 23035166.
15. Emekli, U; Tümerdem, B; Demiryont, M (2002). "Rupture of a silicone gel mammary prosthesis and amyloidosis: A case report". Aesthetic Plastic Surgery. 26 (5): 383–7. doi:10.1007/s00266-002-2022-x. PMID 12432480. S2CID 6865930.
16. Goldman, A. B.; Bansal, M (1996). "Amyloidosis and silicone synovitis: Updated classification, updated pathophysiology, and synovial articular abnormalities". Radiologic Clinics of North America. 34 (2): 375–94, xi. doi:10.1016/S0033-8389(22)00474-2. PMID 8633122. S2CID 251523786.
17. Pérez-Ruiz, Carmen; Barabash-Neila, Román; Zulueta-Dorado, Teresa; Conejo-Mir Sánchez, Julián (March 2019). "Adverse Granulomatous Reaction to Silicone Filler Treated With Methotrexate". Dermatologic Surgery. 45 (3): 489–492. doi:10.1097/DSS.0000000000001574. ISSN 1076-0512.
18. Hashemi, David A.; Tao, Joy; Wang, Jordan V.; Geronemus, Roy G. (2024-01-04). "Injected Silicone Removed Using Dermal Microcoring". Dermatologic Surgery. doi:10.1097/DSS.0000000000004068. ISSN 1076-0512.