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• W1979520632 abstract "A healthy 62-year-old woman was referred to our department for evaluation of a right-sided facial swelling of 10 days' duration. Before admission, she had been seen by a general practitioner and a dermatologist; had ultrasonography, which was unreliable because of subcutaneous emphysema; and had taken nonsteroidal anti-inflammatory drugs for 1 week with no benefit. Her medical history included reflux esophagitis controlled by therapy. On admission, the patient was asymptomatic, but the local clinical picture had dramatically worsened, with an evident swelling of the right cheek (4 × 2.5 cm) and the onset of a second, smaller swelling on the contralateral cheek. Small nodules appeared in the superciliary and perilabial regions. On palpation, the nodules were of increased thickness and were adherent to the cutis and underlying tissues, but no rubor or pain was present. Blood chemistry panel showed only a slight fibrinogen increase (520 mg/dL). A further ultrasonography showed several hypoechogenic spots. After retaking her history, we found that approximately 10 years before, the patient had an ambulatory aesthetic treatment with subcutaneous injections of silicone on the face in the superciliary bilateral regions. The diagnosis of siliconoma was confirmed by light microscopic study of a biopsy specimen, which showed granulomatous nodules in the dermis, with histiocytes, epithelioid histiocytes, and multinucleated giant cells surrounded by lymphocytes and containing amorphous material. The patient was then referred to plastic surgery. There are several forms of silicone in medical use: silicone oil is used as a coating for needles and syringes, silicone gel is used as an implant material (e.g., in the breast and face), and silicone elastomers are used in implanted prosthetic devices and intravenous fluid tubing. Moreover, the liquid form of silicone, or dimethicone (dimethylpolysiloxane), has been used extensively in some countries during the past 4 decades for soft-tissue augmentation. Although considered biologically inert, this material has been reported as potentially inducing a granulomatous inflammatory response of variable severity after tissue injection. Complications of silicone injection may include chronic cellulitis, nodulation, foreign body reaction, and the movement of material to other parts of the body, sometimes many years after injection (1Krayenbuhl B.H. Panizzon R.G. Silicone granuloma.Dermatology. 2000; 200: 360-362Crossref PubMed Scopus (11) Google Scholar). Complications are not limited to the dermis or subcutis, such as at the entry points of acupuncture or venipuncture (2Alani R.M. Busam K. Acupuncture granulomas.J Am Acad Dermatol. 2001; 45: 225-226Abstract Full Text Full Text PDF Scopus (24) Google Scholar) or at the site of injections (3Bigatà X. Ribera M. Bielsa I. Ferràndiz C. Adverse granulomatous reaction after cosmetic dermal silicone injection.Dermatol Surg. 2001; 27: 198-200Crossref PubMed Scopus (115) Google Scholar), but may include severe ocular consequences with optic nerve damage (4Budde M. Cursiefen C. Holbach L.M. Naumann G.O. Silicone oil-associated optic nerve degeneration.Am J Ophtalmol. 2001; 131: 392-394Abstract Full Text Full Text PDF PubMed Scopus (76) Google Scholar). Recently, new inert materials, such as polymerized silicones, have been introduced which are not likely to migrate and which usually do not produce a host-immune response. However, because reactions after cosmetic microimplants have been reported (5Requena C. Izquierdo M.J. Navarro M. et al.Adverse reactions to injectable aesthetic microimplants.Am J Dermatopathol. 2001; 23: 197-202Crossref PubMed Scopus (142) Google Scholar, 6Hoffmann C. Schuller-Petrovic S. Soyer H.P. Kerl H. Adverse reactions after cosmetic lip augmentation with permanent biologically inert implant materials.J Am Acad Dermatol. 1999; 40: 100-102Abstract Full Text Full Text PDF PubMed Scopus (92) Google Scholar), internists should be aware that the use of biologically inert materials does not completely rule out the possibility of adverse reactions." @default.
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• W1979520632 date "2004-01-01" @default.
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• W1979520632 title "Siliconoma: an unusual entity for the internist" @default.
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• W1979520632 doi "https://doi.org/10.1016/j.amjmed.2003.08.020" @default.
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