Eosinophilic foreign body granuloma after multiple self-administered bee stings

Abstract

A bee sting can cause a foreign body granuloma of the skin, due to activated macrophages at the stinging site. A 52-year-old woman presented with a large doughnut-shaped ulcerative tumour on the left side of her face. A bean-sized facial papule had grown to a 4.0 x 3.9 x 1.1 cm mass after multiple bee stings induced by herself over a period of 1 year. Histology showed epidermal ulceration with granulomatous inflammatory cell infiltration of many eosinophils. No micro-organisms or foreign bodies were identified. Intralesional triamcinolone acetonide was not effective, but an excellent outcome was obtained using carbon dioxide laser vaporization of the lesion.

Leukocyte Profile in Peripheral Blood and Neutrophil-Lymphocyte Ratio in Hidradenitis Suppurativa: A Comparative Cross-Sectional Study of 462 Cases

“…Van der Zee et al [7] proposed that deposition of keratin fragments into the dermis cause subsequent foreign body reactions. Cases of eosinophilic foreign body reactions have also been described [31]. The association between HS-POP patients and eosinophilia may therefore be speculated to reflect the HS-related foreign body reaction.…”

Allergy to honeybee … not only stings

“…Reports of allergic reactions after live bee acupuncture showed that the number and interval of bee stings may influence the outcome of the reaction. A singular sting or multiple stings at longer duration may cause foreign body granuloma [34,35] whereas patients with multiple stings within the short term are at risk of suffering from anaphylaxis.…”

A Foreign Body Granuloma of the Buccal Mucosa Induced by Honeybee Sting

“…The honeybee sting is usually left in the tissue after stinging and is difficult to remove [3]. Therefore, the stinging apparatus together with the venom sac and nerve plexus is left in the tissue and may act as antigen for a long time [6]. The persisting antigens are thought to elicit development of an immune complex-medicated reaction, activating macrophage leading to a granulomatous inflammation [6].…”

“…Therefore, the stinging apparatus together with the venom sac and nerve plexus is left in the tissue and may act as antigen for a long time [6]. The persisting antigens are thought to elicit development of an immune complex-medicated reaction, activating macrophage leading to a granulomatous inflammation [6]. As a result, a foreign body granuloma is formed at the site of the sting [4, 6].…”