Fifty-Three Years after a Pencil Puncture Wound

Aswani, Vijay; Kim, Seung Lae

doi:10.1159/000441248

Cited by 10 publications

(11 citation statements)

References 10 publications

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“…Albeit rarely, granulomatous reactions have also been reported in association with metals, for example, piercings or pencil lead . Reactions consistent with delayed‐type hypersensitivity reactions have been observed in patients with piercings consisting of gold or titanium alloys .…”

Section: Granulomatous Foreign Body Reactions and Contact Allergiesmentioning

confidence: 99%

Non‐infectious granulomatous dermatoses

Schmitt¹,

Völz

2019

J Deutsche Derma Gesell

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Summary Granulomatous dermatoses comprise a wide range of etiologically and clinically distinct skin diseases that share a common histology characterized by the accumulation of histiocytes include macrophages. While the pathogenesis of these disorders is not fully understood, the underlying mechanism is thought to involve a reaction pattern caused by an immunogenic stimulus. Antigen‐presenting cells and the effect of various cytokines play a key role. Our understanding of granulomatous reaction patterns has been advanced by insights drawn from observations of such reactions in patients on immunomodulatory therapy and in individuals with genetic immunodeficiency. Traditionally, a distinction is made between infectious and non‐infectious granulomatous dermatoses. The present CME article addresses granulomatous skin diseases for which there is no evidence of a causative infectious agent. Common representatives include granuloma annulare, necrobiosis lipoidica and cutaneous sarcoidosis. Granulomatous dermatoses may be part of the clinical spectrum of various systemic disorders or may be associated therewith. Some neoplastic disorders may mimic granulomatous dermatoses histologically. Given the pathogenetic diversity involved, the clinical presentation, too, is quite varied. Overall, however, each disorder is characterized by typical clinical features. The diagnosis always requires thorough clinicopathologic correlation. Treatment is preferably based on the underlying pathogenesis and frequently involves anti‐inflammatory agents. In most cases, however, there is insufficient study data. The dermal nature of these disorders frequently poses a therapeutic challenge, especially with respect to topical treatment.

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Section: Granulomatous Foreign Body Reactions and Contact Allergiesmentioning

confidence: 99%

Non‐infectious granulomatous dermatoses

Schmitt¹,

Völz

2019

J Deutsche Derma Gesell

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“…Histological examination of the tissue was able to detect granulomatous changes, however it remains unclear whether sophisticated tests should be employed to detect the presence of graphite in tissues given that cases of pencil core granulomas are so rare. 7 In this case, a misdiagnosis of a blue naevus-like localised argyria did not drastically alter the patient's management. However, the case should prompt us to consider the potentially devastating complications that arise as a result of diagnostic uncertainty.…”

Section: Discussionmentioning

confidence: 63%

Section: Discussionmentioning

confidence: 99%

Graphite Foreign Body Misdiagnosed as a Blue Naevus-Like Localised Argyria

Sharma¹

2021

CCID

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Pencil-tip injuries, although usually insignificant, have the potential to provoke granulomatous reactions. Other undesirable consequences of such injuries include pigmentation and abscess formation. Despite the rarity of such outcomes, it is important that clinicians are aware of the varying presentations of pencil-tip injury, as this can cause diagnostic uncertainty. Here, we present a case of graphite foreign body granuloma, originally thought to be a blue naevus-like localised argyria. The diagnostic work-up was complicated by the absence of a history of injury with a pencil-tip.

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“…Granulomatöse Reaktionen sind selten auch bei Metallen, beispielsweise im Bereich von Piercings oder abgebrochenen Stiftspitzen, beschrieben worden . Reaktionen im Sinne einer möglichen allergischen Reaktion vom Spättyp sind bei Körperpiercings mit Gold‐ und Titanlegierungen gesehen worden .…”

Section: Granulomatöse Fremdkörperreaktionen Und Kontaktallergienunclassified

Nicht‐infektiöse granulomatöse Dermatosen

Schmitt¹,

Völz

2019

J Deutsche Derma Gesell

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Zusammenfassung Granulomatöse Dermatosen umfassen ein breites Spektrum ätiologisch und klinisch heterogener Dermatosen, deren Gemeinsamkeit in einem histologisch von Histiozyten‐ bzw. Makrophagen‐Akkumulation geprägten Bild liegt. Die Pathogenese der einzelnen Krankheitsbilder ist unvollständig verstanden. Als Mechanismus wird zumeist ein Reaktionsmuster des Organismus auf einen immunogenen Stimulus angenommen. Antigenpräsentierende Zellen und der Einfluss unterschiedlicher Zytokine spielen eine Schlüsselrolle. Erkenntnisse zu granulomatösen Reaktionen unter iatrogener Immunmodifikation sowie bei genetisch determinierten Schwächen der Immunabwehr verbessern unser Verständnis granulomatöser Reaktionsmuster. Üblicherweise werden infektiöse granulomatöse von nicht‐infektiösen granulomatösen Dermatosen unterschieden. Der vorliegende Artikel behandelt granulomatösen Dermatosen ohne nachweislich kausalen Erregerbezug. Zu den klassischen Vertretern nicht erregerbedingter granulomatöser Dermatosen zählen das Granuloma anulare, die Necrobiosis lipoidica und die kutane Sarkoidose. Granulomatöse Dermatosen können kutane Manifestation einer systemischen Erkrankung darstellen oder mit einer solchen assoziiert sein. neoplastischen Erkrankungen, können das Bild einer granulomatösen Dermatose imitieren. Das klinische Bild ist entsprechend der pathogenetischen Vielfalt heterogen, insgesamt jedoch meist charakteristisch für das jeweilige Krankheitsbild. Die Diagnosestellung erfordert regelhaft eine gute klinisch‐pathologische Korrelation. Die Behandlung orientiert sich an der Pathogenese und erfolgt oft antientzündlich. Allerdings besteht meist eine unzureichende Datenlage und der dermale Charakter der Erkrankung erschwert die topische Behandlung.

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Fifty-Three Years after a Pencil Puncture Wound

Cited by 10 publications

References 10 publications

Non‐infectious granulomatous dermatoses

Non‐infectious granulomatous dermatoses

Graphite Foreign Body Misdiagnosed as a Blue Naevus-Like Localised Argyria

Nicht‐infektiöse granulomatöse Dermatosen

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