Hemorrhagic Foreign Body Granuloma after Cutaneous Surgery Occurring in the Setting of Aspirin Therapy or Thrombocytopenia: A Presentation of Six Cases

Hemorrhagic Papules and Nodules After Mohs Micrographic Surgery

“…2 Histologic features are consistent with foreign body granulomatous inflammation, although no suture material has ever been identified macroscopically or microscopically to date. 2 In our second patient, poliglecaprone 25 suture was visualized and extracted from the wound, but the significance of this is unclear and perplexing because this is a suture with very low tissue reactivity. 3 In both patients discussed here, and the 6 patients reported by Holzmann et al, the violaceous nodules occurred in areas of high tension.…”

“…"Hemorrhagic foreign body granuloma" is a rare postoperative complication previously cited during cutaneous flap reconstruction in patients with primary or secondary platelet diatheses. 2 The clinical presentation of hemorrhagic foreign body granuloma is dramatic and can be concerning for the physician and patient. Lesions present along recent surgical incisions as asymptomatic violaceous hemorrhagic papules or nodules and can mimic infectious, neoplastic, or inflammatory processes.…”

“…This risk catapults to 61.5% within 2 years if an initial diagnosis of a second KC is already present. 2 Although treatments such as Mohs surgery have high cure rates, limited attention has been afforded to the…”

“…1 Hemorrhagic papules and nodules appearing weeks to months after Mohs micrographic surgery (MMS) in the setting of aspirin or thrombocytopenia have been described by Holzmann and colleagues. 2 This group termed these lesions as "hemorrhagic foreign body granulomas," although this entity remains poorly understood. The authors herein present 2 patients with bleeding diatheses who developed similar appearing violaceous lesions after cutaneous surgery.…”