Orofacial granulomas after injection of cosmetic fillers. Histopathologic and clinical study of 11 cases

Lombardi, Tommaso; Samson, Jacky; Plantier, F.; Husson, C.; Küffer, R

doi:10.1111/j.1600-0714.2004.00194.x

Cited by 196 publications

(187 citation statements)

References 25 publications

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“…According to these microscopic findings alone, several differential diagnoses could be considered-from tuberculosis, certain fungal infections, lepromatous leprosy and sarcoidosis to certain foreign-body reactions [15][16][17][18][19]. Although the polarized light microscopy excluded the majority of these interesting hypotheses, it would have been perfect if the compounds could have been analyzed by X-ray dispersive energy analysis, as performed in other studies [15,16,18].…”

Section: Discussionmentioning

confidence: 99%

“…Silica granuloma is a poorly understood, uncommon condition and other foreign bodies, such as powders, talc or starch, can produce similar microscopic findings [15][16][17][18][19][20]. Generally, the treatment of choice is complete surgical excision of the lesion, but intralesional steroid injections, systemic steroids and antibiotics have been considered as alternative treatments.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Uncommon Foreign Body Reactions Occurring in the Lip: Clinical Misdiagnosis and the Use of Special Techniques of Analysis

Gouvêa

Hanemann

Pereira

et al. 2010

Head and Neck Pathol

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This study reports three interesting cases of nodular submucosal lip lesions where foreign-body reactions of unknown origin were detected on hematoxylin and eosin (H&E) analysis. These materials were evaluated under polarized light microscopy, scanning electron microscopy and by energy dispersive X-ray analysis. The results revealed the following materials: an interdental toothbrush bristle, silica, and iron. Unusual mucosal foreign body reaction cases have been reported, but few publications used special techniques to identify the specific foreign material. Clinicians and pathologists might consider these techniques for identifying the precise origin of these foreign bodies.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Uncommon Foreign Body Reactions Occurring in the Lip: Clinical Misdiagnosis and the Use of Special Techniques of Analysis

Gouvêa

Hanemann

Pereira

et al. 2010

Head and Neck Pathol

View full text Add to dashboard Cite

show abstract

“…If not treated intralesionally with corticosteroids, they may increase to the size of a pea or bean, remain unchanged in their clinical appearance, and resolve spontaneously after some years. 7 Because the reasons for the development of a granuloma in an individual patient are not yet known, prediction of patients at risk or preselection of patients is not yet possible.…”

Section: Clinical Appearance Of Foreign Body Granulomasmentioning

confidence: 99%

Foreign Body Granulomas after All Injectable Dermal Fillers: Part 1. Possible Causes

Lemperle

Gauthier-Hazan

Wolters

et al. 2009

Plastic and Reconstructive Surgery

223

243

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Summary Genuine granuloma formation following implantation of injectable dermal fillers is a rare complication, with incidences ranging from one in 100 patients (1 percent) to one in 5000 (0.02 percent). Foreign body granulomas occur several months to years after injection at all implantation sites at the same time. Without treatment, they may grow to the size of beans, remain virtually unchanged for some years, and then resolve spontaneously. Three clinical and histologic types of foreign body granulomas can be distinguished: 1. Cystic granulomas (synonyms: inflammatory, palisading, collagenolytic): these are caused mainly by injected biological gels such as collagens and hyaluronic acids. Their clinical signs are fluctuation (sterile abscess), extreme redness, and induration. Cystic granulomas are small and superficial, occur within the first year, and disappear spontaneously within another year. They are surrounded by a significant number of giant cells. 2. Edematous granulomas (synonym: lipogranuloma): these are caused by artificial fluids such as silicone and polyacrylamides. They appear suddenly years after injection with extensive swelling and are surrounded and infiltrated by mononuclear and inflammatory cells. 3. Sclerosing granulomas (synonyms: sarcoidal and xanthelasmic): these are caused by particulate injectables composed of polymethylmethacrylate, polylactic acid, hydroxyethylmethacrylate, calcium-hydroxylapatite, or dextran microspheres. Sclerosing granulomas occur generally 6 months to 3 years after implantation and are visible, often bluish confined nodules. Histologically, the implant is infiltrated by many macrophages and giant cells, fibroblasts, and collagen fibers but few inflammatory cells. Permanent implants are not characterized by a higher rate of foreign body granuloma per se than temporary implants; however, their clinical appearance is more pronounced and their persistence longer if not treated adequately. (Plast.

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“…We only identified one case of bovine collagen, a substance that differs morphologically from human collagen; in the former no structure is evident whereas in human collagen the fiber morphology is retained. The picture seen with hyaluronic acid fillers is typically represented by small lakes of basophilic material [9][10][11]. One of the cases in this series showed features that could be confused with a salivary neoplasm (papillary cystadenoma, low grade mucoepidermoid carcinoma).…”

Section: Discussionmentioning

confidence: 76%

Lip Augmentation Dermal Filler Reactions, Histopathologic Features

Eversole

Tran²,

Hansen³

et al. 2013

Head and Neck Pathol

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Instances of perioral and labial foreign body reactions to a variety of injectable dermal fillers were selected from the oral and maxillofacial pathology and dermatopathology archives at Pacific Pathology Laboratory of San Diego with the objective being to engender a compilation of histopathologic characteristics that allow the pathologist to identify the inciting materials. All cases of foreign body reactions located in the lips and perioral regions were reviewed by four pathologists, retaining those cases with a history of injection lip augmentation as well as those with histologic features previously documented to represent dermal filler substances. In selected cases, Alcian blue pH 2.5 with and without hyaluronidase pretreatment was performed. Immunohistochemical markers for macrophages (CD 68), adipocytes (S-100) and keratinocytes (AE1/AE2) were undertaken. All instances presented as single or multiple submucosal plaques, nodules or swellings. Natural polymers including collagen, hyaluronate, hydroxyapatite, poly-Llactate and synthetic polymers including carboxymethyl cellulose, dimethylpolysiloxane, and polyethyl methacrylate induce histologically unique features that allow for their identification. Host histopathologic responses included nodule without foreign body reaction, nodule with chronic inflammation, granuloma with epithelioid histiocytic and multinucleated giant cell reaction. Dermal filler foreign body host reactions in conjunction with the morphology of the foreign materials themselves are unique and can be differentiated from one another microscopically.

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Orofacial granulomas after injection of cosmetic fillers. Histopathologic and clinical study of 11 cases

Abstract: Increasing demand for orofacial tissue augmentation makes pathologists face new, and sometimes, puzzling granuloma types. Identification of the foreign product might be required for therapeutic or medico-legal reasons.

Cited by 196 publications

References 25 publications

Uncommon Foreign Body Reactions Occurring in the Lip: Clinical Misdiagnosis and the Use of Special Techniques of Analysis

Uncommon Foreign Body Reactions Occurring in the Lip: Clinical Misdiagnosis and the Use of Special Techniques of Analysis

Foreign Body Granulomas after All Injectable Dermal Fillers: Part 1. Possible Causes

Lip Augmentation Dermal Filler Reactions, Histopathologic Features

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