Silicone granuloma explained

Specialty:	Dermatology

Silicone granulomas are a skin condition that occur as a reaction to liquid silicones, and are characterized by the formation of nodules.^[1]

Formation of a granuloma is a common tissue response to a range of foreign bodies. Silicone can be directly injected into tissue as part of a cosmetic procedure or it can leak from silicone implants. The formation and consequences of silicon-induced granulomas is not well described or understood. The extent of damage that they cause is controversial.^[2]

Localization

• Lymph node: Granulomatous lymphadenitis^{[3] [4]}
• Skin: Granulomatous dermatitis^{[5] [6] [7]}
• Penis^[8]
• Breast: Granulomatous mastitis^{[9] [10]}
• Face: Granulomatous facial reaction ^[11]

Effects

Silicone-induced granuloma can be associated with fever,^[12] calcitriol-mediated hypercalcemia,^[13] reactive amyloidosis.^{[14] [15] [16]}

Treatment

Treatment of silicone granulomas and removal of unwanted silicone have historically been very challenging. Anti-inflammatory agents (e.g., oral corticosteroids, allopurinol, colchicine, isotretinoin, cyclosporine, imiquimod, antibiotics) may help treat the granulomatous inflammation,^[17] but do not address or remove the underlying source silicone material. Surgical excision allows for removal of the underlying source of inflammation, but is often deferred due to associated scarring.^[18]

More recently, a case of successful removal of injected silicone using microcoring technology was reported, providing a potential scar-less option for its removal.

See also

• Granuloma
• Skin lesion

Notes and References

1. Book: James, William D. . Berger, Timothy G. . Andrews' Diseases of the Skin: clinical Dermatology . Saunders Elsevier . 2006 . 978-0-7216-2921-6 . etal.
2. 22798975. 2012. Ellis. L. Z.. Granulomatous reaction to silicone injection. The Journal of Clinical and Aesthetic Dermatology. 5. 7. 44–7. Cohen. J. L.. High. W. 3396457.
3. 10961180. 2000. Péoc'h. M. Silicone lymphadenopathy mimicking a lymphoma in a patient with a metatarsophalangeal joint prosthesis. Journal of Clinical Pathology. 53. 7. 549–51. Duprez. D. Grice. G. Fabre-Bocquentin. B. Gressin. R. Pasquier. B. 1731232 . 10.1136/jcp.53.7.549.
4. 23499209. 2013. García Callejo. F. J.. Neck lymphadenitis due to silicone granuloma after mammary implants. Acta Otorrinolaringológica Española. 64. 3. 217–22. Calvo González. J. Agustí Martínez. J. Bécares Martínez. C. Monzó Gandía. R. Marco Algarra. J. 10.1016/j.otorri.2012.12.003.
5. 24364999. 2013. Rieder. E. Granulomatous dermatitis related to silicone implant. Dermatology Online Journal. 19. 12. 20708. Desai. S. Mundi. J. P.. Boyd. K. P.. Patel. R. R.. Ramachandran. S. Franks Jr. A. G.. 10.5070/D31912020708. free.
6. 23198167. 2011. El-Charnoubi. W. A.. Cutaneous silicone granuloma mimicking breast cancer after ruptured breast implant. Case Reports in Dermatological Medicine. 2011. 1–3. Foged Henriksen. T. Joergen Elberg. J. 10.1155/2011/129138. 3505939. free.
7. 18718204. 2008. Schwartzfarb. E. M.. Foreign body granuloma formation secondary to silicone injection. Dermatology Online Journal. 14. 7. 20. Hametti. J. M.. Romanelli. P. Ricotti. C. 10.5070/D37JX780XV.
8. 23613653. 2012. Inn. F. X.. Penile augmentation with resultant foreign material granuloma and sequalae. The Malaysian Journal of Medical Sciences. 19. 4. 81–3. Imran. F. H.. Ali. M. F.. Ih. R. z. Z. 3629684.
9. 23198167. 2011. El-Charnoubi. W. A.. Cutaneous silicone granuloma mimicking breast cancer after ruptured breast implant. Case Reports in Dermatological Medicine. 2011. 1–3. Foged Henriksen. T. Joergen Elberg. J. 10.1155/2011/129138. 3505939. free.
10. 5690841. 1968. Symmers. W. S.. Silicone mastitis in "topless" waitresses and some other varieties of foreign-body mastitis. British Medical Journal. 3. 5609. 19–22. 1989508 . 10.1136/bmj.3.5609.8-a.
11. 16388285. 2006. Poveda. R. Granulomatous facial reaction to injected cosmetic fillers--a presentation of five cases. Medicina Oral, Patologia Oral y Cirugia Bucal. 11. 1. E1–5. Bagán. J. V.. Murillo. J. Jiménez. Y.
12. 17348488. 2007. Blum. A. Prolonged fever due to silicone granulomatosis. The Israel Medical Association Journal. 9. 2. 121–2. Abboud. W. Shajrawi. I. Tatour. I.
13. 24363673. 2013. Agrawal. N. Silicone-induced granuloma after injection for cosmetic purposes: A rare entity of calcitriol-mediated hypercalcemia. Case Reports in Medicine. 2013. 1–3. Altiner. S. Mezitis. N. H.. Helbig. S. 10.1155/2013/807292. 3864076. free.
14. 23035166. 2012. d'Ythurbide. G. Reactive amyloidosis complicated by end-stage renal disease 28 years after liquid silicone injection in the buttocks. BMJ Case Reports. 2012. bcr2012006803. Kerrou. K. Brocheriou. I. Hertig. A. 10.1136/bcr-2012-006803. 4543521.
15. 12432480. 2002. Emekli. U. Rupture of a silicone gel mammary prosthesis and amyloidosis: A case report. Aesthetic Plastic Surgery. 26. 5. 383–7. Tümerdem. B. Demiryont. M. 10.1007/s00266-002-2022-x. 6865930.
16. 8633122. 1996. Goldman. A. B.. Amyloidosis and silicone synovitis: Updated classification, updated pathophysiology, and synovial articular abnormalities. Radiologic Clinics of North America. 34. 2. 375–94, xi. Bansal. M. 10.1016/S0033-8389(22)00474-2. 251523786.
17. Pérez-Ruiz . Carmen . Barabash-Neila . Román . Zulueta-Dorado . Teresa . Conejo-Mir Sánchez . Julián . March 2019 . Adverse Granulomatous Reaction to Silicone Filler Treated With Methotrexate . Dermatologic Surgery . en . 45 . 3 . 489–492 . 10.1097/DSS.0000000000001574 . 1076-0512.
18. Hashemi . David A. . Tao . Joy . Wang . Jordan V. . Geronemus . Roy G. . 2024-01-04 . Injected Silicone Removed Using Dermal Microcoring . Dermatologic Surgery . en . 10.1097/DSS.0000000000004068 . 1076-0512.