Diagnosis: Silicone granulomas.
MICROSCOPIC AND LABORATORY FINDINGS AND CLINICAL COURSE
An incisional skin biopsy specimen from the glabella showed a diffuse granulomatous infiltrate within the dermis and subcutis (Figure 3 and Figure 4). The infiltrate was composed of lymphocytes, plasma cells, histiocytes, and multinucleated giant cells with vacuolated spaces, giving the specimen a Swiss cheese–like appearance. Scattered asteroid bodies were noted. Energy-dispersive x-ray probe microanalysis demonstrated the presence of silicon.
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A skin biopsy specimen from the forearm showed a nodular granulomatous infiltrate within the dermis. Also, there were well-formed granulomas composed of epithelioid histiocytes and giant cells, with a relatively mild surrounding lymphocytic infiltrate. No silicon was detected on energy-dispersive x-ray probe microanalysis.
The patient was initially treated with prednisone (20 mg twice daily), which resulted in temporary improvement of her facial swelling. However, no appreciable change to her cutaneous lesions was noted. After the dosage of the prednisone therapy was tapered, she developed . . . [Full Text of this Article]
DISCUSSION
