Foreign body granulomas

Last Updated: 2019-08-27

Author(s): Anzengruber F., Navarini A.

ICD11: -

Pinkus und Bortvinick 1957

Granulomatous reaction triggered by foreign bodies.

They are the most common granulomatous diseases.

Trauma: After foreign bodies have penetrated the skin (milker granuloma, hairdresser granuloma, pilonidalsinus, sea urchin spines)

In the context of medical treatments (paraffin, sutures, silicone)

Body's own products: Gout (urate crystals), necrotic fatty tissue (lipophagous granuloma).

This leads to a granulomatous reaction, in the sense of a disordered accumulation of macrophages with giant foreign body cells.

Skin-coloured, coarse-palpable, well demarcable knots and plaques.

Different dermatopathological patterns are possible (sarcoid, necrobiotic granulomas, zirconium granuloma). The foreign objects can be detected by polarization optics.

Excision.

Kenacort, if necessary.

Silicone granulomas: experimental isotretinoin p.o. 0.5 mg / kg bw daily for 6 months.

Off-label TNF alpha antagonists is also a testable option

Friedrich RE et al. Paraffinoma of lips and oral mucosa: Case report and brief review of the literature. GMS Interdiscip Plast Reconstr Surg DGPW. 2014 May 15;3.