Foreign body granulomas
Last Updated: 2019-08-27
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.
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.