Korean J Dermatol.  2007 Mar;45(3):255-261.

The Clinicopathologic Study of Foreign Body Granuloma Induced by Injection of Filler

Affiliations
  • 1Department of Dermatology, College of Medicine, The Catholic University of Korea, Seoul, Korea. yymmpark@hotmail.com

Abstract

BACKGROUND: With the popularization of soft tissue augmentation with dermal fillers, filler-related complications such as foreign body granuloma (FBG) are increasing. However, there has been no comprehensive study performed on FBG induced by dermal fillers in Korea to date.
OBJECTIVE
The purpose of this study was to investigate the clinicopathologic findings of FBG induced by injection of filler.
METHODS
Eighteen biopsy-proven cases of FBG due to injection of filler were reviewed and analyzed by their clinicopathological findings. In addition, the severity of granulomatous inflammation was graded by the classification proposed by Duranti.
RESULTS
Two patients were injected with silicone, one with collagen and fifteen with unknown materials; they were treated by unlicensed practioners. The interval time between the injection and the presence of FBG ranged from 2 months to 30 years (mean: 2 years). Most of the lesions presented as skin-colored or erythematous subcutaneous nodules. In one patient, concomitant infection was discovered and the cultured organisms were coagulase negative staphylococcus and Mycobacteria chelonae. The histopathologic findings showed variable infiltrations of inflammatory cells, predominantly lymphohistiocytes and in fifteen patients (83.3%) multinuclear giant cells were also seen. In ten patients (55.6%), marked foreign body granulomatous inflammation of Duranti grade II were observed. In ten cases (55.6%), 'Swiss cheese appearance' representing granuloma due to lipoid materials such as silicone and paraffin were observed.
CONCLUSION
This study shows various clinical presentations and histopathologic findings of FBGs incurred by filler injections, although most of the injected materials were not identified. Further investigations on different injectable products are necessary to identify the nature of the injected filler.

Keyword

Clinicopathologic study; Filler injection; Foreign body granuloma

MeSH Terms

Cheese
Classification
Coagulase
Collagen
Foreign Bodies*
Giant Cells
Granuloma
Granuloma, Foreign-Body*
Humans
Inflammation
Korea
Paraffin
Silicones
Staphylococcus
Coagulase
Collagen
Paraffin
Silicones
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