Assuntos
Agulhas , Humanos , Feminino , Agulhas/efeitos adversos , Técnicas Cosméticas/efeitos adversos , Técnicas Cosméticas/instrumentação , Ultrassonografia , Granuloma de Corpo Estranho/etiologia , Granuloma de Corpo Estranho/diagnóstico por imagem , Adulto , Terapia por Radiofrequência , Indução Percutânea de ColágenoRESUMO
BACKGROUND: Adverse reactions, caused during the inflammation and healing process, or even later, can be induced by the injection of dermal filler and can present a variety of clinical and histological characteristics. In this study we aimed to review the adverse reactions associated with the injection of aesthetic filling materials in the face and neck. MATERIAL AND METHODS: The review was reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist. Studies published that mentioned adverse reactions in patients with aesthetic filling materials in the face or neck were included. Risk of bias was assessed using the Joanna Briggs Institute appraisal tool. After a 2-step selection process, 74 studies were included: 51 case reports, 18 serial cases, and five cohorts. RESULTS: A total of 303 patients from 20 countries were assessed. Lesions were more prevalent in the lip (18%), nasolabial folds (13%), cheeks (13%), chin (10%), submental (8%), glabella (7%), and forehead (6%). Histopathological analysis revealed a foreign body granuloma in 87.1% of the patients, 3% inflammatory granuloma, 3% lipogranuloma, 2.3% xanthelasma-like reaction, 1% fibrotic reaction, 0.7% amorphous tissues, 0.7% xanthelasma, 0.3% sclerosing lipogranuloma, 0.3% siliconoma, and 0.3% foreign body granuloma with scleromyxedema. In addition, two patients displayed keratoacanthoma and two others displayed sarcoidosis after cutaneous filling. The most commonly used materials were silicone fillers (19.7%), hyaluronic acid (15.5%), and hydroxyethyl methacrylate/ethyl methacrylate suspended in hyaluronic acid acrylic hydrogel (5.6%). All patients were treated, and only 12 had prolonged complications. CONCLUSIONS: There is evidence that adverse reaction can be caused by different fillers in specific sites on the face. Although foreign body granuloma was the most common, other adverse lesions were diagnosed, exacerbating systemic diseases. In this way, we reinforce the importance of previous systemic evaluations and histopathological analyses for the correct diagnosis of lesions.
Assuntos
Técnicas Cosméticas , Granuloma de Corpo Estranho , Humanos , Granuloma de Corpo Estranho/induzido quimicamente , Granuloma de Corpo Estranho/patologia , Técnicas Cosméticas/efeitos adversos , Ácido Hialurônico/efeitos adversos , Estética Dentária , Polimetil MetacrilatoRESUMO
Iatrogenic allogenosis is a disease caused by the injection of biopolymers with esthetic purposes. Clinical manifestations can occur between six hours and 30 years after the procedure with local and/or systemic symptoms. The pathological findings are characterized by the presence of foreign body granulomas with a sarcoid-like reaction. Its interpretation is difficult given its association with sarcoidosis. We report the clinical case of a female patient with granulomatous lesions in reaction to a foreign body secondary to the multiple application of unknown substances on the face and buttocks.
La alogenosis iatrogénica es la enfermedad causada por la aplicación de biopolímeros con fines estéticos. Sus manifestaciones clínicas pueden presentarse entre las seis horas y los 30 años posteriores a la aplicación, con síntomas locales o sistémicos. El principal rasgo de la histopatología es la presencia de granulomas por cuerpo extraño con reacción de tipo sarcoideo, la cual es difícil de interpretar por su asociación con la sarcoidosis. Se reporta aquí el caso de una paciente con lesiones granulomatosas de tipo sarcoideo por reacción a cuerpo extraño, secundaria a la aplicación de múltiples sustancias desconocidas en cara y glúteos.
Assuntos
Granuloma de Corpo Estranho , Sarcoidose , Biopolímeros/efeitos adversos , Feminino , Granuloma de Corpo Estranho/diagnóstico , Granuloma de Corpo Estranho/etiologia , Humanos , Estudos Retrospectivos , Sarcoidose/complicaçõesRESUMO
La alogenosis iatrogénica es la enfermedad causada por la aplicación de biopolímeros con fines estéticos. Sus manifestaciones clínicas pueden presentarse entre las seis horas y los 30 años posteriores a la aplicación, con síntomas locales o sistémicos. El principal rasgo de la histopatología es la presencia de granulomas por cuerpo extraño con reacción de tipo sarcoideo, la cual es difícil de Interpretar por su asociación con la sarcoidosis. Se reporta aquí el caso de una paciente con lesiones granulomatosas de tipo sarcoideo por reacción a cuerpo extraño, secundaria a la aplicación de múltiples sustancias desconocidas en cara y glúteos.
Iatrogenic allogenosis is a disease caused by the injection of biopolymers with esthetic purposes. Clinical manifestations can occur between six hours and 30 years after the procedure with local and/or systemic symptoms. The pathological findings are characterized by the presence of foreign body granulomas with a sarcoid-like reaction. Its Interpretation Is difficult given Its association with sarcoidosis. We report the clinical case of a female patient with granulomatous lesions In reaction to a foreign body secondary to the multiple application of unknown substances on the face and buttocks.
Assuntos
Biopolímeros , Sarcoidose , Granuloma de Corpo EstranhoRESUMO
PURPOSE: To describe the clinical features, histopathological findings, and prognosis of conjunctival Teddy bear granuloma (TBG) diagnosed in a Mexican ophthalmologic referral center in a period of 64 years. METHODS: We reviewed clinical and histopathological material from all patients with documented conjunctival TBG. Patient's age, gender, location, clinical signs and symptoms, duration, treatment and, specimen size, were evaluated. Formalin-fixed paraffin embedded 5 microns hematoxylin-eosin stained slides and periodic acid-Schiff special stain as well as examination under polarized light microscopy were performed in all cases. RESULTS: A total of 5 conjunctival TBG were collected. The ages of the patients ranged between 2 and 11 with a mean of 6 years. Female to male ratio was 4:1. The right inferior fornix was involved in 4 cases (80%) with clinical diagnosis of conjunctival mass of unknown etiology. Treatment consisted of surgical removal by slit-lamp biomicroscopy (3 cases) and in the operating room (2 cases). No complications were informed in a short follow-up period. Histopathologically, numerous cross-sections of synthetic and non-synthetic fibers surrounded by multinucleated foreign body giant cells, epithelioid histiocytes, lymphocytes, plasma cells and sparse neutrophils were seen. Polarization light microscopy demonstrated numerous birefringent colorful foreign fibers. The follow-up period of the patients ranged between 1 and 32 weeks with a mean of 10 weeks. CONCLUSIONS: Most patients with TBG are children with vague, non-specific symptoms troubling precise clinical diagnosis. Treatment of choice involves surgical excision of the foreign body granuloma followed by topical corticosteroids. All surgical specimens obtained must be sent for histopathological examination. Special awareness is recommended during COVID-19 pandemic lockdown to prevent potential exposure to fibers that may cause conjunctival TBG.
Assuntos
COVID-19 , Doenças da Túnica Conjuntiva , Conjuntivite , Granuloma de Corpo Estranho , Corticosteroides , Criança , Pré-Escolar , Cicatriz/complicações , Controle de Doenças Transmissíveis , Doenças da Túnica Conjuntiva/diagnóstico , Doenças da Túnica Conjuntiva/etiologia , Doenças da Túnica Conjuntiva/cirurgia , Amarelo de Eosina-(YS) , Feminino , Formaldeído , Granuloma de Corpo Estranho/diagnóstico , Granuloma de Corpo Estranho/etiologia , Granuloma de Corpo Estranho/cirurgia , Hematoxilina , Humanos , Masculino , Pandemias , Ácido PeriódicoRESUMO
PURPOSE: The aim of this study was to evaluate the presence and distribution of multinucleated giant cell (MGC) reactions in 61 cases of OTSCC and to verify the association of this microscopic finding with clinicopathological parameters (gender, age, tumor size/extent, regional lymph node metastasis, distant metastasis, clinical stage, and histopathological grade of malignancy). METHODS: Clinical data were collected from medical records and the histopathological grade of malignancy of OTSCCs was evaluated using the World Health Organization (WHO) grading system. The presence and distribution of MGC reaction in high power fields (HPFs) were evaluated in hematoxylin-eosin-stained histological sections. In all cases containing MGCs, immunohistochemical analysis for CD68 was performed in order to confirm the histiocytic nature of these cells. RESULTS: Twenty-one (34.4%) cases had MGC reactions, with a higher frequency of the focal distribution pattern (57.1%). All MGCs were immunohistochemically positive for CD68. The absence of MGC reaction was significantly associated with regional lymph node metastasis (PR: 2.75; 95% CI 1.05-7.20; p = 0.027), advanced clinical stage (PR: 3.37; 95% CI 1.28-8.85; p = 0.006), and moderately/poorly differentiated tumors (PR: 3.36; 95% CI 1.51-7.48; p = 0.001). No significant associations were observed between the distribution of MGCs and clinicopathological parameters (p > 0.05). CONCLUSION: Taken together, the results of this study suggest that the absence of MGC reaction may represent an indicator of tumor progression in OTSCCs.
Assuntos
Carcinoma de Células Escamosas , Granuloma de Corpo Estranho , Neoplasias de Cabeça e Pescoço , Neoplasias da Língua , Carcinoma de Células Escamosas/patologia , Células Gigantes/patologia , Granuloma de Corpo Estranho/patologia , Neoplasias de Cabeça e Pescoço/patologia , Humanos , Metástase Linfática/patologia , Carcinoma de Células Escamosas de Cabeça e Pescoço/patologia , Neoplasias da Língua/patologiaRESUMO
BACKGROUND: Subcutaneous injection of illicit polymers can result in a number of local complications, including injection-site deformity, granulomas, and skin changes. OBJECTIVES: The aim of this study was to compare postoperative complications and symptom flare in patients undergoing surgical excision of foreign-body granulomas. METHODS: We retrospectively examined data of patients who underwent surgical removal of foreign-body granulomas caused by polymer injection for cosmetic purposes. The granulomas were removed by ultrasonic-assisted liposuction or en bloc excision with primary closure, skin grafts, or free flaps during 2014 to 2020. Data collected included demographic and operative parameters. Postoperative complications, symptom flare, and time to flare were reported. The relations between type of surgery and complications, symptom flare, and time to flare were determined through statistical analysis. RESULTS: The final cohort included 49 surgeries (42 primary and 7 secondary) in 35 patients. The overall complication rate was 28.9%, with no significant intergroup differences (30.8%, 20%, 66.7%, and 40%; Pâ =â 0.328). Wound dehiscence and skin burns were the main complications. An overall symptom flare of 35.1% in surgically treated areas over a mean period of 28.49 months was reported. Chi-squared test indicated statistical significance between type of surgery and symptom flare (Pâ =â 0.004) and between complications and flare (Pâ =â 0.013). Kaplan-Meier test for flare was statistically significant (Pâ =â 0.006) after comparison of the 4 groups. CONCLUSIONS: The rate of postoperative complications was similar for each type of surgery. However, en bloc excision and reconstruction by either primary closure or free flap was associated with a significantly decreased rate of symptom flare and a longer symptom-free period.
Assuntos
Granuloma de Corpo Estranho , Procedimentos de Cirurgia Plástica , Granuloma de Corpo Estranho/diagnóstico , Granuloma de Corpo Estranho/etiologia , Granuloma de Corpo Estranho/cirurgia , Humanos , Polímeros , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/etiologia , Procedimentos de Cirurgia Plástica/efeitos adversos , Estudos RetrospectivosRESUMO
Hyaline ring granuloma (HRG) is a rare and atypical foreign-body granulomatous chronic inflammatory condition. Our aim was to make a critical review of the literature cases and also to illustrate histochemical and immunohistochemical findings of a new case. A modified PICO strategy was used. Inclusion criteria were met by case reports and case series with a histologically confirmed diagnosis of HRG, necessarily in mouth or maxillary bones. Exclusion criteria were no access to the full-text paper. The search was done up to 2019, totalizing 231 selected cases in 54 papers. The new case was analyzed through PAS, Azan-Mallory's trichrome, and CD34 and CD68 reactions. HRG is found mainly in the mandible of men, edentulous and prosthesis users, between 51 and 60 years of age, with 0.5-120 months of duration, usually causing edema and pain or discomfort. Endogenous and exogenous theories may be complementary in HRG. Eosinophilic areas could represent particles of vegetal origin, while the hyaline material could be the result of collagen degradation. Considering the material is not always present or even is ring-shaped, we suggest the change from "hyaline ring granuloma" to "granuloma induced by vegetal inoculation."
Assuntos
Granuloma de Corpo Estranho , Hialina , Criança , Pré-Escolar , Odontólogos , Face , Humanos , Lactente , Recém-Nascido , Masculino , BocaAssuntos
Contorno Corporal/efeitos adversos , Nádegas/patologia , Granuloma de Corpo Estranho/diagnóstico , Turismo Médico , Géis de Silicone/efeitos adversos , Adalimumab/administração & dosagem , Administração Oral , Adulto , Antibacterianos/administração & dosagem , Betametasona/administração & dosagem , Biópsia , Nádegas/diagnóstico por imagem , República Dominicana , Quimioterapia Combinada/métodos , Feminino , Granuloma de Corpo Estranho/tratamento farmacológico , Granuloma de Corpo Estranho/etiologia , Granuloma de Corpo Estranho/patologia , Humanos , Hidroxicloroquina/administração & dosagem , Tomografia Computadorizada por Raios X , Resultado do Tratamento , Estados UnidosRESUMO
Injection of soft tissue fillers for esthetic purposes is considered a relatively simple, minimally invasive procedure. Although rare, significant complications exist and may occur in the setting of both non-medical grade and medical-grade silicone fillers, administered by untrained or trained providers. We report a case of a 61 y/o male with an unusual case of foreign body granulomas arising on his forehead and periorbital region for the past 3 years. He had no drug allergies or history of trauma. He only recalled administration of "Botox" near the affected area 20 years ago, although he acknowledged being unsure of the nature of the substance. Examination showed bilateral, periorbital, edematous plaques, with subcutaneous nodules on the forehead. Punch biopsy showed multiple vacuoles surrounded by collagen bundles in the dermis, a histiocytic infiltrate, and multinucleated giant cells. Based on clinicopathological correlation, a diagnosis of foreign body granuloma related to silicone filler injections was made. He was treated with intralesional steroids and doxycycline 100 mg twice daily with complete resolution. Physicians should acknowledge this potential complication of silicone fillers and should inquire about their use with close-ended questions. We also review the diagnostic and therapeutic challenges faced by physicians when encountering this diagnosis.
Assuntos
Técnicas Cosméticas , Preenchedores Dérmicos , Granuloma de Corpo Estranho , Colágeno , Técnicas Cosméticas/efeitos adversos , Preenchedores Dérmicos/efeitos adversos , Edema/etiologia , Face/patologia , Testa/patologia , Granuloma de Corpo Estranho/diagnóstico , Granuloma de Corpo Estranho/etiologia , Granuloma de Corpo Estranho/terapia , Humanos , Ácido Hialurônico , MasculinoRESUMO
La fractura de instrumental rotatorio es una complicación transoperatoria rara en cirugía de terceros molares, cuando pasa desapercibida, su diagnóstico como cuerpo extraño suele ser un hallazgo radiográfico y su extracción requiere una valoración minuciosa. Se presenta el caso clínico de un paciente femenino de 21 años, que acude al servicio de Cirugía de la Facultad de Odontología de la Universidad Central del Ecuador (FOUCE), referida por el hallazgo radiográfico de un cuerpo extraño en la mandíbula posterior izquierda, en la historia refiere la extracción de terceros molares inferiores hace 5 años; sin signos clínicos al examen intrao-ral, en el estudio radiográfico se observó la presencia de una sombra radiopaca en la parte distal del órgano dental #37, se confirma en la tomografía como imagen compatible con una fresa fraccionada entre la parte activa y pasiva. El diagnóstico fue alojamiento intraóseo de cuerpo extraño dividido en 2 fragmentos. El trata-miento consistió en la exéresis de la parte pasiva de la fresa, se decidió no extraer la parte activa localizada debajo del paquete vasculonervioso, por riesgo de lesión del nervio dentario inferior. En el posoperatorio se realizaron controles clínicos, radiográficos y tomográficos, no se evidenciaron complicaciones, la paciente se ha mantenido asintomática y estable.
Rotating instrument fracture is a rare trans-operation complication in third molar surgery. When it goes un-noticed, its diagnosis as a foreign body is usually a radiographic finding and its extraction requires careful evaluation. A clinical case of a 21-year-old female patient is presented, who comes to the Surgery service of the Faculty of Dentistry of the Central University of Ecuador (FOUCE), referred by the radiographic finding of a foreign body in the left posterior jaw, the history refers to the extraction of lower third molars 5 years ago; without clinical signs on intraoral examination, in the radiographic study the presence of a radiopaque shadow was observed in the distal part of dental organ # 37, confirmed on tomography as an image compatible with a fractional drill between the active and passive parts. The diagnosis was of an intra-osseous foreign body placed and divided into 2 fragments. The treatment consisted of the excision of the passive part of the drill; it was decided not to extract the active part located below the nervous-vascular package, due to the risk of injury to the lower dental nerve. In the post-operation period, clinical, radiographic and tomographic controls were performed, no complications were observed, the patient remained asymptomatic and stable.
A fratura de instrumental rotatório é uma complicação transoperatória rara na cirurgia de terceiros molares, quando passar despercebida, seu diagnóstico como corpo estranho pode ser um achado radiográfico e sua extração requer avaliação cuidadosa. Apresentamos um caso clínico de uma paciente do sexo feminino, 21 anos, atendida no serviço de Cirurgia da Faculdade de Odontologia da Universidade Central do Equador (FOUCE), foi referida pelo achado radiográfico de um corpo estranho na mandíbula posterior esquerda, na história se refere à extração de terceiros molares inferiores há 5 anos; sem sinais clínicos no exame intraoral, o estudo radiográfico mostrou a presença de sombra radiopaca na parte distal do órgão dentário 37, con-firmada na tomografia como imagem compatível com uma broca fracionada entre as partes ativa e passiva. O diagnóstico foi de corpo estranho intraósseo dividido em 2 fragmentos. O tratamento consistiu na excisão da parte passiva da broca, optou-se por não extrair a parte ativa localizada abaixo do feixe vasculonervoso, devido ao risco de lesão do nervo dentário inferior. No pós-operatório, foram realizados controles clínicos, radiográficos e tomográficos, sem complicações, o paciente permaneceu assintomático e estável.Palavras-chave: Terceiro molar, complicações intraoperatórias, complicações pós-operatórias, diagnósti-co por imagem, tomografia, cirurgia oral.
Assuntos
Cirurgia Bucal , Diagnóstico por Imagem , Dente Serotino , Complicações Pós-Operatórias , Granuloma de Corpo Estranho , Complicações IntraoperatóriasAssuntos
Implante Mamário , Implantes de Mama/efeitos adversos , Mama , Granuloma de Corpo Estranho , Géis de Silicone/efeitos adversos , Adulto , Mama/diagnóstico por imagem , Mama/patologia , Implante Mamário/efeitos adversos , Implante Mamário/instrumentação , Análise de Falha de Equipamento , Feminino , Granuloma de Corpo Estranho/diagnóstico , Granuloma de Corpo Estranho/etiologia , Humanos , Aumento da Imagem/métodos , Imageamento por Ressonância Magnética/métodos , Tamanho do ÓrgãoRESUMO
RESUMEN Paciente de 29 años con antecedente de tres rinomodelaciones en la punta nasal con ácido hialurónico hace cinco años, evaluada por deseo de mejora estética nasal y obstrucción nasal. Al examen visual se observó una leve giba osteocartilaginosa, punta bulbosa, narinas simétricas, sin laterorrinea, no se palparon masas ni nodulaciones. Posterior al manejo de su rinitis y previo consentimiento informado, al realizar rinoseptoplastía abierta se encontró gran cantidad de tejido granulatorio tipo cuerpo extraño en la punta y dorso nasal lo que obligó a cambiar el plan quirúrgico. La biopsia diferida confirmó granuloma por cuerpo extraño por biopolímero derivado de la silicona. Evolucionó satisfactoriamente estética y funcionalmente. La rinomodelación ha aumentado en los últimos años, aunque no existen rellenos faciales aprobados por la FDA para uso nasal. La correcta utilización de los rellenos nasales continúa siendo un tema controvertido. Los granulomas nasales por cuerpo extraño son complicaciones tardías que se han incrementado con el uso de biopolímeros con dosis y técnicas inadecuadas. El uso de ecotomografía ha contribuido a mejorar la planificación quirúrgica, así como el estudio histológico diferido ha permitido identificar el material utilizado en la mayoría de los casos convirtiéndose en el estándar de oro.
ABSTRACT A 29-year-old patient with a history of three nasal fillings in the nasal tip with hyaluronic acid five years ago, reason for consultation improvement nasal aesthetics and nasal obstruction. Physical examination showed a slight osteocartilaginous hump, bulbous tip, symmetrical nostrils, no deviation nasal pyramid, no masses or nodules were palpated. After the management of his rhinitis and previous informed consent, when performing open rhinoseptoplasty, a large amount of foreign body type granulation tissue was found in the tip and nasal dorsum, which forced the surgical plan to change. The post-surgical biopsy showed foreign body granuloma by biopolymer derived from silicone. Evolved satisfactorily aesthetically and functionally. The use of nasal fillers has increased in recent years, although there are no facial fillers approved by the FDA for nasal use. The correct use of nasal fillers is a controversial issue. Nasal granulomas by foreign body are late complications that have increased with the use of biopolymers with inadequate doses and techniques. The use of ecotomography has contributed to improve the surgical planning; the deferred histological study has allowed to identify the material used in most cases becoming the gold standard
Assuntos
Humanos , Feminino , Adulto , Granuloma de Corpo Estranho/etiologia , Reação a Corpo Estranho , Ácido Hialurônico/efeitos adversos , Silicones , Cirurgia Plástica , Biópsia , Obstrução Nasal , Nariz/patologia , Corpos EstranhosRESUMO
Intralesional corticoid infiltration guided by 22-MHz ultrasound is a new, noninvasive, and safe dermatological method for the treatment of foreign body granuloma. The great advantage of the procedure is that the medication is delivered straight to the desired target, preventing adverse treatment effects in noninjured areas.
Assuntos
Glucocorticoides/administração & dosagem , Granuloma de Corpo Estranho/terapia , Triancinolona/administração & dosagem , Idoso , Biópsia , Técnicas Cosméticas/efeitos adversos , Preenchedores Dérmicos/administração & dosagem , Preenchedores Dérmicos/efeitos adversos , Feminino , Granuloma de Corpo Estranho/diagnóstico por imagem , Granuloma de Corpo Estranho/etiologia , Humanos , Injeções Intralesionais , Polimetil Metacrilato/administração & dosagem , Polimetil Metacrilato/efeitos adversos , Pele/diagnóstico por imagem , Pele/efeitos dos fármacos , Pele/patologia , Resultado do Tratamento , Ultrassonografia de IntervençãoRESUMO
The lips are essential part of the beauty and attractiveness of the human face. Lip augmentation has become an increasingly used method to improve appearance. Soft tissue fillers are the most commonly used tools. Permanent fillers, however, have been associated with unwanted side effects after lip augmentation. In the present article the present authors will focus on permanent fillers based on polymethylmethacrylate (PMMA). The present authors provide a short review on PMMA fillers and known associated adverse events. The present authors provide a critical review of treatment options. Illustrated by clinical cases The present authors report our preferred treatment of PMMA nodules on lips by intralesional neodymium:YAG laser and blunt suction cannula with or without minor surgery.