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Oct 2011

Hard, Pink Nodules on the Upper Extremities —Diagnosis

Author Affiliations
 

SECTION EDITOR: MARY S. STONE, MD; ASSISTANT SECTION EDITORS: SOON BAHRAMI, MD; CARRIE ANN R. CUSACK, MD; SENAIT W. DYSON, MD; MOLLY A. HINSHAW, MD; ARNI K. KRISTJANSSON, MD

Arch Dermatol. 2011;147(10):1215-1220. doi:10.1001/archdermatol.2011.287-b

A biopsy specimen showed granulomatous inflammation with multinucleated giant cells and variably sized vacuoles, giving a “Swiss cheese ” appearance in the dermis, consistent with cutaneous silicone deposition with foreign body reaction. No polarizable material was present.

The term siliconoma was first used to describe the local response to the liquid silicone injection technique that had been developed for breast augmentation in the 1950s. The first case of siliconomas was reported in1964.1 Because these lesions are both painful and disfiguring, the recommended treatment is local excision.2 The first peripheral siliconomas were described in the 1980s. They usually appeared as granulomas on the chest and abdomen after silent leakage of a silicone breast implant,3 typically with a latency period of decades after the leak began. There are rare reports of siliconomas at distant sites, such as arms, axillae, and legs. The route of systemic migration remains unclear.3,4

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