The authors of "Foreign Body Granulomas Caused by Polymethylmethacrylate Microspheres: Successful Treatment With Allopurinol"1 have to be applauded for their demonstration of an effective systemic therapy for foreign body granulomas. If such a rare complication arises (and this usually late event can occur with all injectable tissue-augmenting agents currently used2- 5), patients and their physicians are usually left with a sense of fear and few therapeutic options. What can be done? Intralesional corticosteroid injections are certainly the treatment of choice; however, the adverse effect of cutaneous atrophy is well known. Excision is usually a last resort. In general, patients would prefer treatment with oral medications than with injections or excision. Therefore, we are grateful for this novel, less invasive treatment alternative for granulomas.
Thaler MP. Foreign Body Granulomas Caused by Polymethylmethacrylate Microspheres: An Added Perspective. Arch Dermatol. 2003;139(11):1505-1506. doi:10.1001/archderm.139.11.1505-a