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Article
September 1989

Leg Ulcers Following Subcutaneous Injection of a Liquid Silicone Preparation

Author Affiliations

Department of Dermatology Mount Sinai School of Medicine One Gustave L. Levy PI New York, NY 10029

Department of Dermatology New York University School of Medicine 550 First Ave New York, NY 10016

Arch Dermatol. 1989;125(9):1283-1284. doi:10.1001/archderm.1989.01670210121026
Abstract

To the Editor.—  In the May issue of the Archives, Rae et al1 report a case of leg ulcers they claim occurred years after subcutaneous "silicone" injections. However, the authors did not use adequate methods to identify polydimethylsiloxane fluid (silicone fluid), nor did they analyze the affected tissue for other causal agents.Fluid silicone is not stainable or retained during routine preparation of tissue for microscopic examination. Light microscopy and scanning electron microscopy are nonspecific, and energy dispersive microscopy only identifies elements, including silicon. Therefore, these methods do not prove that the silicone polymer was used to treat the patient in their report.Infrared spectroscopy should have been used to detect the silicon-carbon and silicon-oxygen bonds in silicone. Since the silicon-carbon bond is synthetically produced and does not occur spontaneously in nature, a positive test result is considered unequivocal evidence that one or more silicones are present. The test

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