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March 1983

Widespread Foreign-Body Granulomas and Elevated Serum Angiotensin-Converting Enzyme

Author Affiliations

From the Department of Medicine, Division of Dermatology, University of Tennessee Center for the Health Sciences, Memphis (Drs Pucevich and Rosenberg); the Department of Pathology, Baptist Memorial Hospital, Memphis (Dr Bale); and the Kalvin Electron Microscope Laboratory, Lenox Hill Hospital, New York (Dr Terzakis).

Arch Dermatol. 1983;119(3):229-234. doi:10.1001/archderm.1983.01650270047016

• A patient had extensive foreign-body granulomatous inflammation of multiple skin sites and of the inguinal lymph nodes with splenomegaly, cutaneous anergy to common skin antigens, and peripheral blood eosinophilia. The patient had an elevated serum angiotensin-converting enzyme level. Histologically, the granulomas were of the foreign-body type with lymphocytes, histiocytes, eosinophils, and giant cells, some that contained doubly refractile crystalline material. Electron-probe x-ray microanalysis identified silicon, magnesium, iron, calcium, phosphorus, zinc, titanium, and chromium in the crystalline material. These findings suggest talc, cement, and inorganic pigment as possible sources of the crystals. This case is reported for its unusual clinical, laboratory, and morphologic features.

(Arch Dermatol 1983;119:229-234)

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