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首页> 外文期刊>The Internet Journal of Dermatology >Dermalive Granuloma: A Lesion With Distinctive Histological Features
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Dermalive Granuloma: A Lesion With Distinctive Histological Features

机译：真皮肉芽肿：具有明显组织学特征的病变

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We report the clinical and histopathological findings in two patients who had undergone treatment of facial contour abnormalities with the injectable microimplant Dermalive. Both patients presented after approximately 18 months with subcutaneous clearly palpable indurations and nodules in the area of previous augmentation. Histopathological examination of the partially excised lesions showed features of foreign body granulomas with distinctive cystic spaces. The clue to the diagnosis is the particular configuration of these cystic spaces and the characteristic shape of the foreign bodies. Dermalive granulomas show numerous round vacuoles variable in size and shape with uniform transdermal distribution. The vacuoles enclose sharply circumscribed, translucent, non-birefringent foreign bodies with variable diameter. A reactive lymphocytic infiltrate is sparse and intermingled with a few multinucleated giant cells. These histopathologic findings unequivocally allow a correct diagnosis after clinico-pathological correlation. Introduction Augmentation of facial tissue deficiences and other contour abnormalities has been performed for many decades by using various materials, including organic substances such as ivory, liquid paraffin, autologous fat, and coral (1,2,3,4). Inorganic substances such as liquid silicone gel have been used since the early 1960s and injectable bovine collagen since 1970 (5,6). Attempts with gelatin matrix implants were performed during the last two decades (7). None of these treatments gave satisfactory results because of migration, host immune response, or only transitory cosmetic improvement, requiring repeated injections. With the introduction of Goretex and Artecoll a more longlasting therapy has recently become available. These are examples of permanent biologically inert implant materials. On the other hand, the market of currently used cosmetic fillers is rapidly expanding. These cosmetic fillers can be categorised in resordable, biodegradable and (semi-) permanent (table 1). With resordable products the tissue augmentation results from the injected volume; biodegradable products induce formation of new collagen, and permanent products cannot be eliminated. All of these cosmetic injections can give adverse reactions and face the pathologists with new and sometimes distinctive granuloma types (8). This side effect is mainly encountered in thin and constantly moving skin such as the face or neck (9,10,11).
机译：我们报告了两名患者使用可注射的微型植入物Dermalive治疗面部轮廓异常的临床和组织病理学发现。两名患者在大约18个月后均出现皮下明显可见的硬结和结节，且均在先前的隆突区域。部分切除的病变的组织病理学检查显示异物肉芽肿具有明显的囊性间隙。诊断的线索是这些囊性间隙的特殊结构和异物的特征形状。真皮肉芽肿显示出许多圆形泡，大小和形状各异，透皮分布均匀。液泡包围着直径可变的，清晰界定的，半透明的，非双折射的异物。反应性淋巴细胞浸润稀疏并与少数多核巨细胞混合。这些组织病理学发现明确地允许在临床病理相关性之后进行正确的诊断。简介数十年来，通过使用各种材料，包括象牙，液体石蜡，自体脂肪和珊瑚等有机物质，可以增强面部组织缺陷和其他轮廓异常（1,2,3,4）。从1960年代初期开始使用无机物质，例如液态硅凝胶，从1970年开始使用可注射的牛胶原（5,6）。在过去的二十年中进行了明胶基质植入物的尝试（7）。由于迁移，宿主免疫反应或仅短暂的美容改善，需要重复注射，这些治疗均未获得令人满意的结果。随着Goretex和Artecoll的引入，最近出现了一种更持久的疗法。这些是永久性生物惰性植入物材料的例子。另一方面，当前使用的化妆品填充剂的市场正在迅速扩大。这些化妆品填充剂可以分为可修复的，可生物降解的和（半）永久性的（表1）。对于可匹配的产品，组织体积的增加是由注入的体积引起的。可生物降解的产品会诱导新胶原蛋白的形成，并且永久性产品无法消除。所有这些美容注射剂都可能产生不良反应，并使病理学家面对新的，有时与众不同的肉芽肿类型（8）。这种副作用主要发生在薄而经常移动的皮肤（如脸部或颈部）中（9,10,11）。

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