allopurinol and Facial-Dermatoses

Siliconomas are subcutaneous nodules that usuallyappear as a consequence of the migration of freesilicon implanted in other locations. They are morefrequent in women with abnormal breast implants,such as poly implant prostheses (PIP), but they may alsoappear after illegal injection of free silicone. We reporta 57-year-old woman who attended our Dermatologyclinic complaining of relapsing facial panniculitis ofunknown origin. After a thorough work-up, thesenodules were determined to be the consequence ofdermal filler made with fluid silicone, which had beeninjected 20 years prior. High frequency skin ultrasoundof one of the nodules showed a hyperechoic image,also known as "snowstorm," which was located in thesubcutaneous tissue. The disposition of silicone in thisplane obscures the view of any sonographic structurein the underlying plane. Cutaneous sonographyhas become one of the most useful non-invasivetechniques in diagnosis of filler complications andother inflammatory diseases. Combined treatmentwith prednisone and allopurinol was successful, withno recurrence after 1 year of follow-up.

Topics: Allopurinol; Dermal Fillers; Facial Dermatoses; Female; Foreign-Body Reaction; Free Radical Scavengers; Glucocorticoids; Humans; Middle Aged; Panniculitis; Prednisone; Silicones; Subcutaneous Tissue; Ultrasonography

Topics: Allopurinol; Facial Dermatoses; Female; Granuloma, Foreign-Body; Humans; Middle Aged; Rhytidoplasty; Silicones

Topics: Allopurinol; Collagen; Cosmetic Techniques; Facial Dermatoses; Female; Granuloma, Foreign-Body; Humans; Injections; Microspheres; Middle Aged; Polymethyl Methacrylate; Skin

Topics: Adolescent; Allopurinol; Antimetabolites; Facial Dermatoses; Humans; Male; Sarcoidosis; Skin Diseases

Scar sarcoidosis is one of the rare cutaneous manifestations of sarcoidosis. Apart from the clinical picture, suppression of the cell-mediated immunity can often be determined when tuberculin tests and testing for recall antigens are carried out. In the present case of a 68-year-old woman patient scar sarcoidosis and pulmonary sarcoidosis were detected. Remarkably, a strongly positive tuberculin reaction was found, while acute tuberculosis and former BCG vaccination were excluded. Both references in the literature and the case presented demonstrate that a positive tuberculin test, while very unusual in sarcoidosis, does not however, preclude the diagnosis. On the basis of some case reports in the literature, our patient was treated with allopurinol; impressive improvement of both the skin and the pulmonary manifestations was noted. Despite the well-known phenomenon of spontaneous regression in sarcoidosis, we recommend a clinical trial with allopurinol as this substance is well tolerated.

Topics: Allopurinol; Cicatrix; Diagnosis, Differential; Facial Dermatoses; Female; Humans; Immune Tolerance; Middle Aged; Sarcoidosis; Sarcoidosis, Pulmonary; Skin; Tuberculin Test