Bruneu-Avierinos Y, Monestier S, Tasei A-M, Gaudy-Marqueste C, Grob J-J, Richard M-A
Service de dermatologie, université de la Méditerranée, Aix-Marseille II, CHU Sainte-Marguerite, Assistance publique-Hôpitaux de Marseille, Marseille, France.
Ann Dermatol Venereol. 2011 Jan;138(1):35-7. doi: 10.1016/j.annder.2010.08.025. Epub 2010 Oct 12.
Gonadorelin analogues (LHRH) are used for the endocrine treatment of prostatic cancer, central early puberty and various gynaecological conditions. Cutaneous adverse events seldom occur. We report a case of injection-site granulomas induced by leuprorelin acetate (Enantone®).
A 76-year-old man presented with several subcutaneous nodules on his left arm. The nodules were hard but painless. He had received subcutaneous injections of Enantone® for prostatic cancer. Histological examination of a skin biopsy specimen demonstrated granulomatous inflammation with a necrotic centre; screening for an infectious aetiology was negative. Serial sections showed giant cells containing translucent round microspheres in the subcutaneous tissue. Limitation to the leuprorelin acetate injection sites in the arm and detection at histological analysis of microspheres probably bound to an injected product militated in favour of granulomas caused by injections of Enantone®.
Injection-site granulomas caused by Enantone® are rare. Their formation may depend on the mode of administration: the more superficial the injection, the higher the risk of developing granulomas. The formation of these lesions is probably a foreign body reaction to the excipient.
