Novoa R, Barnadas M A, Torras X, Curell R, Alomar A
Servicio de Dermatología, Hospital de la Santa Creu i Sant Pau, Barcelona, España.
Actas Dermosifiliogr. 2013 Dec;104(10):920-3. doi: 10.1016/j.ad.2012.07.007. Epub 2012 Sep 17.
We report the case of a patient who developed sarcoid granulomas 11 months after starting treatment with pegylated interferon alfa and ribavirin for chronic hepatitis C. The sites of the lesions were related to 3 different foreign bodies: silica in old scars on the skin, hyaluronic acid that had been injected into facial tissues, and silicone in an axillary lymph node draining the area of a breast implant. Systemic sarcoidosis was diagnosed on the basis of a history of dry cough and fever and blood tests that revealed elevated angiotensin converting enzyme and liver enzymes. Interruption of the antiviral therapy led to normalization of liver function tests and disappearance of the skin lesions and lymphadenopathies. Dermatologists and cosmetic surgeons should be aware of the risk of sarcoid lesions related to cosmetic implants in patients who may require treatment with interferon in the future.
我们报告了一例患者，该患者在开始使用聚乙二醇化干扰素α和利巴韦林治疗慢性丙型肝炎11个月后出现了结节病肉芽肿。病变部位与3种不同的异物有关：皮肤旧瘢痕中的二氧化硅、注入面部组织的透明质酸以及引流乳房植入物区域的腋窝淋巴结中的硅酮。根据干咳、发热病史以及血液检查显示血管紧张素转换酶和肝酶升高，诊断为系统性结节病。抗病毒治疗中断后，肝功能检查恢复正常，皮肤病变和淋巴结病消失。皮肤科医生和整形外科医生应意识到，对于未来可能需要使用干扰素治疗的患者，与美容植入物相关的结节病病变风险。
