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与乳房植入物相关的皮肤过敏样反应:综述

Cutaneous Hypersensitivity-Like Reactions Associated With Breast Implants: A Review.

作者信息

Labadie Jessica G, Korta Dorota Z, Barton Natalie, Mesinkovska Natasha A

机构信息

University of California Irvine School of Medicine, Irvine, California.

Department of Internal Medicine, Presence St. Joseph Hospital, Chicago, Illinois.

出版信息

Dermatol Surg. 2018 Mar;44(3):323-329. doi: 10.1097/DSS.0000000000001448.

Abstract

BACKGROUND

Breast implantation is an increasingly common procedure for both cosmesis and reconstruction. Risk of cutaneous reactions to breast implants is low and typically described in postsurgical settings. Adverse skin hypersensitivity-like reactions to implants have also been reported but are not well described.

OBJECTIVE

To review the scientific literature on cutaneous hypersensitivity-like reactions to breast implants.

METHODS

A systematic literature review was conducted using PubMed. Articles pertaining to breast implants and cutaneous hypersensitivity-like reactions in humans were included.

RESULTS

In total, 10 studies on hypersensitivity-like reactions from breast implants were included in the review. Potential allergenic compounds in breast implants include silicone, polyurethane texturing, and acellular dermal matrix. Perivascular lymphocytic infiltrate was a common finding on histopathology. Patch testing and preoperative silicone cube implantation were used to determine sensitivity. Attempted treatments included topical and oral corticosteroids, montelukast and antibiotics. Most cases required implant removal for resolution of symptoms.

CONCLUSION

Cutaneous hypersensitivity-like reactions to breast implants seem to be rare complications, sometimes necessitating implant removal. Future studies are needed to establish their incidence and etiology, and the diagnostic role of patch testing and preoperative screening.

摘要

背景

乳房植入术对于美容和重建而言,是一种越来越常见的手术。乳房植入物引起皮肤反应的风险较低,且通常在术后情况中有所描述。也有报道称植入物会引发类似皮肤过敏的不良反应,但描述并不详尽。

目的

回顾关于乳房植入物引起类似皮肤过敏反应的科学文献。

方法

使用PubMed进行系统的文献综述。纳入了与人类乳房植入物和类似皮肤过敏反应相关的文章。

结果

该综述共纳入了10项关于乳房植入物引起类似过敏反应的研究。乳房植入物中的潜在致敏化合物包括硅酮、聚氨酯纹理和脱细胞真皮基质。血管周围淋巴细胞浸润是组织病理学上的常见发现。斑贴试验和术前硅酮立方体植入用于确定敏感性。尝试的治疗方法包括局部和口服皮质类固醇、孟鲁司特和抗生素。大多数病例需要取出植入物以缓解症状。

结论

乳房植入物引起的类似皮肤过敏反应似乎是罕见的并发症,有时需要取出植入物。未来需要开展研究以确定其发病率和病因,以及斑贴试验和术前筛查的诊断作用。

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