Torre Kristin, Murphy Michael, Ricketts Janelle
University of Connecticut School of Medicine, Farmington, Connecticut.
Department of Dermatology, UConn Health, Farmington, Connecticut.
Int J Womens Dermatol. 2018 Nov 8;5(2):126-128. doi: 10.1016/j.ijwd.2018.09.005. eCollection 2019 Jun.
Lipogranulomas represent foreign body reactions to exogenous lipid or oil-like substances introduced into the skin. These lesions characteristically have round-to-ovoid, vacuole-like cavities of varying sizes in the dermis, which results in a Swiss cheese-like appearance. We present the case of a 51-year-old Hispanic woman with an onset of painful, swollen, subcutaneous nodules on the face, most prominently on the right lower lip and both cheeks, after multiple self-injections of vitamin A oil. Histopathology test results of the lower lip showed a superficial-to-deep, nodular and interstitial, polymorphous inflammatory infiltrate of predominantly histiocytes with necrobiotic-type granulomatous changes, lymphocytes, and plasma cells. The cheek revealed deep dermal and subcutaneous small collections of foamy/vacuolated histiocytes, without significant numbers of other inflammatory cells. Given the patient's history of injecting oil extracted from vitamin A capsules into her skin, the light microscopic features are consistent with lipogranulomatous changes that are secondary to a local injection of foreign material. Clinicians and pathologists should be aware of the granulomatous immune reaction generated by the injection of unregulated products into the face and other areas of the body.
脂肪肉芽肿是皮肤对外源性脂质或油样物质产生的异物反应。这些病变的特征是真皮内有大小不一的圆形至椭圆形、类似空泡的腔隙，形成类似瑞士奶酪的外观。我们报告一例51岁西班牙裔女性病例，该患者在多次自行注射维生素A油后，面部出现疼痛、肿胀的皮下结节，最明显的部位是右下唇和双颊。下唇的组织病理学检查结果显示，从浅表到深部，有结节状和间质状的多形性炎症浸润，主要为组织细胞，并伴有坏死型肉芽肿性改变、淋巴细胞和浆细胞。脸颊显示真皮深层和皮下有少量泡沫状/空泡状组织细胞聚集，无大量其他炎症细胞。鉴于患者有将从维生素A胶囊中提取的油注射到皮肤的病史，光镜下特征符合局部注射异物继发的脂肪肉芽肿性改变。临床医生和病理学家应注意向面部和身体其他部位注射未经监管的产品所产生的肉芽肿性免疫反应。
