Pirakitikulr Nathan, Tran Ann Q, Garcia Armando L, Dubovy Sander R, Lee Wendy W
Division of Oculofacial Plastic and Reconstructive Surgery, Bascom Palmer Eye Institute, University of Miami-Miller School of Medicine, Miami, FL, USA.
Florida Lions Ocular Pathology Laboratory, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA.
Case Rep Ophthalmol Med. 2020 Jun 24;2020:6323646. doi: 10.1155/2020/6323646. eCollection 2020.
Silicone-based compounds are commonly used in many medical applications, such as coatings for needles and syringes. Foreign body granulomas are a well-recognized complication of silicone exposure; however, they may be challenging to identify without a clear history. A 61-year-old female patient without prior history of periocular injections, filler, or surgery presented to our oculoplastic clinic with multiple periocular lesions. The patient subsequently underwent excisional biopsy of two prominent lesions, which were identified as granulomas on pathology. Further questioning revealed the cause to be facial acupuncture performed decades prior, and a subsequent targeted exam identified additional lesions at other needling sites. A third lesion was subsequently excised, and there was no recurrence at the last follow-up 3 months postsurgery. Acupuncture is an increasingly common but underrecognized source of silicone exposure and can present up to several decades after exposure as a chronic granulomatous response in a characteristic multifocal pattern.
硅基化合物常用于许多医学应用中，如针头和注射器的涂层。异物肉芽肿是硅暴露公认的并发症；然而，如果没有明确的病史，可能很难识别。一名61岁女性患者，既往无眼周注射、填充或手术史，因多处眼周病变就诊于我们的眼科整形门诊。患者随后对两个突出病变进行了切除活检，病理检查确定为肉芽肿。进一步询问发现病因是数十年前进行的面部针灸，随后的针对性检查在其他针刺部位发现了更多病变。随后切除了第三个病变，术后3个月的最后一次随访时未出现复发。针灸是一种越来越常见但未被充分认识的硅暴露源，在暴露后数十年可能会以特征性的多灶性模式出现慢性肉芽肿反应。
