Facial lipogranulomas due to self-injection of vitamin A oil

Abstract

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.

Serious complication as a result of lip augmentation with vitamin E

“…It is surrounded with inflammatory infiltrate composed of lymphocytes, macrophages and giant cells and fibrosis. 5,6 Treatment of complications is one of the most important…”

“…The oily material may be lost during tissue processing. It is surrounded with inflammatory infiltrate composed of lymphocytes, macrophages and giant cells and fibrosis …”

Retroperitoneal lipogranuloma mimicking recurrence of renal cell carcinoma after laparoscopic partial nephrectomy

“…The responsible etiologic agents are generally identified in granulomas as being due to fungi, bacteria, or foreign bodies 4 . Subcutaneous injection for therapeutic purposes may also result in granuloma formation 1 . Postoperatively, there have been some reports of granulomas arising from non-absorbable suture or surgical sponges 2 , 3 .…”

“…Lipogranuloma is a rare inflammatory reactive process that usually occurs in the dermis and subcutis. Subcutaneous injection for therapeutic purposes may result in granuloma formation 1 . Some cases have been reported of a granuloma arising from non-absorbable suture or a surgical sponge that mimics a malignant lesion 2 .…”

Facial Oil-Granuloma due to Almond Oil and Vitamin E Oil Injection

“…Such a foreign body reaction in the skin, when occurs in response to exogenously derived lipids or oil-like substances, is known as lipogranuloma or oil granuloma. [ 1 ] Here, we describe one such case of oil granuloma on the face induced by a self-injected mixture of almond oil and vitamin E oil.…”