Sclerosing lipogranuloma of the male genitalia: ultrastructural study

Abstract

Ultrastructural study of a case of sclerosing lipogranuloma showed predominantly histiocytic-like cell infiltrate with numerous intracytoplasmic vacuoles of varied sizes without any limiting membrane and located in the deep dermis and subcutaneous fat. Fibroblasts appeared normal. Polymorphonuclear cells and macrophages were absent. This appearance was different from that described in 'classical' phagocytosis, mucopolysaccharidoses or polyvinylpyrrolidone storage syndrome.

Adverse reactions to injectable soft tissue fillers

“…A case of disseminated lipogranulomas and sudden death from self-administered mineral oil injections has been also reported. 147 Histopathologically, lesions of paraffinoma involve the reticular dermis and subcutaneous tissue that shows a mostly lobular panniculitis, in which the subcutaneous fat exhibits a Swiss cheese appearance, with cystic spaces of variable size and shape, surrounded by foamy histiocytes and multinucleated giant cells 149,162 (Fig 13). The stroma is composed of bundles of sclerotic collagen between the foamy histiocytes and the cystic spaces.…”

“…Moreover, accidental injections of paraffin and other mineral oils, such as sheep lanolin, petroleum jelly, and vitamin E, can still be seen today, and patients with psychiatric or personality disorders may be capable of injecting themselves with a wide variety of substances. A specific form of paraffinoma is the so-called sclerosing lipogranuloma, which results from injection of paraffin in the penis causing fibrosis and deformity of the penis body 143,145,148,150,151,154,156,158,161,162 (Fig 12). The involved areas of paraffinoma appear as erythematous indurated plaques and in rare instances the lesion may ulcerate the overlying epidermis, mimicking a squamous cell carcinoma.…”

Cutaneous Deposits

“…333 Sclerosing lipogranuloma is a specific form of paraffinoma, which results from injection of paraffin in the penis causing fibrosis and deformity of the penis body. 334 Silicone Silicone is the most widely used filler material for softtissue augmentation. Recently, it has also been injected as a filler to circumvent facial lipoatrophy in HIV-infected patients receiving antiprotease treatment.…”

Treatment of Paraffin-Induced Lipogranuloma of the Penis by Bipedicled Scrotal Flap With Y-V incision

“…1 In particular, paraffin has been used since the ancient time for the purposes of medical treatment and in cosmetic surgery as an insoluble, inert, nonmetabolic substance. 2 Because such paraffininduced lipogranuloma of the penis rarely disappears naturally and easy to recur when there is any residual paraffin even after the surgical excision of penile lipogranuloma, the best way to treat penile lipogranuloma is complete excision at the earliest stage, as soon as it occurs 3 ; however, over the time, when there are deep subcutaneous extension of penile lipogranuloma into the penile shaft and severe necrosis, the damage to the overlying penile skin is too severe, making the treatment very difficult. Although there are many surgical treatments being introduced depending on the degree of skin damage, the failure rate is relatively high due to wound infection, wound disruption, or the contraction of the skin graft and, in particular, there is no proper treatment method established for the extensively wide area of damaged skin.…”