SILICON GRANULOMAS AND DERMATOMYOSITIS-LIKE CHANGES ASSOCIATED WITH CHRONIC EYELID EDEMA AFTER SILICONE BREAST IMPLANT

Silicone medical products may be associated with various complications . Recent attention has focused particularly on health risks associated with silicone breast implants. The authors present the clinical and h istopathological findings in a 71-year-old woman who had previously un dergone breast reconstruction with a silicone gel-filled elastomer env elope-type breast implant and who developed severe chronic eyelid edem a and inflammation. Extensive systemic evaluation and serologic studie s were unrevealing, prompting biopsy of the eyelids. Histopathologic e valuation of the upper eyelids revealed scattered noncaseating granulo mas throughout the dermis, an atrophying interface dermatitis with a s parse perivascular lymphocytic infiltrate, and focal perivascular and interstitial lymphocytic infiltrates of the muscles. Scanning electron microscopy demonstrated particles of material within the granulomas, which were revealed by electron probe x-ray microanalysis to contain s ilicon. The presence of silicon-containing material within areas of ey elid inflammation supports a role for silicon in the pathogenesis of t his patient's condition. In the absence of other predisposing conditio ns, migration of silicone breast implant material must be considered.