The first case of localized scleroderma (morphea) in a 61-year-old female with unilateral rupture 3 years after bilateral saline breast implant augmentation is reported. Erythematous skin eruptions were noted on the anterior trunk and involved breast. The implant was removed and tissue biopsies were performed. On histology, the clinical lesions showed cupuliform depressed plaques with scleroatrophia of the dermis. Extensive fibrosis including caliber and disposition of collagen bundles and lymphocyte and plasma cell infiltrate were present. Intense deposits of C3d and C5b-9 were noted along the dermo-epidermal junction under direct immunoflourescence. Elevated anti-nuclear antibody and C-reactive protein levels returned to normal after implant removal. It was concluded that this localized scleroderma could be related to the silicone capsule of the ruptured saline implant. In spite of the fact that epidemiological studies have not demonstrated a relationship between silicone implants and autoimmune disease, the continual appearance of new cases such as this requires an open attitude and awareness of the possibility. Photographic and histologic case details along with a review of the literature will be presented.
European Journal of Plastic Surgery – Springer Journals
Published: Apr 1, 2011
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