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We report two cases of eyebrow granulomas in patients who underwent a permanent eye makeup procedure. A rash was observed 16 months after the procedure in Case 1, and 10 years after the procedure in Case 2. Histopathologically, both patients exhibited noncaseating epithelioid cell granulomas. In Case 1, most of the black‐brown granules of the permanent makeup were not present in the granulomas but were localized in the upper dermis. In contrast, in Case 2, some of the black‐brown granules were phagocytized in the granulomas, preferentially within the giant cells. Based on systemic examinations, the patients from Cases 1 and 2 were diagnosed with sarcoidosis and sarcoidal foreign body reaction, respectively. To clarify the pathogenesis of our cases, we performed immunohistochemistry using commercially available monoclonal antibodies specific to Cutibacterium acnes, previously Propionibacterium acnes (PAB), and Mycobacteria (LAM antibody). PAB antibody results were positive in granulomas only in Case 1, and the LAM antibody results were negative in both cases. Immunohistochemical detection of C. acnes in granulomas could provide useful information for differentiating between cutaneous sarcoidosis and sarcoidal foreign body reactions. [ABSTRACT FROM AUTHOR]

The extended‐release formulation of exenatide for treatment of Type II diabetes mellitus is encapsulated in microspheres composed of poly(d,l‐lactide‐co‐glycolide) (PLGA) and administered weekly. This medication has been reported to potentially cause injection‐site reactions such as pruritus, transient nodules, and foreign body reaction. Here, we report a case of exenatide‐induced granulomatous panniculitis. Our patient is a 63‐year‐old female with Type II diabetes presenting for concerns about painful nodules on her abdomen, developing approximately every week over the past year and migrating. Of note, the lesions appeared following exenatide injections in the same locations. Two deep‐seated nodules of 1 cm were identified on examination. There were no overlying skin changes, and the lesions were tender to palpation. Punch biopsies of the two lesions were performed, which revealed a septal panniculitis containing amorphous material, along with a mixed inflammatory infiltrate. Gomori methenamine silver (GMS) and acid‐fast bacilli (AFB) stains were negative for organisms. On infrared (IR) spectroscopy examination of the biopsy tissue, the spectral characteristics of (tissue) protein and PLGA were seen. Evaluation of the clinical and histopathologic findings, along with the IR spectroscopy match, determined that exenatide‐induced panniculitis was the cause of the patient's nodules. This case highlights the importance of clinicians' awareness regarding injection‐site reactions. [ABSTRACT FROM AUTHOR]

Hydrophilic polymer‐coated devices have been increasingly utilized for various endovascular procedures, however not been without adverse effects. We report two cases of subacute cutaneous lesions on the neck encountered in our dermatology clinic. Histopathologic findings were significant for a nodular aggregate of epithelioid histiocytes and lymphocytes with numerous foreign body giant cells in the dermis. The granulomatous infiltrate was associated with an amorphous basophilic non‐polarizable material. Further chart review reveals both patients receiving a central venous procedure in the past, thus attributing the hydrophilic polymers as the likely source of the foreign material found at the insertion site. Our cases contrast to the more commonly reported distal embolization by these hydrophilic polymer layers. We suspect the incidence of retained hydrophilic polymer at the site of prior endovascular procedures may be underreported in the literature with the more inconspicuous presentations. Therefore, retained foreign material should be considered by both treating physicians and dermatopathologists in presenting cases of lesions that occur at common sites of endovascular procedures. [ABSTRACT FROM AUTHOR]

Injection of high‐viscosity fluids into subcutaneous tissues may lead to a granulomatous reaction called sclerosing lipogranuloma (SL). Poly‐(d,l‐lactide‐co‐glycolide) (PLG or PLGA) microspheres are used as vehicles for extended‐release drugs. Here we describe the histopathologic features of a case of SL induced by exenatide extended‐release injections, and the staining pattern of PLG microspheres and microsphere remnants with carbol fuchsin. [ABSTRACT FROM AUTHOR]

Crospovidone is an insoluble pharmaceutical disintegrant that has been implicated in a rare foreign body reaction in injection drug users, classically associated with pulmonary angiothrombosis. We recently reported the first known cases of cutaneous crospovidone deposition. We herein report two additional cases with unique clinicopathologic manifestations, both in the setting of suspected injection drug abuse. Additionally, we provide a comprehensive overview of the distinct histomorphology and reproducible histochemistry of crospovidone. [ABSTRACT FROM AUTHOR]

D, The stromal cells and multinucleated giant cells show cytoplasmic staining for CD68, which can be distinguished from the extracellular golden brown hemosiderin pigments by its darker brown perinuclear cytoplasmic staining (CD68, Dako, Glostrup, Denmark, ×400) gl Clinically, these lesions usually present as a long-standing asymptomatic nodule that may have developed into a symptomatic mass.[[1], [5]] It can be confused with giant cell tumor of tendon sheath or other mesenchymal tumors or tumor-like lesions of the hand.[[1], [5]] History and radiology are helpful. 1 Stefanato CM, Turner MS, Bhawan J. High-pressure paint-gun injury of the finger simulating giant cell tumor of tendon sheath. [Extracted from the article]

Hydrophilic polymer with potassium salt is a hemostatic agent marketed for use by healthcare professionals and as an over-the-counter product available to healthcare consumers. In particular, dermatologic surgeons may use hydrophilic polymer for hemostasis in wounds left to heal by secondary intention. Foreign body reaction to hydrophilic polymer was recently reported. The microscopic findings in four additional patients treated with hydrophilic polymer are presented. The wounds of three patients were treated with hydrophilic polymer following a dermatologic surgical procedure while one patient used over-the-counter hydrophilic polymer on an abrasion. Three patients developed a foreign body reaction. Histopathologic examination revealed angulated fragments of deep purple material representing hydrophylic polymer admixed with round orange-red bodies and yellow-brown granules representing potassium ferrate. The components were found both free in the dermis and within multinucleated giant cells. Hydrophilic polymer must be differentiated from other materials observed in re-excision specimens, including ferric subsulfate, aluminum chloride and Gelfoam® (Pharmacia and Upjohn Co., New York, NY, USA). [ABSTRACT FROM AUTHOR]

The article presents a case study of an older asymptomatic woman with a dermal plaque on the lower abdomen and reported regular prior injections of recombinant exogenous insulins and long-acting insulin determir. It notes that she has a history of type II diabetes. She was diagnosed with palisaded granulomatous dermatitis secondary to recombinant insulin therapy. The article discusses utility of immunostaining for insulin fragments.

Panfolliculoma is a benign follicular tumor comprised of all components of the hair follicle. We report three cases of panfolliculoma with a solid, endophytic architecture, which at scanning magnification had the profile of a hair follicle. The epithelial components included uniform dark blue germinative cells, matrical cells, clear cells and cells containing trichohyaline granules. All the cases also had a central hyperkeratotic horn resembling a hair shaft. Two patients were female and one was male. Two lesions were located on the head and neck, and one was located on the leg. Clinical differential diagnoses included basal cell carcinoma, foreign body and cyst. [ABSTRACT FROM AUTHOR]

The article presents a case study of a 50-year-old woman who visited the clinic with the major complaint of a localized pruritic skin rash on both corners of the mouth that had persisted for 5 months. The patient had a history of recurrent herpes labialis on both corners of the mouth for 7 months and suffered from infections caused by live bee sting therapy several times. The study reconfirmed that live bee sting therapy causes persistent foreign body granuloma.

The article presents a case study of an elderly man who presented with subcutaneous nodule located on his right index finger. Light microscopy evaluation of the related soft tissue showed a well-demarcated, circular aggregate of sclerotic collagen surrounding granular and amorphous material. The patient was diagnosed with a foreign body reaction related to iron deposition.

High-pressure paint injection injury is an uncommon but well-described injury. The histologic features of long-term paint injection injury with retained material are less recognized. A 46-year-old male presented clinically as 'recurrent giant cell tumor of tendon sheath.' The right index finger demonstrated fusiform enlargement by a pigmented mass with diffuse infiltration into the soft tissue of the hand. Histologically the tumor showed multiple giant cells in a fibrotic stroma extending into the dermis. There were multiple types of foreign material including diffuse brown black pigment, weakly optically polarizing foreign material and white inclusions with a 'train track' appearance. The cells were positive for CD68 and negative for S100 antigen. Further investigation revealed that the patient had a history of high-pressure paint injection injury to his digit 6 years prior. Foreign material injected under high pressure into tissues may result in a pseudo-neoplastic foreign body granulomatous reaction that can mimic giant cell tumor of tendon sheath. Our case demonstrates that this reaction can be florid and can have slow growth over years. A high index of suspicion, a good clinical history and careful examination can distinguish these 2 entities. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented about the case of a 56-year-old woman who was found to have perineal nodular induration.