Introduction: The granular cell tumor was first described by Abrikossoff in 1926. It is a benign, uncommon neoplasia, most frequently found on the tongue. It occurs in the vulva in 5 to 6% of cases. Its histogenesis is not known for sure, but is probably linked to Schawann cells. It is treated surgically, with a good prognosis. The tumors may recur, and some may become malignant according to the literature. The authors describe a case of a vulvar nodule with a histopathologic diagnosis of granular cell tumor, which was successfully treated with surgery.

Keywords: VULVA, VULVAR DISEASES, VULVAR NEOPLASMS, GRANULOSA CELL TUMOR

This article describes the case of a female hepatitis C patient who presented with a foreign body granuloma in the nasolabial folds and glabella five years after receiving an application of permanent dermal filler. The patient used interferon and ribavirin for treating hepatitis C for six months, and the granulomas appeared 30 days after the end of the treatment. Treatment with oral steroids was carried out, with a gradual improvement in the appearance of the skin.

Keywords: GRANULOMA, POLYMETHYL METHACRYLATE, FACE

Pyogenic granuloma is a common vascular proliferation that can be found on skin and mucous membranes. Its clinical presentation is that of a nodular, friable and erythematous lesion, with fast growth history. The nail bed pyogenic granuloma is generally related to onychocryptosis and trauma, being very painful in that site. There are several treatment options, including surgical excision, cryotherapy, electrocautery, curettage, lasers, application of trichloroacetic acid, imiquimod and microembolization. The present study reports a case of bilateral pyogenic granuloma in the halluces with exuberant growth, leading to the occlusion of the nail plate. The surgical excision of the lesion was performed with good cosmetic results.

Keywords: PYOGENIC GRANULOMA, SURGERY, TRICHLOROACETC ACID, CRYOTHERAPY.

p>Pyogenic granuloma is a common, benign, vascular proliferation, usually secondary to other events, such as cutaneous trauma. It is known that some lesions can mimic melanoma and vice versa, and it is recommended that the lesion be surgically removed and analyzed histologically. The advent of technologies-such as dermoscopy-that amplify the image recognized by the eye through the identification of certain structures and specific patterns, can facilitate this differentiation and assist in decision-making. In rare situations, its clinical presentation is unusual. The current article is aimed at demonstrating this fact and reviewing the medical literature on the subject, focusing on dermoscopic findings.

Keywords: PYOGENIC GRANULOMA, DERMOSCOPY, MELANOMA.

Description of a case where a female patient who received facial filling with polymethylmethacrylate developed late formation of a nodule and ipsilateral trigeminal neuralgia. The authors question whether there is a possible link between the two morbidities, which could have a common triggering factor or a causal relationship with each other.

Keywords: GRANULOMA; POLYMETHYLMETHACRYLATE; TRIGEMINAL NEURALGIA

Pyogenic granuloma or lobular capillary hemangioma is a benign skin and mucous membranes lesion whose etiology is not yet explained. The authors report an atypical and exuberant clinical case of this benign dermatologic condition, clinically simulating malignancy.

Keywords: GRANULOMA, PYOGENIC; SCALP DERMATOSES; HEMANGIOMA, CAPILLARY; MELANOMA

Hyaluronic acid is the currently most used filler in dermatology due to its low risk of adverse events. The objective of this study is to report a case of granulomatous reaction after filling with two types of hyaluronic acid, in the perioral region and in the nasolabial folds. A female patient with rheumatoid arthritis treated with leflunomide presented onset of symptoms 30 months after filling. Autoimmune diseases may facilitate the occurrence of complications and should be followed carefully before filling with hyaluronic acid. As already reported with the use of interferon and omalizumab, granulomatous reaction to fillers may occur after use of leflunomide.

Keywords: HYALURONIC ACID; GRANULOMA; RHEUMATOID ARTHRITIS; FOREIGN-BODY REACTION

Filler injections are among the most popular cosmetic procedures performed worldwide. Although fillers have a safety profile, there has been a rise in litigation as a result of treatments in the USA. In the Brazilian scenario, the number of non-surgical procedures has increased in the past years, mainly due to the increase of filler options available in the Brazilian market, as well as in the type of professionals allowed to perform injectable procedures. Therefore we sought to review the related literature regarding semi-permanent and temporary fillers adverse effects and outline a practical guide for complications avoidance, diagnosis and management.

Keywords: GRANULOMA; ISCHEMIA; ESTHETICS; HYALURONIC ACID; DERMIS; SUBCUTANEOUS FAT; BIOFILMS; INFECTION

Injectable fillers have long been used for cosmetic purposes and in HIV induced lipodystrophy patients. A foreign body granuloma may be a side effect of the application of absorbable products/temporary and most often the nonabsorbable/permanent fillers. It is not possible to predict the formation of these granulomas, and it may occur regardless of the application technique. In this article we describe the surgical treatment of a patient with multiple granulomas caused by intradermal injection of PMMA in the face, with poor response to conservative treatments, and severe psychosocial impairment due to this unsightly and disfiguring complication.

Keywords: POLYMETHYL METHACRYLATE; GRANULOMA; AMBULATORY SURGICAL PROCEDURES

Paraffinoma results from the implantation of mineral oil in the skin, being characterized by inflammatory reaction of foreign body type, with variable latency period. Initial lesions consist of hardened nodules, which can ulcerate, fistulate or necrose. This technique was widely used for aesthetic purposes in the 20th century, and is no longer performed by physicians. However, it is still used by non-medical professionals or by the patients themselves, mainly in the genital region, aimed at improving sexual activity. This paper reports a case of implantation of mineral oil in the penis, performed by a non-medical professional, for aesthetic purposes that evolved with necrosis after three years.

Keywords: GRANULOMA, FOREIGN-BODY; MINERAL OIL; NECROSIS; PENIS

Sarcoidosis is a non-infectious granulomatous disease of unknown etiology in which environmental, infectious, immunological, and genetic factors appear to be correlated. Clinical manifestations can occur in any organ, however there is predominance in the lungs and in intrathoracic lymph nodes. The cutaneous involvement of the disease occurs in roughly 25% of cases, with cutaneous filling procedures figuring as a potential trigger. The authors of the present article report a case of a patient who had granulomatous lesions on the face following cutaneous filling with hyaluronic acid. In the investigation of cutaneous lesions, the patient presented diagnostic criteria for sarcoidosis, with extensive pulmonary involvement.

Keywords: sarcoidosis; granuloma; hyaluronic acid

Follicular thyroid carcinoma is a well-differentiated tumor, and is considered the second most common subtype of thyroid cancer. Its metastasis usually arises hematogenously — mainly to the lungs and bones — and is considered rare when it occurs cutaneously. The authors report a case of a patient with follicular thyroid carcinoma for 5 years who noticed an erythematous, friable exophytic nodular lesion measuring 1cm on the scalp with 7 months of development, simulating a pyogenic granuloma. Biopsy analysis revealed an adenocarcinoma with glandular differentiation and colloid material in the lumen. The immunohistochemical profile was positive for CK-7 and thyroglobulin, favoring the diagnosis of cutaneous metastasis of primary thyroid neoplasia.

Keywords: Dermatology; Granuloma, Pyogenic; Neoplasms; Neoplasm metastasis

NK/T cell lymphoma is a rare, aggressive, non-Hodgkin tumor that is closely related to the Epstein-Barr virus. It has a poor prognosis and poor response to treatments. We report the case of a 91-year-old woman with a history of injury in the nasal region for three months. Histological study showed diffuse infiltration of the dermis by small and atypical lymphoid cells and positive immunohistochemistry for Ki-67, CD30, and CD3 (cytoplasmic). Due to the fast growth of the lesion and the high morbidity of the neoplasm, the patient was referred to the hospital for assistance but died before starting treatment.

Keywords: Epstein-Barr Virus Infections; Lymphocytes; Medical oncology; Extranodal T-NK Cell Lymphoma; Lethal Midline Granuloma

Sclerosing lipogranuloma is a chronic granulomatous reaction in response to the injection of non-medical substances such as paraffin, silicone, or mineral oil into the skin. This report describes one case of a large defect on the penis following sclerosing lipogranuloma excision surgery that was successfully closed by a double reverse V- Y-plasty reconstruction. The surgery aimed to remove all affected tissue as soon as possible, preventing the persistent granulomatous process that leads to necrosis and severe penile deformity. The double reverse V- Y-plasty is a simple, single-stage procedure useful to reconstruct of a large defect on the penis.

Keywords: Granuloma; Sclerosing solutions; Surgery.

Foreign body granuloma can occur after injection of filling substances into the dermis. We report a case of a 35-year-old woman who performed a self-injectable injection of a commercial serum for exclusively topical use containing hyaluronic acid in the region of the dark circles for aesthetic reasons. After the procedure, she presented a nodule in the lower right eyelid, which she judged to be an accumulation of product. Then she injected betamethasone + hyaluronidase ointment (Postec^®), evolving into a foreign body granuloma.

Keywords: Granuloma; Dermal fillers; Hyaluronic acid