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Foreign body granuloma: causes, symptoms, diagnosis, treatment
Last reviewed: 07.07.2025
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Foreign body granuloma is caused by both endogenous and exogenous factors. Endogenous factors include keratin, sebum, urates, cholesterol and its crystals, etc.; exogenous factors include tattoo ink, paraffin, oils, silicone, etc. Such a reaction to keratin, for example, occurs with calcified epithelioma of Malherbe, ruptured epidermal and follicular cysts, and common acne. Clinically, foreign body granuloma is manifested by nodular elements located deep in the dermis or subcutaneous tissue, mobile or fused with the surrounding tissue, covered with normal or cyanotic skin. Ulceration is possible.
Pathomorphology of foreign body granuloma. The skin reaction to a foreign body is characterized by clusters of macrophages and foreign body giant cells with an admixture of plasma cells and eosinophilic granulocytes. Foreign material is often found near the macrophages. In the case of an allergic granulomatous reaction to foreign bodies, granulomas of tuberculoid structure arise, consisting of epithelioid cells, among which there may be, although not always, giant cells and caseous necrosis.
Histogenesis of foreign body granuloma. W. T. Epstein (1986) considers foreign body granuloma to be a non-immune reaction of mononuclear cells to an endo- or exogenous irritant. A. V. Ackerman et al. (1997), considering foreign body granuloma to be an inflammatory response to biologically inert substances, indicate that foreign bodies can cause all other types of granulomatous inflammation, including the formation of tuberculoid, sarcoid, palisading and suppurative granulomas.
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