Dermalive Granuloma: A Lesion With Distinctive Histological Features

We report the clinical and histopathological findings in two patients who had undergone treatment of facial contour abnormalities with the injectable microimplant Dermalive. Both patients presented after approximately 18 months with subcutaneous clearly palpable indurations and nodules in the area of previous augmentation. Histopathological examination of the partially excised lesions showed features of foreign body granulomas with distinctive cystic spaces. The clue to the diagnosis is the particular configuration of these cystic spaces and the characteristic shape of the foreign bodies. Dermalive granulomas show numerous round vacuoles variable in size and shape with uniform transdermal distribution. The vacuoles enclose sharply circumscribed, translucent, non-birefringent foreign bodies with variable diameter. A reactive lymphocytic infiltrate is sparse and intermingled with a few multinucleated giant cells. These histopathologic findings unequivocally allow a correct diagnosis after clinicopathological correlation.