Case and Research Letters
Delayed Foreign Body Reaction to Steel Wire Suture Resembling Basal Cell Carcinoma
Reacción retardada a cuerpo extraño por alambre de acero inoxidable simulando un carcinoma basocelular
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Infiltrado inflamatorio difuso en la dermis. Epidermis sin alteraciones histológicas significativas (HE x25). B. El infiltrado inflamatorio era linfoplasmocitario y contenía aisladas células gigantes multinucleadas (HE x200).</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "J. Neila, M. Perea, J.J. Ríos-Martín, F.M. Camacho" "autores" => array:4 [ 0 => array:2 [ "nombre" => "J." "apellidos" => "Neila" ] 1 => array:2 [ "nombre" => "M." "apellidos" => "Perea" ] 2 => array:2 [ "nombre" => "J.J." "apellidos" => "Ríos-Martín" ] 3 => array:2 [ "nombre" => "F.M." 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Neila, M. Perea, J.J. Ríos-Martín, F.M. Camacho" "autores" => array:4 [ 0 => array:4 [ "nombre" => "J." "apellidos" => "Neila" "email" => array:1 [ 0 => "drneils@hotmail.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">¿</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "M." "apellidos" => "Perea" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 2 => array:3 [ "nombre" => "J.J." "apellidos" => "Ríos-Martín" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 3 => array:3 [ "nombre" => "F.M." "apellidos" => "Camacho" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Departamento de Dermatología Médico Quirúrgica, Hospital Universitario Virgen Macarena, Sevilla, Spain" "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Servicio de Anatomía Patológica, Hospital Universitario Virgen Macarena, Sevilla, Spain" "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Reacción retardada a cuerpo extraño por alambre de acero inoxidable simulando un carcinoma basocelular" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 765 "Ancho" => 952 "Tamanyo" => 103542 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">A,<span class="elsevierStyleHsp" style=""></span>pearly papule of 1.5<span class="elsevierStyleHsp" style=""></span>cm in diameter over the previous scar. B,<span class="elsevierStyleHsp" style=""></span>surgical specimen containing the steel suture wire.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">A foreign body is any live or inanimate material introduced in the human body, and the body responds by using its mechanisms of defense. Although a broad definition would also include microorganisms that elicit an immune response, foreign bodies are usually considered to be inorganic compounds or high-molecular-weight organic materials that resist destruction by inflammatory cells.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> These substances can enter iatrogenically during surgical procedures, as is the case with foreign body reactions to suture material.<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">We describe an 87-year-old man with a history of prostate cancer, atrial fibrillation, hypertension, and chronic bronchitis who had undergone surgery 30<span class="elsevierStyleHsp" style=""></span>years earlier for a malignant neoplastic process classified by the hospital at the time as nasal natural killer lymphoma; no further information was available. In March<span class="elsevierStyleHsp" style=""></span>2010 the patient consulted for an excrescent mass from 5<span class="elsevierStyleHsp" style=""></span>months previously that was present on the nasal bridge, on top of an old scar. The examination revealed an erythematous, pearly plaque with a maximum diameter of 1.5<span class="elsevierStyleHsp" style=""></span>cm adherent to the deep layer (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>), and dermoscopy showed spider telangiectasia and grayish-blue areas.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall">Because basal cell carcinoma was suspected, the lesion was biopsied to rule out recurrence of the lymphoproliferative process, at which time a stainless steel suture wire was found (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>).</p><p id="par0020" class="elsevierStylePara elsevierViewall">On further questioning, the patient reported that a bone autograft from the hip had been used in one of the previous nasal reconstruction operations. The x-ray showed other suture wires used to fix an abnormal bone structure that corresponded to the hip graft used for nasal reconstruction (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>).</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0025" class="elsevierStylePara elsevierViewall">Histology revealed the presence of a diffuse inflammatory infiltrate in the dermis, composed predominantly of plasma cells, lymphocytes, and occasional multinucleated giant cells (<a class="elsevierStyleCrossRef" href="#fig0015">Fig. 3</a>). No epidermal involvement or well-formed granulomas were observed. Lymphoid cells showed no atypia, and immunohistochemistry ruled out any recurrence of a lymphoid neoplasm. Removal of the wire and direct suture during the biopsy resolved the symptoms.</p><elsevierMultimedia ident="fig0015"></elsevierMultimedia><p id="par0030" class="elsevierStylePara elsevierViewall">Stainless steel is sufficiently strong, flexible, ductile, and biocompatible to be used in most maxillofacial implants.<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> The material is also inexpensive and easy to handle and, therefore, has been frequently used in needles, wires, and plates for reconstructive surgery of the facial region. In implants, it has now been replaced with other materials, such as titanium.<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a></p><p id="par0035" class="elsevierStylePara elsevierViewall">Foreign body reaction to stainless steel implants is rare. Deterioration of the wire used in sternotomy reconstruction has been reported, however.<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> In these cases, the reaction appeared in the months after surgery and the patients consulted for atypical chest pain.</p><p id="par0040" class="elsevierStylePara elsevierViewall">The appearance of a reaction 30<span class="elsevierStyleHsp" style=""></span>years after the wire was implanted is also rare, and cannot be explained by the patient's history, as there were no injuries or recent procedures in the area. Moreover, the patient did not wear glasses or use an oxygen mask. In 2006 Surov et al<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a> described a similar case of delayed reaction in an 84-year-old man with a World War II grenade injury 60<span class="elsevierStyleHsp" style=""></span>years previously who developed a mass in the area caused by a foreign body reaction to steel fragments from the weapon.</p><p id="par0045" class="elsevierStylePara elsevierViewall">Our letter describes a new case of foreign body reaction to stainless steel wire 3 decades after implantation. In this patient the lesion resembled basal cell carcinoma. This case report is unusual in that the condition presented 30<span class="elsevierStyleHsp" style=""></span>years after implantation with no previous triggering injury. Foreign body reaction should be included in the differential diagnosis of any skin process that develops over a surgical scar, even if the process takes place many years after the operation.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2010-05-30" "fechaAceptado" => "2011-03-26" "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara">Please cite this article as: Neila J, et al. Reacción retardada a cuerpo extraño por alambre de acero inoxidable simulando un carcinoma basocelular. Actas Dermosifiliogr.2011;102:740-742.</p>" ] ] "multimedia" => array:3 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 765 "Ancho" => 952 "Tamanyo" => 103542 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">A,<span class="elsevierStyleHsp" style=""></span>pearly papule of 1.5<span class="elsevierStyleHsp" style=""></span>cm in diameter over the previous scar. B,<span class="elsevierStyleHsp" style=""></span>surgical specimen containing the steel suture wire.</p>" ] ] 1 => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 847 "Ancho" => 658 "Tamanyo" => 34506 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Autograft radiography. Radiopaque suture wire and hip graft used to replace the normal nasal anatomy.</p>" ] ] 2 => array:7 [ "identificador" => "fig0015" "etiqueta" => "Figure 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 1419 "Ancho" => 952 "Tamanyo" => 370811 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">A,<span class="elsevierStyleHsp" style=""></span>diffuse inflammatory infiltrate in the dermis. Epidermis with no significant histologic abnormalities (hematoxylin-eosin, original magnification, x25). B,<span class="elsevierStyleHsp" style=""></span>lymphoplasmacytic inflammatory infiltrate containing isolated multinucleated giant cells (hematoxylin-eosin, original magnification, x200).</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:6 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Pathology of granulomatosus diseases. Foreign body granulomas" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "B.C. Hirsh" 1 => "W.C. 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Cole Jr" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Ann Thorac Surg" "fecha" => "1991" "volumen" => "51" "paginaInicial" => "56" "paginaFinal" => "59" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1985576" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0030" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A Delayed Complication after Injury in World War II" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "A. Surov" 1 => "C. Taege" 2 => "C. Behrmann" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "N Engl J Med" "fecha" => "2006" "volumen" => "18" "paginaInicial" => "1963" "paginaFinal" => "1964" ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/15782190/0000010200000009/v1_201304241238/S1578219011000989/v1_201304241238/en/main.assets" "Apartado" => array:4 [ "identificador" => "6157" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Case and Research Letters" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/15782190/0000010200000009/v1_201304241238/S1578219011000989/v1_201304241238/en/main.pdf?idApp=UINPBA000044&text.app=https://actasdermo.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219011000989?idApp=UINPBA000044" ]
| año/Mes | Html | Total | |
|---|---|---|---|
| 2024 Noviembre | 6 | 14 | 20 |
| 2024 Octubre | 83 | 56 | 139 |
| 2024 Septiembre | 90 | 45 | 135 |
| 2024 Agosto | 109 | 63 | 172 |
| 2024 Julio | 105 | 50 | 155 |
| 2024 Junio | 94 | 47 | 141 |
| 2024 Mayo | 97 | 44 | 141 |
| 2024 Abril | 98 | 23 | 121 |
| 2024 Marzo | 74 | 33 | 107 |
| 2024 Febrero | 67 | 39 | 106 |
| 2024 Enero | 64 | 35 | 99 |
| 2023 Diciembre | 57 | 23 | 80 |
| 2023 Noviembre | 99 | 41 | 140 |
| 2023 Octubre | 89 | 33 | 122 |
| 2023 Septiembre | 90 | 43 | 133 |
| 2023 Agosto | 70 | 32 | 102 |
| 2023 Julio | 70 | 42 | 112 |
| 2023 Junio | 68 | 25 | 93 |
| 2023 Mayo | 76 | 34 | 110 |
| 2023 Abril | 56 | 38 | 94 |
| 2023 Marzo | 50 | 39 | 89 |
| 2023 Febrero | 46 | 24 | 70 |
| 2023 Enero | 32 | 27 | 59 |
| 2022 Diciembre | 62 | 46 | 108 |
| 2022 Noviembre | 30 | 30 | 60 |
| 2022 Octubre | 25 | 47 | 72 |
| 2022 Septiembre | 21 | 39 | 60 |
| 2022 Agosto | 37 | 37 | 74 |
| 2022 Julio | 42 | 43 | 85 |
| 2022 Junio | 46 | 37 | 83 |
| 2022 Mayo | 47 | 36 | 83 |
| 2022 Abril | 57 | 46 | 103 |
| 2022 Marzo | 61 | 58 | 119 |
| 2022 Febrero | 66 | 44 | 110 |
| 2022 Enero | 58 | 39 | 97 |
| 2021 Diciembre | 45 | 54 | 99 |
| 2021 Noviembre | 83 | 54 | 137 |
| 2021 Octubre | 67 | 53 | 120 |
| 2021 Septiembre | 50 | 56 | 106 |
| 2021 Agosto | 49 | 36 | 85 |
| 2021 Julio | 42 | 40 | 82 |
| 2021 Junio | 45 | 36 | 81 |
| 2021 Mayo | 33 | 52 | 85 |
| 2021 Abril | 83 | 95 | 178 |
| 2021 Marzo | 61 | 45 | 106 |
| 2021 Febrero | 46 | 24 | 70 |
| 2021 Enero | 35 | 26 | 61 |
| 2020 Diciembre | 38 | 19 | 57 |
| 2020 Noviembre | 24 | 17 | 41 |
| 2020 Octubre | 16 | 11 | 27 |
| 2020 Septiembre | 28 | 20 | 48 |
| 2020 Agosto | 27 | 18 | 45 |
| 2020 Julio | 29 | 23 | 52 |
| 2020 Junio | 34 | 25 | 59 |
| 2020 Mayo | 25 | 19 | 44 |
| 2020 Abril | 40 | 26 | 66 |
| 2020 Marzo | 30 | 33 | 63 |
| 2020 Febrero | 7 | 12 | 19 |
| 2020 Enero | 0 | 13 | 13 |
| 2019 Diciembre | 4 | 6 | 10 |
| 2019 Noviembre | 0 | 1 | 1 |
| 2019 Octubre | 0 | 3 | 3 |
| 2019 Septiembre | 4 | 3 | 7 |
| 2019 Agosto | 0 | 7 | 7 |
| 2019 Julio | 0 | 6 | 6 |
| 2019 Junio | 0 | 28 | 28 |
| 2019 Mayo | 3 | 28 | 31 |
| 2019 Abril | 0 | 17 | 17 |
| 2019 Marzo | 2 | 13 | 15 |
| 2019 Enero | 0 | 4 | 4 |
| 2018 Diciembre | 3 | 0 | 3 |
| 2018 Noviembre | 3 | 0 | 3 |
| 2018 Octubre | 2 | 0 | 2 |
| 2018 Septiembre | 2 | 0 | 2 |
| 2018 Marzo | 2 | 0 | 2 |
| 2018 Febrero | 43 | 4 | 47 |
| 2018 Enero | 51 | 11 | 62 |
| 2017 Diciembre | 52 | 10 | 62 |
| 2017 Noviembre | 40 | 6 | 46 |
| 2017 Octubre | 59 | 9 | 68 |
| 2017 Septiembre | 50 | 4 | 54 |
| 2017 Agosto | 55 | 9 | 64 |
| 2017 Julio | 37 | 7 | 44 |
| 2017 Junio | 42 | 7 | 49 |
| 2017 Mayo | 54 | 7 | 61 |
| 2017 Abril | 43 | 10 | 53 |
| 2017 Marzo | 47 | 7 | 54 |
| 2017 Febrero | 40 | 9 | 49 |
| 2017 Enero | 37 | 6 | 43 |
| 2016 Diciembre | 69 | 11 | 80 |
| 2016 Noviembre | 69 | 3 | 72 |
| 2016 Octubre | 64 | 7 | 71 |
| 2016 Septiembre | 107 | 11 | 118 |
| 2016 Agosto | 70 | 12 | 82 |
| 2016 Julio | 56 | 11 | 67 |
| 2016 Junio | 10 | 12 | 22 |
| 2016 Mayo | 7 | 16 | 23 |
| 2016 Abril | 6 | 6 | 12 |
| 2016 Marzo | 14 | 9 | 23 |
| 2016 Febrero | 3 | 17 | 20 |
| 2016 Enero | 6 | 9 | 15 |
| 2015 Diciembre | 7 | 10 | 17 |
| 2015 Noviembre | 15 | 12 | 27 |
| 2015 Octubre | 19 | 11 | 30 |
| 2015 Septiembre | 11 | 9 | 20 |
| 2015 Agosto | 17 | 6 | 23 |
| 2015 Julio | 51 | 9 | 60 |
| 2015 Junio | 60 | 6 | 66 |
| 2015 Mayo | 74 | 13 | 87 |
| 2015 Abril | 61 | 15 | 76 |
| 2015 Marzo | 59 | 14 | 73 |
| 2015 Febrero | 58 | 6 | 64 |
| 2015 Enero | 48 | 15 | 63 |
| 2014 Diciembre | 66 | 9 | 75 |
| 2014 Noviembre | 48 | 5 | 53 |
| 2014 Octubre | 58 | 19 | 77 |
| 2014 Septiembre | 42 | 16 | 58 |
| 2014 Agosto | 55 | 9 | 64 |
| 2014 Julio | 68 | 20 | 88 |
| 2014 Junio | 83 | 16 | 99 |
| 2014 Mayo | 109 | 18 | 127 |
| 2014 Abril | 72 | 9 | 81 |
| 2014 Marzo | 83 | 12 | 95 |
| 2014 Febrero | 63 | 9 | 72 |
| 2014 Enero | 54 | 11 | 65 |
| 2013 Diciembre | 62 | 13 | 75 |
| 2013 Noviembre | 41 | 13 | 54 |
| 2013 Octubre | 15 | 4 | 19 |
| 2013 Septiembre | 13 | 8 | 21 |
| 2013 Agosto | 14 | 13 | 27 |
| 2013 Julio | 5 | 11 | 16 |
| 2013 Junio | 12 | 8 | 20 |
| 2013 Mayo | 18 | 5 | 23 |
| 2013 Abril | 12 | 14 | 26 |
| 2013 Marzo | 19 | 8 | 27 |
| 2013 Febrero | 26 | 7 | 33 |
| 2013 Enero | 28 | 6 | 34 |
| 2012 Diciembre | 15 | 4 | 19 |
| 2012 Noviembre | 1 | 0 | 1 |
| 2012 Agosto | 1 | 0 | 1 |
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