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By Gary M. White, MD

When silica is embedded in the skin, granulomas form around it over time.


The enlarging of a scar years to decades after cutaneous trauma is characteristic. Erythematous, firm, non-tender, dermal or subcutaneous nodules are typical. Regional lymphadenopathy may be present with silica present on biopsy.

Diagnosis/Differential Diagnosis

Sarcoidosis may cause scar enlargement and must be excluded.


Surgical excision is the treatment of choice. IL steroid injection usually causes only a transient reduction in these lesions. The lesion may recur after incomplete excision.


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