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CUTANEOUS SILICA GRANULOMA
By Gary M. White, MD
When silica is embedded in the skin, granulomas form around it over time.
- The mean latency period is about 10 years with a range from 6 months to 59 years.
- Most of the traumatic events are major, e.g. land mine explosion, laceration by glass in motor vehicle accidents, memorable falls with abrasions, cycling accidents.
- Silica is one of the most abundant elements in the earth's crust. The most common form of silica is quartz which is a constituent of nearly every rock.
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.
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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