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Paraffinoma
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Paraffinoma

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Contributors: Michael Nguyen, Susan Burgin MD
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Synopsis

The practice of local injection of paraffin for tissue augmentation is illegal in most countries because of the high frequency of attendant granulomatous foreign body reactions (paraffinomas) that accompany this procedure. However, paraffinomas are still encountered as paraffin injections are still sporadically performed, usually by nonmedical personnel.

Paraffin has been used in various anatomic areas for tissue augmentation, including for penile enlargement, breast augmentation, or as a facial filler. Paraffin foreign body reactions can also occur following the application of paraffin-containing materials, such as gauze packs.

Classically, paraffinoma presents with nontender, firm nodules and indurated plaques at injection sites. Necrosis, ulceration, fistulae, and abscess formation may also be seen. The degree of reaction is typically proportional to the amount of paraffin injected. Paraffin reactions may take months to years to manifest clinically.

Codes

ICD10CM:
T88.8XXA – Other specified complications of surgical and medical care, not elsewhere classified, initial encounter

SNOMEDCT:
299007 – Paraffinoma of skin

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

  • Foreign body reaction to silicone injection – Similar histologically but has negative fat stains.
  • Foreign body reactions to hyaluronic acid and other injectable soft tissue fillers are rare.
  • Atypical mycobacterial infection or deep fungal infections need to be considered in the clinical differential diagnosis.

Best Tests

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Therapy

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References

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Last Updated: 04/21/2016
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Paraffinoma
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Paraffinoma : Buttocks, Face, Penis, Smooth nodules, Cosmetic paraffin injection, Indurated plaques
Clinical image of Paraffinoma
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