Autoimmune Syndrome Induced by Adjuvants (ASIA) in the Middle East: morphea following silicone implantation

  1. S Kivity1,2,3
  2. M Katz3
  3. P Langevitz1,2
  4. I Eshed4
  5. D Olchovski3
  6. A Barzilai5

  1. 1Rheumatology Unit, Sheba Medical Center, Tel-Hashomer, affiliated to Sackler Faculty of Medicine, Tel Aviv University, Israel

  2. 2Center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer, affiliated to Sackler Faculty of Medicine, Tel Aviv University, Israel

  3. 3Department of Medicine ‘A’, Sheba Medical Center, Tel-Hashomer, affiliated to Sackler Faculty of Medicine, Tel Aviv University, Israel

  4. 4Imaging Division, Sheba Medical Center, Tel-Hashomer, affiliated to Sackler Faculty of Medicine, Tel Aviv University, Israel

  5. 5Dermatology Department, Sheba Medical Center, Tel-Hashomer, affiliated to Sackler Faculty of Medicine, Tel Aviv University, Israel
  1. Dr Shaye Kivity, Rheumatology Unit, Sheba Medical Center, Tel-Hashomer, affiliated to Sackler Faculty of Medicine, Tel Aviv University, Israel Email: kivitys{at}gmail.com

Morphea and other scleroderma-like skin conditions are occasionally linked with exposure to chemical compounds such as silicone. We treated a 56-year-old woman with generalized severe skin induration accompanied with systemic symptoms and peripheral eosinophilia, which appeared 2.5 years after breast silicone implantation and abdominal liposuction. Blood test results and histopathological examination of her skin suggested the diagnosis of morphea overlapping with eosinophilic fasciitis. Her skin disease was presumed to be an autoimmune reaction to silicone implantation. While the removal of the implants did not improve her illness, treatment with 1 mg/kg prednisone and PUVA bath was initiated, with some improvement. This patient illustrates an example of ASIA (Autoimmune Syndrome Induced by Adjuvants), as her disease appeared following exposure to an adjuvant stimulus, with ‘typical’, although not well-defined, autoimmune manifestations.

  • © The Author(s), 2012. Reprints and permissions: http://www.sagepub.co.uk/journalsPermissions.nav

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