Abstract
Silicone is a chemical compound that is composed of one silicone atom and two atoms of oxygen. It has a variety of clinical applications such as breast and joint implants, intraocular lenses and others. Silicone is associated with a variety of autoimmune/inflammatory syndromes induced adjuvant, called ASIA syndrome, among them is lupus development. A 48year-old woman who had silicone breast implantation bilaterally 4 months earlier, presented to us with abrupt, extensive erythematosus skin manifestations affecting her face, nose and lips. She presented annular lesions affecting the upper back and erythematosus lesions affecting the palms of both hands. She manifested also epidermal necrolysis involving the breasts, areolas and nipples bilaterally. Laboratory evaluation revealed low white blood cells, positive antinuclear antibodies at a titre of 1/320, fine speckled pattern and Ro(SSA) and Smith(Sm) antibodies. The patient satisfied the classification criteria for lupus and the proposed criteria for silicone induced ASIA syndrome. She was treated with prednisone 40mg/day plus hydroxychloroquine 400mg/day with excellent results. Thus, through the above case we review and discuss the relevant literature of silicone induced lupus. This is a unique described case with such extensive and severe skin manifestations induced from silicone. To this end, physicians must be aware and recognise these symptoms and signs of patients exposed to silicone and treat them promptly and appropriately.