**6. Classification and etiology**

There are many kinds of granuloma classification; however, the common classifications are those which have been adjusted to the etiologies [7, 8]. Granuloma formation may occur due to various factors such as biologic, chemical, and physical irritative agents [7]. Classification based on clinical, etiological, and histopathological features


**5**

*Management of Nasal Silicone Granuloma DOI: http://dx.doi.org/10.5772/intechopen.87188*

*M. kansasii*

Lymphogranuloma

**Infections Immunological aberration**

*M. avian* Farmers' lung *BCG vaccine* Bird fanciers'

*Brucella* Bagassosis

**Other infections** Coffee bean Cat-scratch Spatlese lung

**Bacteria** Suberosis (cork dust)

*Yersinia* Maple bark strippers'

**Neoplasia** Fibrosing alveolitis Carcinoma Whipple's disease

Pinealoma Radiotherapy Dysgerminoma Cancer chemotherapy

Seminoma Panniculitis Reticulum cell sarcoma Chalazion Malignant nasal granuloma Sebacous cyst

Beryllium Tattoo Zirconium Malakoplakia Silica Blau's syndrome

Reticulosis Pyrexia of unknown origin

**Chemicals** Sea urchin spine injury

*Classification of granulomatous disorders (cited from James DG, Wiliams WL) [8].*

*M. marinum* **Hypersensitivity pneumonitis**

Mushroom workers'

Paprika splitters'

**Other**

Dermoid

can be categorized further into infection, vasculitis, immunological aberration, leukocyte oxidation deficiency, hypersensitivity, chemicals, or neoplasma [14, 15]. **Table 1**

Silicone granuloma is a foreign body granuloma, which is characterized by the presence of multinuclear Datia cells and macrophages surrounded by lymphocytes and infiltrates of neutrophils. The granulomatous histological lesion caused by

Tissue reactions to silicone gel or liquids are characterized by the formation of silicone granuloma with cystic space containing foreign body [9]. The irregular surface of silicone cannot be phagocytosed completely by macrophage. Datia cells are formed due to "frustrated" macrophages. Microspheres in the size of less than 15

presents classification of granuloma based on etiology [8].

silicone varies depending on the type of silicone.

**7. Silicone granuloma**

Starch

**Table 1.**

*Cosmetic Surgery*

**5. Granuloma: definition**

**6. Classification and etiology**

Granuloma is a foreign body reaction against foreign substances that enter the skin. Granuloma occurs due to continuous or chronic inflammation against foreign substances. Silicone is a foreign substance in the body, which will be encapsulated by the body. Datia cells (giant cells) will encapsulate silicone material, and therefore inflammatory mediators cannot perform phagocytosis, which results in continuous inflammation and causes side effect. The encapsulated material has poor vascular-

There are many kinds of granuloma classification; however, the common classifications are those which have been adjusted to the etiologies [7, 8]. Granuloma formation may occur due to various factors such as biologic, chemical, and physical irritative agents [7]. Classification based on clinical, etiological, and histopathological features

> Hepatic granulomatous disease Immune complex disease

**Vasculitic granulomatosis**

Lymphomatoid

ization; therefore, it may potentially induce infections [6].

**Infections Immunological aberration**

*Coccidioides* Primary biliary cirrhosis *Blastomyces* Giant cell arteritis *Sporothrix* Peyronie's disease *Aspergillus* Hypogammaglobulinemia *Cryptococcus* Langerhans' granulomatosis

**Fungi** Sarcoidosis *Histoplasma* Crohn's disease

**Metazoa** Wegener's

Toxocara Necrotizing sarcoidal Schistosoma Churg-Strauss

**Spirochaetes** Polyarteritis nodosa *T. Pallidum* Bronchocentric *T. carateum* Systemic lupus

**Mycobacteria Leukocyte oxidase defect** *M. tuberculosis* Chronic granulomatous *M. leprae* disease of childhood

**4**

**Protozoa**

Toxoplasma Leishmania

*T. pertune*

Interferon-δ-receptor deficiency


#### **Table 1.**

*Classification of granulomatous disorders (cited from James DG, Wiliams WL) [8].*

can be categorized further into infection, vasculitis, immunological aberration, leukocyte oxidation deficiency, hypersensitivity, chemicals, or neoplasma [14, 15]. **Table 1** presents classification of granuloma based on etiology [8].
