title: Type IV hypersensitivity to a textured silicone breast implant.
abstract: We present a case of hypersensitivity to a breast implant in a 57-year old female with breast cancer and hypersensitivity to adhesive dressings. A mastectomy, axillary node clearance, latissimus dorsi flap and silicone implant-based reconstruction were performed. The mammary wound dehisced within three weeks and the implant required removal. No pus was present, and cultures were negative. Three years later, a further silicone implant was inserted. Within three weeks from insertion, the patient required readmission with serous discharge from the wound, flu-like symptoms, low-grade pyrexia and painful swelling at the operative site. The implant was removed. Capsule biopsies demonstrated a large lymphoid cell reaction, in keeping with a delayed hypersensitivity reaction. Patch testing to samples of the implant was positive.
authors.affiliation: Burns Unit, Royal Victoria Hospital, Grosvenor Road, Belfast BT12 6BA, UK. dallan_dargan@hotmail.com
authors.forename: D
authors.initials: D
authors.lastname: Dargan
authors.forename: C
authors.initials: C
authors.lastname: McGoldrick
authors.forename: K
authors.initials: K
authors.lastname: Khan
mesh_terms: D018427:Breast Implants / Q000009:adverse effects*; D001943:Breast Neoplasms / Q000601:surgery; D020878:Device Removal; D005260:Female; D006801:Humans; D006968:Hypersensitivity, Delayed / Q000209:etiology* / Q000601:surgery*; D016462:Mammaplasty / Q000379:methods; D008408:Mastectomy; D008875:Middle Aged; D012828:Silicones / Q000009:adverse effects*; D013524:Surgical Flaps
chemical_list: D012828:Silicones