title: Mirror, mirror on the wall: hypercalcemia as a consequence of modern cosmetic treatment with liquid silicone.
abstract: BACKGROUND
  Hypercalcemia is a common problem in clinical practice and can be related to endocrine disorders or malignant disease, especially in elderly patients. Although rare, other causes can also be responsible.
  
  
  METHODS
  Granulomatous inflammation of the skin and lymph nodes induced by intravenous or injectable silicone is a rare condition of hypercalcemia that is usually not within the scope of differential diagnosis. Here, we report a 72-year-old woman with symptomatic hypercalcemia related to cosmetic treatment of the neck. Topical applied liquid silicone by means of a focal ultrasound device induced extensive granulomatous inflammation of the skin and local lymph nodes, being the underlying cause for hypercalcemia in this case.
  
  
  CONCLUSIONS
  In rare cases, symptomatic hypercalcemia can be caused by silicone due to a severe granulomatous tissue reaction. This is the first time that a transdermal silicone treatment has been reported to cause severe granulomatous tissue inflammation.
authors.affiliation: Department of Endocrinology and Clinical Chemistry, University Hospital Heidelberg, Heidelberg, Germany.
authors.forename: Jurik
authors.initials: J
authors.lastname: Schanz
authors.forename: Katharina
authors.initials: K
authors.lastname: Flux
authors.forename: Claudia
authors.initials: C
authors.lastname: Kircher
authors.forename: Maria
authors.initials: M
authors.lastname: Tsioga
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Hartschuh
authors.forename: Peter P
authors.initials: PP
authors.lastname: Nawroth
authors.forename: Gottfried
authors.initials: G
authors.lastname: Rudofsky
mesh_terms: D000368:Aged; D003358:Cosmetics / Q000009:adverse effects*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D006934:Hypercalcemia / Q000139:chemically induced* / Q000175:diagnosis; D012828:Silicones / Q000009:adverse effects*
chemical_list: D003358:Cosmetics; D012828:Silicones