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Nasal tip abscess due to adverse skin reaction to Prolene: an unusual long term complication of rhinoplasty

Published online by Cambridge University Press:  22 November 2012

A Teymoortash*
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, Philipp University, Marburg, Germany
J A Fasunla
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, Philipp University, Marburg, Germany
W Pfützner
Affiliation:
Department of Dermatology and Allergology, Philipp University, Marburg, Germany
S Steinbach-Hundt
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, Philipp University, Marburg, Germany
*
Address for correspondence: Dr Afshin Teymoortash, Department of Otolaryngology, Head and Neck Surgery, Philipp University, Baldinger Str, 35043 Marburg, Germany Fax: +49 6421 5866367 E-mail: [email protected]

Abstract

Objectives:

Allergic reactions to Prolene are rare. This paper reports a nasal tip abscess which developed in a patient with an adverse skin reaction to Prolene after rhinoplasty.

Methods and results:

A 26-year-old woman presented with painful, progressive nasal tip swelling and redness. She had undergone septo-rhinoplasty two years previously. She was initially treated with endonasal drainage of the abscess and antibiotics, but a revision rhinoplasty three months later became necessary because of recurrent abscess formation. Intra-operative findings included granulation tissue with pockets of pus and knotted Prolene sutures at the tip-defining points of the lower lateral cartilages. She was patch-tested with Prolene and a cutaneous Prolene suture was placed on her back; an adverse skin reaction was seen for the latter.

Conclusion:

Use of non-absorbable sutures, such as Prolene, in the subcutaneous layer may be a potential, rare risk factor for adverse skin reactions.

Type
Clinical Records
Copyright
Copyright © JLO (1984) Limited 2012

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References

1 Holt, GR, Garner, ET, McLarey, D. Postoperative sequelae and complications of rhinoplasty. Otolaryngol Clin North Am 1987;20:853–76Google Scholar
2 Dionyssopoulos, A, Nikolis, A, Papaconstantinou, A, Kakas, P, Miliaras, D, Kekes, D. Mucous cysts of the nose: a postrhinoplasty complication?: a long-term follow-up. Ann Plast Surg 2010;64:381–4Google Scholar
3 Eloy, JA, Jacobson, AS, Elahi, E, Shohet, MR. Enophthalmos as a complication of rhinoplasty. Laryngoscope 2006;116:1035–8Google Scholar
4 Foda, HM. External rhinoplasty: a critical analysis of 500 cases. J Laryngol Otol 2003;117:473–7Google Scholar
5 Luis-Montoya, P, Saez-de Ocariz Mdel, M, Vega-Memije, ME. Chronic granulomatous disease: two members of a single family with different dermatologic manifestations. Skinmed 2005;4:320–2CrossRefGoogle ScholarPubMed
6 Yilmaz, B, Yüksel, O, Coban, S, Cakmak, I, Basar, O, Ekiz, F. Rare complication of ulcerative colitis: aseptic nasal septal abscess. Inflamm Bowel Dis 2011;17:E71Google Scholar
7 Sandel, HD 4th, Davison, SP. Three spontaneous occurrences of nasal septal abscess in patients with chronic asymptomatic HIV. The need for early intervention and reconstruction. Ear Nose Throat J 2009;88:1058–66Google Scholar
8 Debnam, JM, Gillenwater, AM, Ginsberg, LE. Nasal septal abscess in patients with immunosuppression. AJNR Am J Neuroradiol 2007;28:1878–9Google Scholar
9 Shah, SB, Murr, AH, Lee, KC. Nontraumatic nasal septal abscess in the immunocompromised: etiology, recognition, treatment, and sequelae. Am J Rhinol 2000;14:3943 CrossRefGoogle ScholarPubMed
10 Anon, JB. Upper respiratory infections. Am J Med 2010;123:1625 Google Scholar
11 Olwoch, IP. Microbiology of acute complicated bacterial sinusitis at the University of the Witwatersrand. S Afr Med J 2010;100:529–33Google Scholar
12 Elosua de Juan, I, Lopez Garcia, S, Bove Guri, M, Mata Diaz, E, Martinez Garchitorena, J. Supposed nylon allergy after cataract surgery [in Spanish]. Arch Soc Esp Oftalmol 2001;76:263–6Google Scholar
13 Fisher, AA. Nylon allergy: nylon suture test. Cutis 1994;53:1718 Google Scholar
14 Balyeat, HD, Davis, RM, Rowsey, JJ. Nylon suture toxicity after cataract surgery. Ophthalmology 1988;95:1509–14Google Scholar
15 Stewart, RH, Kimbrough, RL. Complications of 10-0 nylon sutures. Eye 1991;5:106–12Google Scholar
16 Marcus, VA, Roy, I, Sullivan, JD, Sutton, JR. Necrobiotic palisading suture granulomas involving bone and joint: report of two cases. Am J Surg Pathol 1997;21:563–5Google Scholar
17 Hollander, DH. Interstitial cystitis and silk allergy. Med Hypotheses 1994;43:155–6Google Scholar
18 Kurosaki, S, Otsuka, H, Kunitomo, M, Koyama, M, Pawankar, R, Matomuto, K. Fibroin allergy: IgE mediated hypersensitivity to silk suture materials. Nippon Ika Daigaku Zasshi 1999;66:41–4Google Scholar
19 Engler, RJ, Weber, CB, Turnicky, R. Hypersensitivity to chromated catgut sutures: a case report and review of the literature. Ann Allergy 1986;56:317–20Google Scholar
20 Skrypuch, OW, Willis, NR. Giant papillary conjunctivitis from an exposed Prolene suture. Can J Ophthalmology 1986;21:189–92Google Scholar
21 Sanchez-Morillas, L, Reano Martos, M, Rodriguez Mosquera, M, Iglesias Cadarso, A, Perez Pimiento, A, Dominguez Lazaro, AR. Delayed sensitivity to Prolene. Contact Dermatitis 2003;48:337–49CrossRefGoogle ScholarPubMed
22 Ascherman, JA, Hunter, CJ, Bickers, DR. Refractory eczematous dermatitis associated with retained suture material. Ann Plast Surg 2006;56:205–7Google Scholar
23 Chung, HS, Feder, RS, Weston, BC, Bryar, PJ. Suture reaction masquerading as a conjunctival malignancy. Can J Opthalmol 2006;41:207–9Google Scholar
24 Hausen, BM. Allergic contact dermatitis from colored surgical suture material: contact allergy to epsilon-caprolactam and acid blue 158. Am J Contact Dermat 2003;14:174–5Google ScholarPubMed
25 Raap, U, Wieczorek, D, Kapp, A, Wedi, B. Allergic contact dermatitis to acid blue 158 in suture material. Contact Dermatitis 2008;59:192–3Google Scholar
26 Gabrielli, F, Potenza, C, Puddu, P, Sera, F, Masini, C, Abeni, D. Suture materials and other factors associated with tissue reactivity, infection, and wound dehiscence among plastic surgery outpatients. Plast Reconstr Surg 2001;107:3845 Google Scholar