Abstract
Autoimmune/inflammatory syndrome induced by adjuvant (ASIA) includes the following conditions: siliconosis, Gulf War syndrome, macrophagic myofasciitis syndrome, and post-vaccination phenomena. Afterward, other syndromes have been recognized, such as in ASIA by mineral oil (ASIA-MO). These conditions are triggered by adjuvants and they are the result of the interplay of genetic and environmental factors. ASIA-MO is defined as the infiltration of oily type modeling substances for cosmetic purposes. It has been reported in many countries and used surreptitiously. Pathogenesis of ASIA-MO is not clear, but is characterized by chronic granulomatous inflammation, like the pristane model in mice, with increase of proinflammatory cytokines: type I interferons (IFNα and IFNß), systemic lupus erythematosus (SLE), and erosive arthritis. In humans, an increase of interleukin 1 (IL-1) has been found. Clinical spectrum of ASIA-MO is heterogeneous, varying from mild to severe and being local and systemic. The systemic manifestations can be non-specific and specific, meeting criteria for any autoimmune disease (AID), i.e., SLE, rheumatoid arthritis, and systemic sclerosis, among others. The areas of the body where the mineral oil is mostly applied include the following: buttocks (38–72%), breasts (12–16%), lower extremities (18–22%), and face (6–10%). The penis augmentation is also common. Treatment is focused on local and systemic manifestations and requires medical and surgical management representing a challenge for the physician.
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Shoenfeld Y, Agmon-Levin N (2011) ASIA—autoimmune/inflammatory syndrome induced by adjuvant. J Autoimmun 36:4–8
Vera-Lastra O, Medina G, Cruz-Dominguez M del P, Cruz-Dominguez MP, Ramirez P, Gayosso-Rivera JA, Anduaga-Dominguez H, Lievana-Torres C, Jara LJ (2012) Human adjuvant disease induced by foreign substances: a new model of ASIA (Shoenfeld’s syndrome). Lupus 21:128–135
Kumagai Y, Abe C, Shiokawa Y (1979) Scleroderma after cosmetic surgery: four cases of human adjuvant disease. Arthritis Rheum 22:532–537
Peters W, Fornasier V (2009) Complications from injectable materials used for breast augmentation. Can J Plast Surg 17:89–96
Petry T, Bury D, Fautz R et al (2017) Review of data on the dermal penetration of mineral oils and waxes used in cosmetic applications. Toxicol Lett 280:70–78
Israeli E, Agmon-Levin N, Blank M, Shoenfeld Y (2009) Adjuvants and autoimmunity. Lupus 18:1217–1225
Kimber I, Dearman RJ (2010) An assessment of the ability of phthalates to influence immune and allergic responses. Toxicology 271:73–82
Reeves WH, Lee PY, Weinstein JS, Satoh M, Lu L (2009) Induction of autoimmunity by pristane and other naturally occurring hydrocarbons. Trends Immunol 30:455–464
Vera-Lastra O, Medina G, Cruz-Dominguez MDP, Jara LJ, Shoenfeld Y (2013) Autoimmune/inflammatory syndrome induced by adjuvants (Shoenfeld’s syndrome): clinical and immunological spectrum. Expert Rev Clin Immunol 9:361–373
Kumagai Y, Shiokawa Y, Medsger TA Jr et al (1984) Clinical spectrum of connective tissue disease after cosmetic surgery. Observations on eighteen patients and a review of the Japanese literature. Arthritis Rheum 27:1–12
Jara LJ, García-Collinot G, Medina G et al (2017) Severe manifestations of autoimmune syndrome induced by adjuvants (Shoenfeld’s syndrome). Immunol Res 65:8–16
Ortiz-Monasterio F, Trigos I (1972) Management of patients with complications from injections of foreign materials into the breasts. Plast Reconstr Surg 50:42–47
Martínez-Villarreal AA, Asz-Sigall D, Gutiérrez-Mendoza D, Serena TE, Lozano-Platonoff A, Sanchez-Cruz LY, Toussaint-Caire S, Domínguez-Cherit J, López-García LA, Cárdenas-Sánchez A, Contreras-Ruiz J (2017) A case series and a review of the literature on foreign modelling agent reaction: an emerging problem. Int Wound J 14:546–554
Inn FX, Imran FH, Ali MF, Ih R, Z Z (2012) Penile augmentation with resultant foreign material granuloma and sequalae. Malays J Med Sci 19:81–83
Moon DG, Yoo JW, Bae JH, Han CS, Kim YK, Kim JJ (2003) Sexual function and psychological characteristics of penile paraffinoma. Asian J Androl 5:191–194
Svensøy JN, Travers V, Osther PJS (2018) Complications of penile self-injections: investigation of 680 patients with complications following penile self-injections with mineral oil. World J Urol 36:135–143
Koppang EO, Bjerkås I, Haugarvoll E et al (2008) Vaccination-induced systemic autoimmunity in farmed Atlantic salmon. J Immunol 181:4807–4814
Kuroda Y, Akaogi J, Nacionales DC, Wasdo SC, Szabo NJ, Reeves WH, Satoh M (2004) Distinctive patterns of autoimmune response induced by different types of mineral oil. Toxicol Sci 78:222–228
Cabral AR, Alcocer-Varela J, Orozco Topete R et al (1994) Clinical, histopathological, immunological and fibroblast studies in 30 patients with subcutaneous injections of modelants including silicone and mineral oils. Rev Investig Clin 46:257–266
Yau ACY, Lönnblom E, Zhong J et al (2017) Influence of hydrocarbon oil structure on adjuvanticity and autoimmunity. Sci Rep 7(1):14998. https://doi.org/10.1038/s41598-017-15096-z
Medrano Ramírez G, García León ML, Priego Blancas R et al (2016) Función de la respuesta Th1/Th 17 en los pacientes con enfermedad humana por aplicación de substancias modeladoras. Reumatol Clin. 2016; 12 Ext 1 (abst):55
Speil C, Rzepka R (2011) Vaccines and vaccine adjuvants as biological response modifers. Infect Dis Clin N Am 25:755–772
Perricone C, Colafrancesco S, Mazor RD, Soriano A, Agmon-Levin N, Shoenfeld Y (2013) Autoimmune/inflammatory syndrome induced by adjuvants (ASIA): unveiling the pathogenic, clinical and diagnostic aspects. J Autoimmun 47:1–16
Kozeny G, Barbato A, Bansal V et al (1984) Hypercalcemia associated with silicone-induced granulomas. N Engl J Med 311:1103–1105
Chastre J, Bouchama A, Basset F (1983) Acute pneumonitis after sub-cutaneous injections of silicone in transsexual men. N Engl J Med 308:764–767
Watad A, Quaresma M, Bragazzi NL, Cervera R, Tervaert JWC, Amital H, Shoenfeld Y (2018) The autoimmune/inflammatory syndrome induced by adjuvants (ASIA)/Shoenfeld’s syndrome: descriptive analysis of 300 patients from the international ASIA syndrome registry. Clin Rheumatol 37:483–493
Friedmann DP, Kurian A, Fitzpatrick RE (2016) Delayed granulomatous reactions to facial cosmetic injections of polymethylmethacrylate microspheres and liquid injectable silicone: a case series. J Cosmet Laser Ther 18(3):170–173
Christensen L, Breiting V, Janssen M, Vuust J, Hogdall E (2005) Adverse reactions to injectable soft tissue permanent fillers. Aesthet Plast Surg 29:34–48
Alijotas-Reig J (2015) Human adjuvant-related syndrome or autoimmune/inflammatory syndrome induced by adjuvants. Where have we come from? Where are we going? A proposal for new diagnostic criteria. Lupus 24:1012–1018
Barker TT, Lee PY, Kelly-Scumpia KM, Weinstein JS, Nacionales DC, Kumagai Y, Akira S, Croker BP, Sobel ES, Reeves WH, Satoh M (2011) Pathogenic role of B cells in the development of diffuse alveolar hemorrhage induced by pristane. Lab Investig 91:1540–1550
Zimmermann US, Clerici TJ (2004) The histological aspects of fillers complications. Semin Cutan Med Surg 23:241–250
Dagan A, Kogan M, Shoenfeld Y, Segal G (2016) When uncommon and common coalesce: adult onset Still’s disease associated with breast augmentation as part of autoimmune syndrome induced by adjuvants (ASIA). Clin Rheumatol 35:1643–1648
Colaris MJL, van der Hulst RR, Tervaert JWC (2017) Vitamin D deficiency as a risk factor for the development of autoantibodies in patients with ASIA and silicone breast implants: a cohort study and review of the literature. Clin Rheumatol 36:981–993
Ma Z, Li Z, Shou K et al (2017) Negative pressure wound therapy: Regulating blood flow perfusion and microvessel maturation through microvascular pericytes. Int J Mol Med 40(5):1415–1425. https://doi.org/10.3892/ijmm.2017.3131
Ho WS, Chan CW, BKB L (2001) Management of paraffinoma of the breast: 10 years’ experience. Br J Plast 54:232–234
Priego-Blancas R, Rincón-Lozano R, Serrano A et al (2010) Clasificación y tratamiento de la enfermedad mamaria por modelantes. Cir Plast 20:112–119
Champaneria MC, Wong WW, Hill ME, Gupta SC (2012) The evolution of breast reconstruction: a historical perspective. World J Surg 36:730–742
Fodor L, Bota IO, Filip CI, Grecea D, Fodor M, Dindelegan G, Motocu R, Ciuce C (2011) New trends in breast reconstruction. Chirurgia (Bucur) 106:485–489
Frank SJ, Flusberg M, Friedman S, Sternschein M, Wolf EL, Stein MW (2014) Aesthetic surgery of the buttocks: imaging appearance. Skelet Radiol 43:133–139
Koshima I, Nanba Y, Tsutsui T, Takahashi Y, Itoh S (2002) Perforator flaps in lower extremity reconstruction. Handchir Mikrochir Plast Chir 34:251–256
Bassetto F, Abatangelo S, Masetto L, Vindigni V (2012) Ultrasound-assisted liposuction as a safe and effective method for the removal of siliconomas. Aesthet Plast Surg 36:220–222
Salgado CJ, Sinha VR, Desai U (2014) Liposuction and lipofilling for treatment of symptomatic silicone toxicosis of the gluteal region. Aesthetic Surg J 34:571–577
Hazani R, Engineer N (2008) Surreptitious injection of mineral oil: a case report of sclerosing lipogranulomatosis. Ann Plast Surg 61:555–558
Novo RC, Salgado CJ, Yim E, Sinha V, Chim HW, Romanelli P (2016) A staging system for gluteal foreign body reaction to injectables. J Plast Reconstr Aesthet Surg 69:e174–e179
Lee JM, Kim JY (2015) Foreign body granulomas after the use of dermal fillers: pathophysiology, clinical appearance, histologic features, and treatment. Arch Plast Surg 42:232–239
De Gado F, Mazzocchi M, Chiummariello S et al (2006) Johnson’s baby oil, a new type of filler? Acta Chir Plast 48:123–126
Glicenstein J (2007) The first “fillers”, vaseline and paraffin. From miracle to disaster. Ann Chir Plast Esthet 52:157–161
Manny T, Pettus J, Hemal A, Marks M, Mirzazadeh M (2011) Penile sclerosing lipogranulomas and disfigurement from use of “1Super Extenze” among Laotian immigrants. J Sex Med 8:3505–3510
Oñate Celdrán J, Sanchez Rodríguez C, Tomás Ros M, González Valverde FM, Morga Egea JP, Ruiz Marín M, Valdelvira Nadal P, Jiménez López JM, Fontana Compiano LO (2012) Penile paraffinoma after subcutaneous injection of paraffin. Treatment with a two step cutaneous plasty of the penile shaft with scrotal skin. Arch Esp Urol 65:575–578
Nyirády P, Kelemen Z, Kiss A, Bánfi G, Borka K, Romics I (2008) Treatment and outcome of vaseline-induced sclerosing lipogranuloma of the penis. Urology 71:1132–1137
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Vera-Lastra, O., Medina, G., Cruz-Domínguez, M.P. et al. Autoimmune/inflammatory syndrome induced by mineral oil: a health problem. Clin Rheumatol 37, 1441–1448 (2018). https://doi.org/10.1007/s10067-018-4078-2
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DOI: https://doi.org/10.1007/s10067-018-4078-2