Granuloma due to sweet almond oil injection: Difficulties of diagnosis and treatment

Foreign body granuloma reaction is a tissue response to some extraneous materials which incite a characteristic pattern of granulomatous reaction. Several cases of foreign body granulomas on the face have been reported, especially after the injection of dermal fillers. Oleoma or paraffinoma is defined as a foreign body granuloma resulting from the injection of oily substances into the skin or subcutaneous tissue. We report a case of an adult woman who had developed foreign body granulomas due to a self-injection of sweet almond oil into the glabella and periorbital area. The diagnosis was based on a thorough interrogation, clinical features and histopathological findings. Treatment of foreign body granuloma is challenging. At first, oral prednisone was initiated with the improvement of the inflammatory signs and reduction of the lesions’ dimension, but recurrence of the lesions occurred when the dose was decreased. After research of literature, a low-dose minocycline regime was prescribed for its beneficial effects in granulomatous diseases, with encouraging results.