Extraordinary Case ReportSarcoidal-Type Allergic Contact Granuloma A Rare Complication of Ear PiercingCasper, Claus MD; Groth, Wolfgang MD; Hunzelmann, Nicolas MD Author Information From the Department of Dermatology, University of Cologne, Germany. Reprints: Dr. N. Hunzelmann, Department of Dermatology, University of Cologne, Joseph-Stelzmannstr. 9, 50924 Cologne (e-mail: [email protected]). The American Journal of Dermatopathology 26(1):p 59-62, February 2004. Buy Abstract As body piercing is increasingly en vogue, complications are on the rise as well. Biopsies of such lesions can impose special problems to the reviewing dermatopathologist. We present two patients who developed papulonodular lesions at the sites of ear piercings. Unexpectedly, the findings included prominent sarcoidal granuloma formation with confluent areas of fibrinoid necrosis. An infectious etiology was excluded. However, patch testing revealed contact allergy to palladium, platinum, and nickel. Interestingly, histopathologic examination of the patch test sites also demonstrated granuloma formation. These findings suggest that the lesions represent allergic contact granulomas. When confronted with this special type of tissue reaction in skin biopsies of piercing sites, the reviewing dermatopathologist should consider the possibility of an allergic reaction. Careful history and thorough diagnostic procedures, including biopsy of the patch test site can establish the diagnosis of contact allergic granuloma. © 2004 Lippincott Williams & Wilkins, Inc.
