Leuprolide Acetate-induced Foreign Body Granuloma in a Patient with Prostate Cancer / 대한피부과학회지

ABSTRACT

Leuprolide acetate is an established luteinizing hormone-releasing hormone (LHRH) agonist used as a first-line treatment in advanced prostate cancer. An 80-year-old man presented with a localized erythematous patch with an indurated plaque and nodule and pustules on the left upper arm. The patient had been treated for metastatic prostate cancer with subcutaneous injections of leuprolide acetate 18 months previously. Histopathologic findings revealed granulomas with multinucleated giant cells from the dermis to the subcutaneous fat layer. The granuloma contained numerous round vacuoles. Cultures from the tissue for bacteria, fungi, and mycobacteria were all negative. The diagnosis of leuprolide acetate-induced foreign body granuloma was made by clinicopathologic findings. Various theories on the mechanism of local reactions to leuprolide have been suggested. The formation of granulomas may be related to the poly (lactic-co-glycolic acid) polymers or leuprolide itself. The depth of injection could have also contributed; therefore, intramuscular injection is recommended to minimize granuloma formation. To the best of our knowledge, there has been no reported case of leuprolide-induced foreign body granuloma in a patient with prostate cancer in the Korean literature. Dermatologists need to know that leuprolide acetate depot injection may cause a granulomatous reaction.