Dermatopathology

Polilastic Acid Glaucoma

Poly-lactic acid is sometimes used as a dermal filler. The lesion presented in this case is that of a reaction to exogenous material. While the histology is suggestive of poly-lactic acid, clinico-pathologic correlation is needed for confirmation.

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Slide 1: 50 year-old woman with a forehead mass.

Slide 2: Cleft-like spaces are appreciated at this magnification. The clefts are surrounded by a densely collagenous/fibrous stroma.

Slide 3: When polarized, exogenous material is easily appreciated.

Slide 4: On closer inspection, the cleft-like spaces contain fragments of white/light-yellow material resembling broken glass. This material is contained within the cytoplasm of scavenger macrophages.

Slide 5: The mass noted clinically is captured histomorphologically representing a foreign body response to an exogenous material. The nature of the material including its polariscopic properties is highly suggestive of polylactic acid..