Name of the Condition

• Foreign body granuloma of the skin and subcutaneous tissue

Summary

Foreign body granuloma of the skin and subcutaneous tissue is a condition where a localized inflammatory response occurs due to the presence of a foreign substance within the skin or beneath it. When the body recognizes this substance as foreign, it forms a granuloma—a small area of inflammation—as a protective mechanism.

Causes

This condition typically arises when the skin is penetrated by foreign materials such as splinters, sutures, or other materials left inadvertently under the skin. These materials prompt the body's immune response to isolate and attempt to remove the foreign substance.

Risk Factors

• Injuries or procedures involving penetration, such as surgery or injections
• Occupational exposure to foreign materials
• Individuals with compromised skin barriers

Symptoms

• A palpable lump or nodule under the skin
• Localized redness and swelling
• Possible tenderness or pain in the affected area

Diagnosis

• Physical examination by a healthcare provider
• Imaging techniques like ultrasound or MRI to view the granuloma
• Biopsy to confirm the presence of a foreign material and to rule out other conditions

Treatment Options

• Surgical removal of the foreign body to alleviate symptoms and prevent further inflammation
• Corticosteroid injections to reduce inflammation in certain cases
• Observation if the granuloma is small and not causing significant symptoms

Prognosis and Follow-Up

Once the foreign material is removed and any inflammation is managed, the prognosis is typically good with minimal risk of recurrence. Regular monitoring may be necessary to ensure that inflammation subsides and no additional foreign materials are present.

Complications

• Chronic inflammation and discomfort
• Infection at the site of the granuloma
• Potential scarring if surgical intervention is required

Lifestyle & Prevention

• Minimize activities that increase risk of skin penetration by foreign materials
• Immediate and proper care of wounds to remove any potential foreign bodies
• Use of protective clothing when necessary to avoid skin penetration

When to Seek Professional Help

• Persistent lump under the skin without healing
• Increasing pain, redness, or swelling at the site
• Signs of infection such as fever or pus

Additional Resources

• American Academy of Dermatology (AAD): aad.org
• National Institutes of Health (NIH): nih.gov

Tips for Medical Coders

• Ensure the foreign body's presence is documented to use ICD code L92.3 accurately
• Double-check for any secondary codes that may apply if the granuloma leads to other conditions
• Be meticulous in reviewing medical records to avoid missing the diagnosis of foreign body granuloma