We report a case of severe cyanoacrylate granuloma (CAG) that developed shortly after cyanoacrylate closure (CAC) in a patient receiving dupilumab. A 74-year-old female had an uneventful postoperative course until the day before initiation of dupilumab; however, on postoperative day (POD) 16, 1 day after starting dupilumab, she developed fever and painful inguinal nodules. Computed tomography revealed multiple subcutaneous nodules without abscess formation. Despite systemic corticosteroids and antihistamines, the lesions progressed, requiring repeated bilateral excisions through POD 93. This case suggests that immune modulation at the time of cyanoacrylate exposure may influence the severity and progression of granulomatous inflammation after CAC.
Imai et al. (Thu,) studied this question.