Clinical spectrum of connective tissue disease after cosmetic surgery. Observations on eighteen patients and a review of the Japanese literature.

Connective tissue disease has been reported to occur following cosmetic surgery with injection of the foreign substances paraffin and silicone (human adjuvant disease). The clinical findings in 18 such patients and a review of 28 additional cases from the Japanese literature are presented. The patients were classified into 2 major groups: group I consisted of 24 patients with definite connective tissue disease--12 with scleroderma, including 8 with progressive systemic sclerosis (PSS), 6 with rheumatoid arthritis, 5 with systemic lupus erythematosus, and 1 with polymyositis; group II consisted of 22 patients with human adjuvant disease with some symptoms, signs, and laboratory abnormalities suggestive, but not diagnostic of a connective tissue disease. The occurrence of PSS is approximately three-fold greater than expected for all women believed to have undergone such surgery, and PSS developed primarily in individuals injected with paraffin. Prolonged exposure to the injected substance may play a role in the induction of these immunologic disorders.