Adverse Reactions to Bovine Collagen Implant: Clinica1 and Histologic Features

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Abstract
Over the past several years, the clinical and histologic features of reactions at Zyderm Collagen Implant (ZCI) and Zyplast Implant (ZI) test and treatment sites have been reported by pathologists, dermatologists, and the scientific staff of the manufacturer (Collagen Corporation, Palo Alto, California). This cooperative effort has shown that adverse reactions commonly manifest as erythematous, indurated, occasionally pruritic lesions that usually resolve spontaneously. Approximately 1/3 of the ZCI test sites with clinical signs and symptoms appear normal histologically while the other 2/3 show palisading or diffusely organized granulomas; all of the reactive treatment sites exhibit one of these two patterns of granuloma. Both forms of granuloma occur with equal frequency at test and treatment locations. Microscopic examination of a limited number of adverse reactions from patients treated with cross‐linked collagen (ZI) showed that the reactions closely resemble those from ZCI treatment areas. The reactions are localized and self limiting; they resolve within a few months without therapeutic intervention.

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