Autoimmune/Inflammatory Syndrome Induced by Adjuvants (ASIA) in a Patient With Silicone Breast Implants and Scleroderma-Like Manifestations: A Case Report.

Autoimmune/inflammatory syndrome induced by adjuvants (ASIA) encompasses a spectrum of immune-mediated clinical conditions triggered by exposure to adjuvant substances such as aluminum, vaccine components, and silicone breast implants (SBIs).  We present the case of a 68-year-old woman with a history of silicone breast augmentation, followed by implant rupture and reimplantation. Years later, she developed Raynaud's phenomenon, cutaneous calcinosis, and sicca symptoms. The patient also exhibited cognitive impairment and depressive symptoms. Laboratory investigations confirmed the presence of anti-centromere antibodies and elevated acute-phase reactants. Nailfold capillaroscopy demonstrated an early scleroderma pattern. Imaging revealed silicone migration into axillary lymph nodes, histopathologically consistent with siliconomas. A diagnosis of limited cutaneous systemic sclerosis was made. Following implant removal and the excision of silicone-laden lymph nodes, the patient experienced significant improvement in systemic, cutaneous, and neuropsychiatric symptoms, with subsequent normalization of her autoimmune profile, supporting the diagnosis of ASIA.  While the relationship between SBIs and systemic autoimmune manifestations remains controversial, this case highlights the broad clinical spectrum of ASIA and underscores the importance of clinical suspicion, multidisciplinary evaluation, and individualized therapeutic strategies in patients with unexplained autoimmune manifestations and a history of adjuvant exposure.