Numerosas enfermedades cutáneas pueden presentarse como lesiones azules, el diagnóstico diferencial incluye entidades tan diferentes como las metástasis de melanoma, los angiomas, los lipomas, los quistes epidermoides, los pilomatrixoma, los nevus azules, los tumores glómicos o los hidrocistomas, como el que presentamos. La ecografía cutánea será una técnica diagnóstica complementaria de gran valor para hacer un correcto diagnostico diferencia pues cada una de estas lesiones tienen hallazgos ecográficos diferentes que orientaran el diagnóstico.

Siliconomas are subcutaneous nodules that usuallyappear as a consequence of the migration of freesilicon implanted in other locations. They are morefrequent in women with abnormal breast implants,such as poly implant prostheses (PIP), but they may alsoappear after illegal injection of free silicone. We reporta 57-year-old woman who attended our Dermatologyclinic complaining of relapsing facial panniculitis ofunknown origin. After a thorough work-up, thesenodules were determined to be the consequence ofdermal filler made with fluid silicone, which had beeninjected 20 years prior. High frequency skin ultrasoundof one of the nodules showed a hyperechoic image,also known as “snowstorm,” which was located in thesubcutaneous tissue. The disposition of silicone in thisplane obscures the view of any sonographic structurein the underlying plane. Cutaneous sonographyhas become one of the most useful non-invasivetechniques in diagnosis of filler complications andother inflammatory diseases. Combined treatmentwith prednisone and allopurinol was successful, withno recurrence after 1 year of follow-up.