Advertisement

A Subdermal Source: Contact Dermatitis

      Can a patient be allergic to a new knee? Such allergies are an often-overlooked complication of prosthetic implant surgery. We treated a 60-year-old woman who presented to our dermatology clinic with a pruritic, crusted rash on her right knee. Eighteen months earlier, she had undergone a right knee replacement with an Evolution Medial-Pivot knee system (MicroPort Orthopedics Inc, Arlington, TN).

      MicroPort Orthopedics Inc. Evolution Medial-Pivot Total Knee System [package insert]. 2014. Available at: http://www.ortho.microport.com/physicians/Prescribing/documents/151251-0_EN.pdf. Accessed August 1, 2014.

      No complications occurred, and the patient had normal healing at the surgical site.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to The American Journal of Medicine
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

      1. MicroPort Orthopedics Inc. Evolution Medial-Pivot Total Knee System [package insert]. 2014. Available at: http://www.ortho.microport.com/physicians/Prescribing/documents/151251-0_EN.pdf. Accessed August 1, 2014.

      2. SmartPractice. T.R.U.E. Test: Thin-Layer Rapid Use Epicutaneous Patch Test [package insert]. 2012. Available at: http://www.truetest.com/29543%20SmartP.%20US%20Brugs%2052-0292-00.1.pdf. Accessed August 1, 2014.

        • Thyssen J.P.
        • Linneberg A.
        • Menné T.
        • Johansen J.D.
        The epidemiology of contact allergy in the general population—prevalence and main findings.
        Contact Dermatitis. 2007; 57: 287-299
        • Basko-Plluska J.L.
        • Thyssen J.P.
        • Schalock P.C.
        Cutaneous and systemic hypersensitivity reactions to metallic implants.
        Dermatitis. 2011; 22: 65-79
        • Kubba R.
        • Taylor J.S.
        • Marks K.E.
        Cutaneous complications of orthopedic implants. A two-year prospective study.
        Arch Dermatol. 1981; 117: 554-560
        • Gawkrodger D.J.
        Nickel sensitivity and the implantation of orthopaedic prostheses.
        Contact Dermatitis. 1993; 28: 257-259
        • Granchi D.
        • Cenni E.
        • Tigani D.
        • Trisolino G.
        • Baldini N.
        • Giunti A.
        Sensitivity to implant materials in patients with total knee arthroplasties.
        Biomaterials. 2008; 29: 1494-1500
        • Atanaskova Mesinkovska N.
        • Tellez A.
        • Molina L.
        • et al.
        The effect of patch testing on surgical practices and outcomes in orthopedic patients with metal implants.
        Arch Dermatol. 2012; 148: 687-693
        • Niki Y.
        • Matsumoto H.
        • Otani T.
        • et al.
        Screening for symptomatic metal sensitivity: a prospective study of 92 patients undergoing total knee arthroplasty.
        Biomaterials. 2005; 26: 1019-1026
        • Cederbrant K.
        • Hultman P.
        • Marcusson J.A.
        • Tibbling L.
        In vitro lymphocyte proliferation as compared to patch test using gold, palladium and nickel.
        Int Arch Allergy Immunol. 1997; 112: 212-217
        • Pollack Jr., C.V.
        • Romano T.J.
        Outpatient management of acute urticaria: the role of prednisone.
        Ann Emerg Med. 1995; 26: 547-551
        • Reynolds N.J.
        • Franklin V.
        • Gray J.C.
        • Diffey B.L.
        • Farr P.M.
        Narrow-band ultraviolet B and broad-band ultraviolet A phototherapy in adult atopic eczema: a randomised controlled trial.
        Lancet. 2001; 357: 2012-2016