The Journal of Allergy and Clinical Immunology: In Practice
Ask the ExpertSystemic Contact Dermatitis Possibly Related to Metal Implants
Section snippets
Question
I saw a patient with a knee replacement that resulted in prolonged swelling and a multiple macular, flat, almost violaceous rash of the tibial area that was nonpruritic. The procedure was done in 2009. In 2011, the patient had a laboratory test done in Chicago (orthopedic analysis) that amounted to a PHA test against several metals and bone cement. This test came back with numerous positive results, and the patient had the knee procedure corrected with a repeated replacement in 2011. He
Response
This question was posed to Luz Fonacier, MD, Head of Allergy Section, Division of Rheumatology and Immunology, Winthrop University Hospital, Mineola, NY, a nationally known expert in contact dermatitis. She responded as follows.
This is a complicated answer to a complicated question, so I will just present to you the literature and what we have written in the Practice Parameters for Contact Dermatitis that is in preparation.
Allergic contact dermatitis from bone cement components have been
References (5)
- et al.
Allergy to bone cement components [in German with English abstract]
Orthopade
(2008) - et al.
Hypersensitivity reactions to metallic implants: diagnostic algorithm and suggested patch test series for clinical use
Contact Dermatitis
(2011)
Cited by (5)
Nickel and skin: From allergy to autoimmunity
2020, Endocrine, Metabolic and Immune Disorders - Drug TargetsCompatibility and allergies of osteosynthesis materials
2017, UnfallchirurgAllergy in Total Knee Replacement. Does It Exist?: Review Article
2017, HSS JournalNickel allergy in adults in the US: 1962 to 2015
2015, Dermatitis