A Rare Case of Dermatitis Caused by Hypersensitivity to Orthopedic Synthetic Implant
Mariana Bessa Marinho
Medical School at Evangelical University of Goiás - UniEVANGÉLICA, Anápolis, GO, Brazil.
Leonardo Pinheiro Rezende *
Medical School at Evangelical University of Goiás - UniEVANGÉLICA, Anápolis, GO, Brazil.
Fábio Felippe da Silva
State Hospital of Anápolis Dr. Henrique Santillo (HEANA), Brazil.
Henrique Costa Sardinha
Medical School at Evangelical University of Goiás - UniEVANGÉLICA, Anápolis, GO, Brazil.
Danilo Marques Leal
Medical Residency in Orthopedics and Traumatology, Evangelical University of Goiás, (UniEVANGÉLICA), Brazil.
Adryan Tyrone Alves de Morais
Medical School at Evangelical University of Goiás - UniEVANGÉLICA, Anápolis, GO, Brazil.
Enzo Boaventura Sandes
Medical School at Evangelical University of Goiás - UniEVANGÉLICA, Anápolis, GO, Brazil.
Matheus Maciel Machado
Medical School at Evangelical University of Goiás - UniEVANGÉLICA, Anápolis, GO, Brazil.
Jalsi Tacon Arruda
Medical School at Evangelical University of Goiás - UniEVANGÉLICA, Anápolis, GO, Brazil.
*Author to whom correspondence should be addressed.
Abstract
Aims: The present case report aims to describe a rare case of hypersensitivity to orthopedic synthetic materials, an adverse event that developed following surgical intervention for the correction of an open fracture of the radius and proximal ulna.
Presentation of Case: A 63-year-old woman sustained an open fracture of the right olecranon, requiring multiple surgeries, including external fixation and osteosynthesis. Postoperative complications included recurrent infections and persistent chronic dermatitis. A Patch Test identified allergies to cobalt chloride, nickel sulfate, and formaldehyde resin, potentially linked to the orthopedic implant. After the external fixator was removed, there was a gradual improvement of the skin lesions and pruritus.
Discussion: Hypersensitivity reactions to metal orthopedic implants, though rare, can cause cutaneous and extracutaneous symptoms, including eczema, urticaria, and implant complications. Diagnosis relies on patch testing. Treatment includes allergen removal, local therapy for mild cases, or systemic corticosteroids for severe symptoms.
Conclusion: Stainless-steel prostheses are common in osteosynthesis but can rarely cause hypersensitivity due to metal ion release from biomechanical stress. This case underscores the need for preoperative allergy screening and highlights the importance of developing implant materials that minimize hypersensitivity risks
Keywords: Allergic Contact, dermatitis, delayed, external fixators, hypersensitivity