سامانه مدیریت نشریات علمی دانشگاه علوم پزشکی مشهد

Arria Maury, Camila, Gruson, Konrad, Tabeayo, Eloy, Gruson, Lisa, RODRIGUEZ-MERCHAN, E. Carlos. (1402). Allergic Contact Dermatitis (ACD) to Topical Products in Orthopedic Surgery: Clinical Characteristics and Treatment Strategies. , 11(10), 604-616. doi: 10.22038/abjs.2023.70444.3303
Camila Arria Maury; Konrad I. Gruson; Eloy Tabeayo; Lisa M. Gruson; E. Carlos RODRIGUEZ-MERCHAN. "Allergic Contact Dermatitis (ACD) to Topical Products in Orthopedic Surgery: Clinical Characteristics and Treatment Strategies". , 11, 10, 1402, 604-616. doi: 10.22038/abjs.2023.70444.3303
Arria Maury, Camila, Gruson, Konrad, Tabeayo, Eloy, Gruson, Lisa, RODRIGUEZ-MERCHAN, E. Carlos. (1402). 'Allergic Contact Dermatitis (ACD) to Topical Products in Orthopedic Surgery: Clinical Characteristics and Treatment Strategies', , 11(10), pp. 604-616. doi: 10.22038/abjs.2023.70444.3303
Arria Maury, Camila, Gruson, Konrad, Tabeayo, Eloy, Gruson, Lisa, RODRIGUEZ-MERCHAN, E. Carlos. Allergic Contact Dermatitis (ACD) to Topical Products in Orthopedic Surgery: Clinical Characteristics and Treatment Strategies. , 1402; 11(10): 604-616. doi: 10.22038/abjs.2023.70444.3303

Allergic Contact Dermatitis (ACD) to Topical Products in Orthopedic Surgery: Clinical Characteristics and Treatment Strategies

The Archives of Bone and Joint Surgery
مقاله 2، دوره 11، شماره 10، دی 2023، صفحه 604-616    اصل مقاله (996.27 K)
نوع مقاله: CURRENT CONCEPTS REVIEW
شناسه دیجیتال (DOI): 10.22038/abjs.2023.70444.3303
نویسندگان
Camila Arria Maury1؛ Konrad I. Gruson2؛ Eloy Tabeayo2؛ Lisa M. Gruson3؛ E. Carlos RODRIGUEZ-MERCHAN* 4
1SINY Dermatology, Brooklyn, NY, USA
2Montefiore Medical Center - Department of Orthopedic Surgery, New York, USA
31 SINY Dermatology, Brooklyn, NY, USA 3 Department of Dermatology, NYU Langone Medical Center, New York, NY, USA
4Department of Orthopedic Surgery, La Paz University Hospital-IdiPaz, Madrid, Spain
چکیده
The potential for many of the commonly used surgical site wound adhesives, skin antiseptic solutions, 
topical antibiotics, and suture materials to sensitize and subsequently result in allergic contact 
dermatitis (ACD) has become increasingly recognized within orthopedic surgery. Particularly with 
subsequent exposure to the offending allergen, the cutaneous allergic reaction may present in a similar 
fashion to cellulitis, thus making early differentiation between the two etiologies to initiate the 
appropriate and timely treatment crucial. Recognition of the characteristic appearance and severity of 
ACD surrounding a surgical wound often drives the initial management. This typically consists of anti -
histamines, topical corticosteroids, and possible removal of the offending allergen for low grade findings 
and oral steroids and prophylactic oral antibiotics for the more severe reactions. Multidisciplinary care, 
including the expertise of a dermatologist or wound care specialist when faced with this challenging 
clinical scenario is critical and elective patch testing may be indicated to ascertain the exact allergen 
involved, particularly in patients with a prior history of wound issues. Finally, any clinical cases of ACD 
following an orthopedic procedure should be documented in the patient’s chart so that exposure can 
be avoided with any future surgery. 
 Level of evidence: III
کلیدواژه‌ها
Allergic contact dermatitis؛ Orthopedic surgery؛ Topical products
مراجع
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  2. Sasseville D. Acrylates in contact dermatitis. Dermatitis. 2012; 23(1):6-16. doi: 10.1097/DER.0b013e31823d1b81.
  3. Hivnor CM, Hudkins ML. Allergic contact dermatitis after postsurgical repair with 2-octylcyanoacrylate. Arch Dermatol. 2008; 144(6):814-815. doi: 10.1001/archderm.144.6.814.
4.                Drucker AM, Pratt MD. Acrylate contact allergy: patient characteristics and evaluation of screening allergens. 

Dermatitis. 2011; 22(2):98-101.

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  3. Sundaram K, Piuzzi NS, Patterson BM, Stearns KL, Krebs VE, Mont MA. Skin closure with 2-octyl cyanoacrylate and polyester mesh after primary total knee arthroplasty offers superior cosmetic outcomes and patient satisfaction compared to staples: a prospective trial. Eur J Orthop Surg Traumatol. 2020; 30(3):447-453. doi: 10.1007/s00590-019-02591-4.
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  9. Chalmers BP, Melugin HP, Sculco PK, Schoch JJ, Sierra RJ, Pagnano MW, Stuart MJ, Taunton MJ. Characterizing the diagnosis and treatment of allergic contact dermatitis to 2-octyl cyanoacrylate used for skin closure in elective orthopedic surgery. J Arthroplasty. 2017; 32(12):3742-3747. doi: 10.1016/j.arth.2017.07.012.
  10. Chan FJ, Richardson K, Kim SJ. Allergic dermatitis after total knee arthroplasty using the Prineo wound-closure device: a report of three cases. JBJS Case Connect. 2017; 7(2):e39. doi: 10.2106/JBJS.CC.17.00064.
  11. Pate RC, Neumeister MW. Severe wound complication due to Prineo surgical dressing in shoulder hemiarthroplasty: a case report. JBJS Case Connect. 2020; 10(1):e0306. doi: 10.2106/JBJS.CC.18.00306.
  12. Lee GW, Kwak WK, Lee KB. Comparison of 2-octyl cyanoacrylate skin adhesive and interrupted polypropylene sutures for wound closure in total ankle arthroplasty. J Orthop Surg Res. 2021; 16:636. doi.org/10.1186/s13018-021-02791-x.
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  23. Lauriola MM, Corazza M. Allergic contact dermatitis due to a preoperative antiseptic solution. Contact Dermatitis. 2021; 85(4):460-462. doi: 10.1111/cod.13879.
  24. Dick AG, Dhinsa B, Walker RP, Singh S. Delayed allergic reaction to ChloraPrepTM in foot and ankle surgery. J Foot Ankle Surg. 2019; 58(1):192-194. doi: 10.1053/j.jfas.2018.08.019.
  25. Kalthoff AM, Gupta AK. Contact dermatitis after hip arthroscopic surgery. Orthop J Sports Med. 2019; 7(1):2325967118821858. doi: 10.1177/2325967118821858.
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32. Al-Qattan MM, Kfoury H. A delayed allergic reaction to 

  1. Adler BL, DeLeo VA. Allergic contact dermatitis. JAMA Dermatol. 2021; 157(3):364. doi: 10.1001/jamadermatol.2020.5639.
  2. Sasseville D. Acrylates in contact dermatitis. Dermatitis. 2012; 23(1):6-16. doi: 10.1097/DER.0b013e31823d1b81.
  3. Hivnor CM, Hudkins ML. Allergic contact dermatitis after postsurgical repair with 2-octylcyanoacrylate. Arch Dermatol. 2008; 144(6):814-815. doi: 10.1001/archderm.144.6.814.
  4. Drucker AM, Pratt MD. Acrylate contact allergy: patient characteristics and evaluation of screening allergens. Dermatitis. 2011; 22(2):98-101.
  5. Thornton NJ, Gibson BR, Ferry AM. Contact dermatitis and medical adhesives: a review. Cureus. 2021; 13(3):e14090. doi: 10.7759/cureus.14090.
  6. Robinson J, Smidt KP, Houk G, McKie J, Barton RS, Massey P. Allergic dermatitis after knee arthroscopy with repeated exposure to Dermabond Prineo™ in pediatric patients: Two case reports. World J Ortho. 2021; 12(11):931-937. doi: 10.5312/wjo.v12.i11.931.
  7. Sundaram K, Piuzzi NS, Patterson BM, Stearns KL, Krebs VE, Mont MA. Skin closure with 2-octyl cyanoacrylate and polyester mesh after primary total knee arthroplasty offers superior cosmetic outcomes and patient satisfaction compared to staples: a prospective trial. Eur J Orthop Surg Traumatol. 2020; 30(3):447-453. doi: 10.1007/s00590-019-02591-4.
  8. Choi KY, Koh IJ, Kim MS, Park DC, Sung YG, In Y. 2-Octyl Cyanoacrylate topical adhesive as an alternative to subcuticular suture for skin closure after total knee arthroplasty: a randomized controlled trial in the same patient. J Arthroplasty .2021; 36(9):3141-3147. doi: 10.1016/j.arth.2021.04.033.
  9. Gonzalo-Garijo MA, Pérez-Calderón R, Pérez-Rangel I, et al. Contact dermatitis after orthopaedic surgery. Contact Dermatitis. 2009; 61(5):299-300. doi: 10.1111/j.1600-0536.2009.01632.x.
  10. El-Dars LD, Chaudhury W, Hughes TM, Stone NM. Allergic contact dermatitis to Dermabond after orthopaedic joint replacement. Contact Dermatitis .2010; 62(5):315-317. doi: 10.1111/j.1600-0536.2010.01720.x.
  11. Durando D, Porubsky C, Winter S, Kalymon J, O'Keefe T, LaFond AA. Allergic contact dermatitis to dermabond (2-octyl cyanoacrylate) after total knee arthroplasty. Dermatitis. 2014; 25(2):99-100. doi: 10.1097/DER.0000000000000018.
  12. Yagnatovsky M, Pham H, Rokito A, Jazrawi L, Strauss E. Type IV hypersensitivity reactions following Dermabond adhesive utilization in knee surgery: a report of three cases. Phys Sportsmed. 2017; 45(2):195-198. doi: 10.1080/00913847.2017.1283208.
  13. Chalmers BP, Melugin HP, Sculco PK, Schoch JJ, Sierra RJ, Pagnano MW, Stuart MJ, Taunton MJ. Characterizing the diagnosis and treatment of allergic contact dermatitis to 2-octyl cyanoacrylate used for skin closure in elective orthopedic surgery. J Arthroplasty. 2017; 32(12):3742-3747. doi: 10.1016/j.arth.2017.07.012.
  14. Chan FJ, Richardson K, Kim SJ. Allergic dermatitis after total knee arthroplasty using the Prineo wound-closure device: a report of three cases. JBJS Case Connect. 2017; 7(2):e39. doi: 10.2106/JBJS.CC.17.00064.
  15. Pate RC, Neumeister MW. Severe wound complication due to Prineo surgical dressing in shoulder hemiarthroplasty: a case report. JBJS Case Connect. 2020; 10(1):e0306. doi: 10.2106/JBJS.CC.18.00306.
  16. Lee GW, Kwak WK, Lee KB. Comparison of 2-octyl cyanoacrylate skin adhesive and interrupted polypropylene sutures for wound closure in total ankle arthroplasty. J Orthop Surg Res. 2021; 16:636. doi.org/10.1186/s13018-021-02791-x.
  17. So SP, Yoon JY, Kim JW. Postoperative contact dermatitis caused by skin adhesives used in orthopedic surgery: Incidence, characteristics, and difference from surgical site infection. Medicine (Baltimore). 2021; 100(20):e26053. doi: 10.1097/MD.0000000000026053.
  18. Ezeh UE, Price HN, Belthur MV. Allergic contact dermatitis to Mastisol adhesive used for skin closure in orthopedic surgery: a case report. J Am Acad Orthop Surg Glob Res Rev. 2018; 2(9):e037. doi: 10.5435/JAAOSGlobal-D-18-00037.
  19. Hood CR Jr, Cornell RS, Greenfield B. Liquid adhesive contact dermatitis after bunionectomy: a case report and literature review. J Foot Ankle Surg. 2016; 55(1):209-214. doi: 10.1053/j.jfas.2015.08.019.
  20. Lee GW, Kwak WK, Lee KB. Comparison of 2-octyl cyanoacrylate skin adhesive and interrupted polypropylene sutures for wound closure in total ankle arthroplasty. J Orthop Surg Res. 2021; 16(1):636. doi: 10.1186/s13018-021-02791-x.
  21. Schlarbaum JP, Hylwa SA. Allergic contact dermatitis to operating room scrubs and disinfectants. Dermatitis. 2019; 30(6):363-370. doi: 10.1097/DER.0000000000000525.
  22. Marks JG Jr. Allergic contact dermatitis to povidone-iodine. J Am Acad Dermatol. 1982; 6(4 Pt 1):473-475. doi: 10.1016/s0190-9622(82)80363-0.
  23. Letzelter J, Hill JB, Hacquebord J. An overview of skin antiseptics used in orthopaedic surgery procedures. J Am Acad Orthop Surg. 2019; 27(16):599-606. doi: 10.5435/JAAOS-D-18-00105.
  24. Butler L, Mowad C. Allergic contact dermatitis in dermatologic surgery: review of common allergens. Dermatitis. 2013; 24(5):215-221. doi: 10.1097/DER.0b013e3182a0d3a.
  25. de la Cuadra-Oyanguren J, Zaragozá-Ninet V, Sierra-Talamantes C, Alegre de Miquel V. Postsurgical contact dermatitis due to povidone iodine: a diagnostic dilemma. Actas Dermosifiliogr. 2014; 105(3):300-304. doi: 10.1016/j.adengl.2012.11.028.
  26. Mastrocola M, Matziolis G, Böhle S, Lindemann C, Schlattmann P, Eijer H. Meta-analysis of the efficacy of preoperative skin preparation with alcoholic chlorhexidine compared to povidone iodine in orthopedic surgery. Sci Rep. 2021; 11(1):18634. doi: 10.1038/s41598-021-97838-8.
  27. Lauriola MM, Corazza M. Allergic contact dermatitis due to a preoperative antiseptic solution. Contact Dermatitis. 2021; 85(4):460-462. doi: 10.1111/cod.13879.
  28. Dick AG, Dhinsa B, Walker RP, Singh S. Delayed allergic reaction to ChloraPrepTM in foot and ankle surgery. J Foot Ankle Surg. 2019; 58(1):192-194. doi: 10.1053/j.jfas.2018.08.019.
  29. Kalthoff AM, Gupta AK. Contact dermatitis after hip arthroscopic surgery. Orthop J Sports Med. 2019; 7(1):2325967118821858. doi: 10.1177/2325967118821858.
  30. García-Gavín J, Lissens R, Timmermans A, Goossens A. Allergic contact dermatitis caused by isopropyl alcohol: a missed allergen? Contact Dermatitis. 2011; 65(2):101-106. doi: 10.1111/j.1600-0536.2011.01936.x.
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