Metal Hypersensitivity Mimicking Periprosthetic Erysipelas-Like Infection by Daniela Kulichová, Thorsten Gehrke, Daniel Kendoff, Burkhard Summer, Javad.

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Presentation transcript:

Metal Hypersensitivity Mimicking Periprosthetic Erysipelas-Like Infection by Daniela Kulichová, Thorsten Gehrke, Daniel Kendoff, Burkhard Summer, Javad Parvizi, and Peter Thomas JBJS Case Connect Volume 4(3):e65 August 13, 2014 ©2014 by The Journal of Bone and Joint Surgery, Inc.

Anteroposterior radiograph taken after reconstruction with a cemented long-shaft component. Daniela Kulichová et al. JBJS Case Connect 2014;4:e65 ©2014 by The Journal of Bone and Joint Surgery, Inc.

Erythematous skin changes on the right thigh. Daniela Kulichová et al. JBJS Case Connect 2014;4:e65 ©2014 by The Journal of Bone and Joint Surgery, Inc.

Histology of the lesional skin with dermal edema and perivascular lymphocytic infiltrate; there were no eosinophils, neutrophils, or mucin deposits. Daniela Kulichová et al. JBJS Case Connect 2014;4:e65 ©2014 by The Journal of Bone and Joint Surgery, Inc.

Cytokine expression (RT-PCR assay) of the lesional skin in relation to the uninvolved skin indicates T-lymphocye activation (IL-2) and expression of the Th1 mediator IFNγ. Daniela Kulichová et al. JBJS Case Connect 2014;4:e65 ©2014 by The Journal of Bone and Joint Surgery, Inc.

At the twenty-four-month follow-up, the scar had a normal appearance, and no skin changes were noted. Daniela Kulichová et al. JBJS Case Connect 2014;4:e65 ©2014 by The Journal of Bone and Joint Surgery, Inc.

Anteroposterior (left) and lateral (right) radiographs at the twenty-four-month follow-up show the uncomplicated cemented long-shaft component. Daniela Kulichová et al. JBJS Case Connect 2014;4:e65 ©2014 by The Journal of Bone and Joint Surgery, Inc.