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Contact Dermatitis From Biomedical Devices, Implants, and Metals-Trouble From Within.

Karin A Pacheco1, Jacob P Thyssen2

  • 1Division of Environmental & Occupational Health Sciences, National Jewish Health, Denver, Colo; Environmental & Occupational Health Division, Colorado School of Public Health, Aurora, Colo.

The Journal of Allergy and Clinical Immunology. in Practice
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PubMed
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Internal reactions to biomedical implants, like orthopedic devices, can cause symptoms similar to allergic contact dermatitis. This review covers diagnosis and treatment for these implant-related immune responses.

Keywords:
Biomedical devicesContact dermatitisJoint failureMetal hypersensitivitySensitization to bone cementSensitization to cardiac devicesSensitization to dental materialsSensitization to spinal hardwareTotal hip arthroplastyTotal knee arthroplasty

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Area of Science:

  • Immunology
  • Materials Science
  • Biomedical Engineering

Background:

  • Allergic contact dermatitis involves immune responses to low-molecular-weight chemicals, often found in metals, preservatives, and adhesives.
  • These allergens can cause sensitization and inflammation when used in internal biomedical devices.
  • Reactions to internal devices may manifest as swelling, pain, stiffness, reduced range of motion, or itching.

Purpose of the Study:

  • To review reported skin and local internal reactions to orthopedic implants.
  • To discuss immune reactions to other medical appliances, including cardiac devices, vascular stents, and dental implants.
  • To summarize diagnostic tools, interpretation consensus, and treatment strategies for implant-related reactions.

Main Methods:

  • Literature review of reported cases and studies on allergic reactions to internal biomedical devices.
  • Analysis of diagnostic approaches for identifying implant-related hypersensitivity.
  • Synthesis of current treatment strategies for managing implant-induced inflammation.

Main Results:

  • Orthopedic implants are a major category of internal metal devices associated with immune reactions.
  • Reactions can range from localized internal symptoms to external contact dermatitis.
  • Various medical appliances, including cardiac and dental implants, can also elicit immune responses.

Conclusions:

  • Internal biomedical devices containing allergens can trigger immune responses similar to external contact dermatitis.
  • Accurate diagnosis and appropriate management are crucial for patients experiencing implant-related reactions.
  • Further research and standardized diagnostic/treatment protocols are needed.