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Eczematous Neurodermatitis Following Total Knee Arthroplasty: Expanding Awareness of a Rare and Underdiagnosed
Eliana Jolkovsky1, Erik Zeegen2, Iris Ahronowitz1
1Dermatology, University of California Los Angeles David Geffen School of Medicine, Los Angeles, USA.
Abstract:
SKINTED (surgery of the knee, injury to the infrapatellar branch of the saphenous nerve, traumatic eczematous dermatitis) is a recently described dermatological condition resulting from injury to the infrapatellar branch of the saphenous nerve (IPBSN) during knee surgery. This rare and underdiagnosed surgical complication characteristically presents as an eczematous eruption within an area of altered skin sensation in the distribution of IPBSN innervation. We describe a case of SKINTED in a 64-year-old female patient who presented with localized dermatitis, severe pruritus, intermittent pain, and mild numbness of her knee six months following total knee arthroplasty. Dermatologic evaluation led to a clinical diagnosis of SKINTED, and treatment with topical corticosteroids successfully resolved her symptoms. This case reinforces the need to consider SKINTED in appropriate patients. Increased awareness of this condition among both dermatologists and orthopedic surgeons can prevent misdiagnoses and unnecessary use of antibiotics, biopsies, and imaging, as well as help alleviate patient anxiety.
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