Mahajan Vikram K, Sharma Vikas, Sharma Neeraj, Rani Ritu, Chandel Monika
Department of Dermatology, Venereology & Leprosy, Dr. Radhakrishnan Government Medical College Hamirpur 177001, Himachal Pradesh, India.
Am J Neurodegener Dis. 2023 Feb 25;12(1):16-22. eCollection 2023.
Surgery of the nee, injury to the nfrapatellar branch of the saphenous erve, raumatic czematous ermatitis (SKINTED) involving the skin lateral to the surgical incision/scar area is a site- and procedure-specific diagnosis associated with total knee replacement surgery. It results from autonomic denervation following surgical trauma to the nerve and occurs months to years after surgical trauma. It needs to be differentiated from post traumatic eczema/dermatitis, neuropathic dermatitis and contact dermatitis/sensitization due to topical therapies or implant material. Herein, we report a case of 70-year-old woman having no preexisting medical or dermatological disorder of significance presenting with eczematous lesions around both knees lateral to the incision site developing few months after bilateral total knee replacement surgery. Treatment with twice daily application of betamethasone dipropionate 0.05% cream, gabapentine 100 mg/d PO and liberal use of bland emollient cream given over 2 months was remittive without recurrence during more than one year of follow up. Since its exact prevalence, pathophysiology and clinical course remain uncertain its awareness remains relevant to both dermatologists and orthopedic surgeons to address unnecessary anxiety and dissatisfaction of the patient.
膝关节手术、隐神经髌下支损伤、涉及手术切口/瘢痕区域外侧皮肤的创伤性湿疹性皮炎(SKINTED)是一种与全膝关节置换手术相关的特定部位和手术相关的诊断。它是由于手术创伤导致神经自主神经去神经支配引起的,发生在手术创伤后的数月至数年。它需要与创伤后湿疹/皮炎、神经性皮炎以及因局部治疗或植入材料引起的接触性皮炎/致敏反应相鉴别。在此,我们报告一例70岁女性,既往无重大内科或皮肤病史,双侧全膝关节置换手术后数月,在切口部位外侧的双膝周围出现湿疹样病变。给予每日两次外用0.05%丙酸倍他米松乳膏、口服加巴喷丁100mg/d,并大量使用温和润肤霜,治疗2个月后病情缓解,随访一年多无复发。由于其确切的患病率、病理生理学和临床过程仍不确定,皮肤科医生和骨科医生认识到这一点对于解决患者不必要的焦虑和不满仍然很重要。