Liu Chaocheng, de Gannes Gillian
Department of Dermatology and Skin Science, University of British Columbia, Vancouver, BC, Canada.
Division of Dermatology, Department of Medicine, St. Paul's Hospital, Vancouver, BC, Canada.
Plast Surg (Oakv). 2024 Nov;32(4):762-764. doi: 10.1177/22925503231169776. Epub 2023 Apr 17.
Allergic contact dermatitis (ACD) is a delayed-type hypersensitivity reaction that presents as a pruritic eczematous rash occurring 24 to 48 h after allergen exposure. It is a surgical complication that can impact people's quality of life after plastic surgeries. A 44-year-old female with right breast cancer presented with three recurrent episodes of severe pruritic cutaneous eczematous eruption over her right breast extending down to her trunk and vulva each time soon after her multiple breast surgeries. She was labeled as having allergies to several intravenous antibiotics received perioperatively. She was then patch tested with a positive reaction to bacitracin, a component of a modified double antibiotic solution used for pocket irrigation intraoperatively. It highlights the need for plastic surgeons to consider ACD to bacitracin in patients with dermatitis soon after having bacitracin for pocket irrigation or implant soaking during breast surgeries. Comprehensive patch testing can delineate the cause of surgery-related ACD.
过敏性接触性皮炎（ACD）是一种迟发型超敏反应，表现为在接触过敏原后24至48小时出现的瘙痒性湿疹样皮疹。它是一种手术并发症，会影响整形手术后人们的生活质量。一名44岁的右乳腺癌女性在多次乳房手术后不久，每次右乳都会反复出现三次严重的瘙痒性皮肤湿疹样皮疹，皮疹向下延伸至躯干和外阴。她被标记为对围手术期接受的几种静脉用抗生素过敏。随后对她进行了斑贴试验，结果显示对杆菌肽呈阳性反应，杆菌肽是术中用于囊袋冲洗的改良双抗生素溶液的一种成分。这凸显了整形外科医生在乳房手术中对使用杆菌肽进行囊袋冲洗或植入物浸泡后的皮炎患者考虑ACD由杆菌肽引起的必要性。全面的斑贴试验可以明确手术相关ACD的病因。
