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全膝关节置换术后的湿疹样神经性皮炎:提高对一种罕见且诊断不足的术后皮肤并发症的认识

Eczematous Neurodermatitis Following Total Knee Arthroplasty: Expanding Awareness of a Rare and Underdiagnosed Postoperative Dermatologic Complication.

作者信息

Jolkovsky Eliana, Zeegen Erik, Ahronowitz Iris

机构信息

Dermatology, University of California Los Angeles David Geffen School of Medicine, Los Angeles, USA.

Orthopedic Surgery, University of California Los Angeles David Geffen School of Medicine, Los Angeles, USA.

出版信息

Cureus. 2025 Jun 29;17(6):e86989. doi: 10.7759/cureus.86989. eCollection 2025 Jun.

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.

摘要

SKINTED(膝关节手术、隐神经髌下支损伤、创伤性湿疹性皮炎)是一种最近描述的皮肤病,由膝关节手术中隐神经髌下支(IPBSN)损伤引起。这种罕见且诊断不足的手术并发症的典型表现是在IPBSN支配区域内皮肤感觉改变的区域出现湿疹样皮疹。我们描述了一例64岁女性患者的SKINTED病例,该患者在全膝关节置换术后6个月出现局部皮炎、严重瘙痒、间歇性疼痛和膝关节轻度麻木。皮肤科评估导致SKINTED的临床诊断,局部使用皮质类固醇治疗成功缓解了她的症状。该病例强调了在合适的患者中考虑SKINTED的必要性。皮肤科医生和骨科医生对这种疾病的认识提高可以防止误诊以及不必要地使用抗生素、活检和影像学检查,同时有助于减轻患者的焦虑。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4c2b/12307027/e9ea10889164/cureus-0017-00000086989-i01.jpg

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