PMID- 37261304
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20230604
IS  - 2223-8956 (Electronic)
IS  - 1016-3190 (Print)
IS  - 1016-3190 (Linking)
VI  - 35
IP  - 2
DP  - 2023 Apr-Jun
TI  - Orthopedic implant hypersensitivity: Characterization of clinical presentation 
      and effects of photobiomodulation therapy.
PG  - 176-181
LID - 10.4103/tcmj.tcmj_255_22 [doi]
AB  - OBJECTIVES: Orthopedic implants have improved the quality of life in aging 
      society but also induces several kinds of tissue reactions, referred to as 
      orthopedic implant hypersensitivity (OIH). The aim of our study is to report the 
      clinical characteristics of OIH and the effects of photobiomodulation therapy 
      (PBMT) on these groups of patients. MATERIALS AND METHODS: We collected cases 
      that complained of skin rashes with pruritus after orthopedic implants from 
      January 2017 to June 2022 at the Dermatology clinic in Hualien Tzu Chi Hospital. 
      We recorded the sites and material of orthopedic implants, skin lesions onset 
      time, symptoms, location after implantation, and the disease duration. Laboratory 
      tests were measured, including complete blood count, differential count, serum 
      immunoglobulin E (IgE) level, as well as inflammatory and autoimmune markers. 
      PBMT, including UVB311 nm or low-level laser therapy 808 nm, was performed. Dose, 
      duration, and response were documented. RESULTS: Fourteen patients were diagnosed 
      with OIH; twelve presented with localized eczema at the implant sites, and two 
      with generalized eczema. Eleven patients (78.6%) had either elevated eosinophils 
      percentage (>6%) or IgE level (>200 U/mL) or both. Seven patients (50%) had 
      favorable outcome after PBMT and successfully withdrew from systemic steroid. 
      CONCLUSION: In our case series, localized eczema at implant sites was a common 
      cutaneous presentation in OIH. Hence, a surgical scar at the eczema site or 
      long-term waxing and waning generalized eczema should prompt physicians on the 
      possibility of OIH. Blood eosinophils percentage and serum IgE level can be 
      reference biomarkers for OIH. PBMT provides a noninvasive and effective treatment 
      strategy for immune regulation and tissue regeneration.
CI  - Copyright: (c) 2023 Tzu Chi Medical Journal.
FAU - Wu, Ro-Wei
AU  - Wu RW
AD  - Skin Institute, Department of Dermatology, Hualien Tzu Chi Hospital, Buddhist Tzu 
      Chi Medical Foundation, Hualien, Taiwan.
FAU - Chang, Chung-Hsing
AU  - Chang CH
AD  - Skin Institute, Department of Dermatology, Hualien Tzu Chi Hospital, Buddhist Tzu 
      Chi Medical Foundation, Hualien, Taiwan.
AD  - Doctoral Degree Program in Translational Medicine, Tzu Chi University and 
      Academia Sinica, College of Medicine, Tzu Chi University, Hualien, Taiwan.
AD  - Institute of Medical Sciences, College of Medicine, Tzu Chi University, Hualien, 
      Taiwan.
LA  - eng
PT  - Journal Article
DEP - 20230221
PL  - India
TA  - Tzu Chi Med J
JT  - Tzu chi medical journal
JID - 101770275
PMC - PMC10227683
OTO - NOTNLM
OT  - Aged
OT  - Eczema
OT  - Hypersensitivity
OT  - Orthopedic implant
OT  - Photobiomodulation therapy
COIS- Dr. Chung-Hsing Chang, an editorial board member at Tzu Chi Medical Journal, had 
      no role in the peer review process of or decision to publish this article. The 
      other author declared no conflicts of interest in writing this paper.
EDAT- 2023/06/01 13:10
MHDA- 2023/06/01 13:11
PMCR- 2023/02/21
CRDT- 2023/06/01 10:39
PHST- 2022/09/13 00:00 [received]
PHST- 2022/11/28 00:00 [revised]
PHST- 2022/12/14 00:00 [accepted]
PHST- 2023/06/01 13:11 [medline]
PHST- 2023/06/01 13:10 [pubmed]
PHST- 2023/06/01 10:39 [entrez]
PHST- 2023/02/21 00:00 [pmc-release]
AID - TCMJ-35-176 [pii]
AID - 10.4103/tcmj.tcmj_255_22 [doi]
PST - epublish
SO  - Tzu Chi Med J. 2023 Feb 21;35(2):176-181. doi: 10.4103/tcmj.tcmj_255_22. 
      eCollection 2023 Apr-Jun.