Abstract

LOPES, Ana G. et al. Titanium hypersensitivity in a patient with a titanium medical implant. Port J Dermatol Venereol. [online]. 2023, vol.81, n.3, pp.205-208.  Epub May 24, 2023. ISSN 2795-501X.  https://doi.org/10.24875/pjdv.23000016.

A 53-year-old male patient with priors of psoriasis suffered a left tibial plateau fracture and underwent open reduction and internal fixation with a titanium plating system. He had no history of atopy or contact-hypersensitivity reactions to metals. Almost 1 year later, the patient continued to have chronic pain and edema at the site of the implant. On examination, the patient had a well-healed surgical incision on the left leg without erythema or induration but with tenderness to touch and two fluctuating nodular lesions. Subsequent allergy patch testing revealed an allergy-positive reaction to nickel sulfate, titanium oxalate and sodium tetrachloropalladate. The patient was diagnosed with titanium hypersensitivity secondary to recent implantation. The patient underwent hardware removal with a resolution of the complaints. The allergic risk of titanium material is smaller than that of other metal materials. Positive patch test reactions to titanium are rare and a negative patch does not exclude the diagnosis. Preimplant patients should be asked about a history of hypersensitivity reactions to metals and patch testing should be recommended for those who have experienced such reactions.

Keywords : Allergy; Medical implant; Patch testing; Titanium; Titanium hypersensitivity.

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