title: Psoriasis vulgaris caused by ceramic inserts used in total hip replacement.
abstract: BACKGROUND
  Ceramics are inorganic nonmetallic materials and are used as bioinert components in joint replacement surgeries. Ceramics are known to be low allergenic. We experienced a ceramic-induced psoriasis.
  
  
  OBJECTIVE
  We report a first case of possible ceramic-induced psoriasis caused by a ceramic insert.
  
  
  METHODS
  A 55-year-old female received an implanted ceramic-on-ceramic total hip replacement for osteoarthritis of the right hip joint. Following surgery, she developed psoriatic lesions, which continued for 10 years. We suspected that psoriasis was caused by a ceramic insert and removed it surgically.
  
  
  RESULTS
  When the ceramic insert was replaced with a polyethylene-on-metal hip joint, the psoriatic lesions completely disappeared.
  
  
  CONCLUSIONS
  The pathogenesis of psoriasis is still an enigma, although deregulation of nuclear factor κB signaling and resulting abnormal cytokine secretion are speculated to be involved. Ceramics may affect these signaling events and cause the onset of psoriasis.
authors.affiliation: Department of Orthopedic Surgery, Kurume University Medical Center.
authors.forename: Fujio
authors.initials: F
authors.lastname: Higuchi
authors.forename: Daisuke
authors.initials: D
authors.lastname: Tsuruta
authors.forename: Yumiko
authors.initials: Y
authors.lastname: Ishibashi
authors.forename: Kazuko
authors.initials: K
authors.lastname: Imamura
authors.forename: Tokiko
authors.initials: T
authors.lastname: Shimoyama
authors.forename: Takahiro
authors.initials: T
authors.lastname: Ookawa
authors.forename: Shinichiro
authors.initials: S
authors.lastname: Kume
authors.forename: Shiro
authors.initials: S
authors.lastname: Yoshida
authors.forename: Masafumi
authors.initials: M
authors.lastname: Gotoh
authors.forename: Akio
authors.initials: A
authors.lastname: Noda
authors.forename: Toshie
authors.initials: T
authors.lastname: Mori
authors.forename: Takahiro
authors.initials: T
authors.lastname: Hamada
authors.forename: Norito
authors.initials: N
authors.lastname: Ishii
authors.forename: Teruki
authors.initials: T
authors.lastname: Dainichi
authors.forename: Hiromi
authors.initials: H
authors.lastname: Kobayashi
authors.forename: Kensei
authors.initials: K
authors.lastname: Nagata
authors.forename: Takashi
authors.initials: T
authors.lastname: Hashimoto
mesh_terms: D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects; D001672:Biocompatible Materials / Q000009:adverse effects*; D002516:Ceramics / Q000009:adverse effects*; D005260:Female; D006622:Hip Prosthesis / Q000009:adverse effects*; D006801:Humans; D008875:Middle Aged; D015207:Osteoarthritis, Hip / Q000601:surgery; D011565:Psoriasis / Q000139:chemically induced*; D012086:Reoperation
chemical_list: D001672:Biocompatible Materials