title: [Metal implant sensitivity: clinical and histological presentation].
abstract: Metal implant sensitivity (intolerance) can cause pain, reduced mobility, loosening of the implant and skin rashes. Knowledge of differential diagnoses, histology and appropriate diagnostics are essential for proper diagnosis. To outline typical clinical signs and histology in metal-implant-associated skin lesions we present three exemplary patients from our implant allergy outpatient department and give an overview of the current literature regarding metal implant sensitivity. In patients with a negative patch test the lymphocyte transformation test may reveal metal sensitization. Even "pure" titanium alloys may contain traces of nickel. The histology of implant-associated skin reactions goes from teleangiectatic postimplantation erythema to eczema and vasculitis. Based on the synopsis of history, clinical picture, allergological testing and histology, metal implant sensitivity can be diagnosed more precisely.
authors.affiliation: Klinik und Poliklinik für Dermatologie und Allergologie, Ludwig-Maximilians-Universität München, Frauenlobstr. 9-11, München, Deutschland. daniela.hartmann@med.uni-muenchen.de.
authors.forename: D
authors.initials: D
authors.lastname: Hartmann
authors.affiliation: Klinik und Poliklinik für Dermatologie und Allergologie, Ludwig-Maximilians-Universität München, Frauenlobstr. 9-11, München, Deutschland.
authors.forename: V
authors.initials: V
authors.lastname: Letulé
authors.affiliation: Klinik und Poliklinik für Dermatologie und Allergologie, Ludwig-Maximilians-Universität München, Frauenlobstr. 9-11, München, Deutschland.
authors.forename: J J
authors.initials: JJ
authors.lastname: Schneider
authors.affiliation: Klinik und Poliklinik für Dermatologie und Allergologie, Ludwig-Maximilians-Universität München, Frauenlobstr. 9-11, München, Deutschland.
authors.forename: M J
authors.initials: MJ
authors.lastname: Flaig
mesh_terms: D003877:Dermatitis, Contact / Q000209:etiology* / Q000276:immunology / Q000473:pathology*; D003937:Diagnosis, Differential; D006970:Disorders of Excessive Somnolence / Q000209:etiology* / Q000276:immunology / Q000473:pathology*; D006801:Humans; D008670:Metals / Q000009:adverse effects*; D019736:Prostheses and Implants / Q000009:adverse effects*
chemical_list: D008670:Metals
keywords: Allergy; Arthroplasty; Contact dermatitis; Histology; Nickel