What is in a name?—Demystifying “SKINTED”—A review of literature from dermatological perspective

Abstract

Surgery of the knee, injury to the infrapatellar branch of the saphenous nerve, traumatic eczematous dermatitis (SKINTED) is a regional dermatitis specific to total knee arthroplasty, occurring postsurgically. It is characterized by an eczematous eruption localized to the knee, mostly the anteroinferior aspect, presenting as pruritic, dry, erythematous, scaly, or at times papulovesicular lesions. Having been known over the past decade by various nomenclatures, the basic pathogenesis has now been agreed upon as a locoregional immune dysfunction because of damage to lymphatics occurring postsurgically. We have described three case reports of typical eczematous lesions occurring after total knee replacement surgery and reviewed the literature for similar cases described across the literature. A PubMed and Google Scholar search pertaining to the articles published with the keywords “SKINTED” and “autonomic denervation dermatitis” was conducted. A total of 10 results were obtained after exclusion of duplicated and irrelevant search results. This yielded one review article, one original article, seven case reports, and two correspondence articles. Based on the review, the authors agree with the concept of Rucco’s immunocompromised district, being the most logical explanation for the occurrence of SKINTED. SKINTED should be differentiated from implant eczema occurring because of hypersensitivity to metal implants, which presents as systematized contact dermatitis and has a predefined set of diagnostic criteria.