We know that exposure to the sun can damage our skin and cause skin cancer. A recent study also showed that chronic skin allergy to metals in orthopedic implants can also lead to skin cancer.
Orthopedic implants are used to replace something that are missing or damaged. Implants are used for a number of reasons, for example:
- Drug delivery
- Rods, pins, screws or plates to anchor fractured bones
- Joint replacement
Not all implants contain metal, however, many do contain metal and metal alloys such as nickel, cobalt and chromium. These metals help make the implants stronger and more durable, however, some people have an allergic reaction which can appear on the skin as a rash or inflammation. This inflammation might cause joint pain, swelling or joint failure.
Researchers at Washington University School of Medicine and Barnes-Jewish Hospital in St. Louis recently published a study that looked at the effects of chronic allergic reaction from metal implants. The researchers first became interested in a possible connection based on a woman who had received a metal rod in her ankle as a result of a fracture. She did not have any history of skin cancer. She developed a skin lesion on the skin above the implant which did not heal. A year later, she was diagnosed with an allergic reaction to the nickel in the rod and it was removed. The lesion still not heal and squamous cell carcinoma with Marjolin’s ulcer (a rare type of skin cancer) was found and removed.
Marjolin’s ulcer is an invasive and potentially deadly type of squamous cell carcinoma. It is very rare in young people who are otherwise healthy. It is usually only seen in people who have a history of skin cancer. The woman diagnosed with it was only 46 years old, was healthy and had no history of skin cancer.
Using mice, the researchers found that tumors can develop from continuous contact with allergens. A contact allergy occurs when the skin comes in contact with an allergen, for example, poison ivy. During the initial exposure to the allergen, the skin can become inflamed. When the exposure is continuous, different inflammatory molecules and cells become active at the site and can then develop skin tumors. The scientists noted that some of the mice developed tumors similar to the original patient’s tumor.
The best course of action when you are allergic to something is to avoid it. For example, if you are allergic to poison ivy, the best way to protect yourself is to be aware of different plants and to stay away from poison ivy. However, you cannot avoid an implant once it is inside you. The researchers suggest that doctors test patients for possible allergic reactions before placing a metal implant and closely monitoring skin reactions in those who do receive metal implants.
There are some allergen-free versions of some implants available, however, they are more expensive and not as durable as those that contain metal. Because of this, doctors frequently use the implants containing metal. Evaluating patients for metal allergies can help to cut down on skin reactions.