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Concepts in Allergy to Pectus Metal Implants

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Chest Wall Deformities

Abstract

Allergy to pectus implants is infrequent. Cutaneous allergic reactions to stainless steel Nuss bars may take the form of skin erosions, granulomas, erythema or seromas; keloids have also been reported, posssibly as an end result of an erosion in a predisposed patient. Pleural effusions and pericarditis have also been implicated as systemic reactions to metals. Epicutaneous patch testing is a tool that can be used to identify allergy to metal implants. Although routine pre-operative patch testing is not recommended for most implants and prostheses unless the patient has a significant history of metal sensitivity or previous cutaneous or systemic reaction to an implant or device, Nuss’s group now performs metal patch testing on all patients priot to the Nuss procedure. Patients in whom a diagnosis of allergy to an implant is made have been treated with corticosteroids and antihistamines, removal of the implant, or replacement of the implant. Titanium implants are generally well tolerated in patients with nickel metal allergy.

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Authors and Affiliations

  1. Department of Dermatology, Cleveland Clinic, 9500 Euclid Ave, Cleveland, OH, USA, 44195

    Savina Aneja MD, James S. Taylor MD, Apra Sood MD & Golara Honari MD

  2. Dermatology and Plastic Surgery Institute, Cleveland Clinic, 9500 Euclid Ave, Cleveland, OH, USA, 44195

    Savina Aneja MD, James S. Taylor MD, Apra Sood MD & Golara Honari MD

  3. Department of Pediatric Surgery, The Children’s Hospital and Pediatric Institute, Cleveland Clinic, 9500 Euclid Ave, Cleveland, OH, USA, 44195

    John D. DiFiore MD

Authors
  1. Savina Aneja MD
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  2. James S. Taylor MD
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  3. Apra Sood MD
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  4. Golara Honari MD
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  5. John D. DiFiore MD
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Corresponding author

Correspondence to James S. Taylor MD .

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Editors and Affiliations

  1. Consultant Pediatric Surgeon Chelsea Children’s Hospital, Chelsea and Westminster Hospital NHS Foundation Trust Imperial College London, London, United Kingdom

    Amulya K. Saxena

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Aneja, S., Taylor, J.S., Sood, A., Honari, G., DiFiore, J.D. (2017). Concepts in Allergy to Pectus Metal Implants. In: Saxena, A. (eds) Chest Wall Deformities. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-53088-7_25

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  • DOI: https://doi.org/10.1007/978-3-662-53088-7_25

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  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-662-53086-3

  • Online ISBN: 978-3-662-53088-7

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