Systemic contact dermatitis following spinal cord stimulation in a patient with complex regional pain syndrome: A case report

초록

Rationale:Spinal cord stimulation (SCS) has been widely used since the 1960s to treat intractable pain. However, hypersensitivity related to inserted devices such as implantable pulse generators, leads, and electrode contacts has rarely been reported as a side effect. We report a case of systemic contact dermatitis following SCS insertion in a patient with complex regional pain syndrome and suggest preventive and therapeutic strategies. Patient's concerns:A 50-year-old man was diagnosed with complex regional pain syndrome due to persistent severe pain following surgery for a left ankle fracture and sprain. The patient had an SCS inserted because his leg pain was not controlled despite medication and nerve block for several years, and he was discharged without any side effects. Diagnoses:A dermatologist diagnosed the patient with contact dermatitis and prescribed medications. Outcomes:Itching worsened near the arms, neck, and scrotum; hence, 4 mg methylon and 0.3% difuco ointment (difucortolone valerate) were additionally prescribed. The patient was undergoing continuous treatment in the pain and dermatology department for these symptoms. Lessons:Hypersensitivity after SCS insertion is difficult to treat and may require the removal of the insertion device. Therefore, the patient's medical history and screening tests, such as patch tests, are important before the procedure.

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