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Contact allergy to metals in total knee arthroplasties is a well-documented event due to its occurrence in the general population; however, sensitivity to other components, such as the chemicals used in the bone cement, is becoming more prominent as joint replacement surgeries continue to rise. We report a case of benzoyl peroxide (BPO) allergy leading to a persistent skin reaction in a patient with normal mechanical function after bilateral total knee arthroplasty. A thorough review of the literature reveals all published cases of orthopedic implant patients with dermatological reactions and sensitivity to benzoyl peroxide concomitantly showed symptoms of joint failure, including pain, swelling, and prosthetic loosening. Our case study presents a patient who has developed a delayed-type sensitivity reaction without joint dysfunction of any kind. This clinical presentation is a variant of those previously reported and represents a new genre of treatment challenges for surgeons and dermatologists. In this article, we discuss the implications this case has in preventing post-surgical complications and possible treatment options for this novel patient presentation.

Successful Bilateral Total Knee Replacements with ongoing Allergic Contact Dermatitis to Benzoyl Peroxide