Permanent sterilization using intratubal implants is becoming increasingly popular worldwide. We report the first case of a 40-year-old woman presenting a systemic contact dermatitis due to nickel-containing intratubal implants: the Essure system. The diagnosis was confirmed with positive patch test result for nickel and total clearance of dermatitis after removing the implants that contain a metallic spiral of nitinol (alloy of 55% nickel and 45% titanium). Systemic contact dermatitis to the intratubal implants could be explained by the corrosion of nitinol after implantation resulting in the release of nickel. In the literature, no similar case has been reported despite the introduction of intratubal implants since 2002. Dermatologists and gynecologists need to be aware of this type of complication. In practice, a thorough assessment for possible nickel contact dermatitis in a woman undergoing sterilization with Essure is recommended. Preoperative patch testing must be carried out if there is any doubt.
From the *Dermatology Department and Paul Sabatier University, University Hospital, Toulouse, France; and †Rue de Metz, Toulouse, France.
Address reprint requests to Françoise Giordano-Labadie, MD, Dermatology Department, Larrey Hospital, TSA 30030-31059 Toulouse cedex9, France. E-mail: email@example.com.
One author has financial relationships with Abbott, Amgen, Astellas, Celgene, Janssen-Cilag, Novartis, Pfizer, and Pierre Fabre.