According to S. William Levy’s “Skin Problems of the Amputee” on the Digital Resource Foundation for the Orthotics and Prosthetics Community web site, seniors who wear prosthetic devices to replace lost limbs are likely to experience an allergic reaction where the artificial limb connects to the body. People who are older may have less obvious immediate symptoms related to inflammation than a younger amputee, but chronic contact dermatitis causes skin irritation in many seniors with an artificial limb.
Symptoms of contact dermatitis may appear gradually, perhaps over years, in seniors. Those who experience reactions may decide not to wear the prosthetic device because they may think that all artificial limbs would produce the same results, but often the symptoms will improve once the allergen is located and replaced with something that does not produce the allergic response.
Symptoms of Contact Dermatitis in Amputees
Symptoms of contact dermatitis tend to increase with the use of the artificial limb and may include:
- itching, which may be severe
- burning
- small blisters, swelling and oozing that one would see with eczema (usually with the more acute form)
- scaly and mildly red skin (usually appears with more chronic form)
Causes of Contact Dermatitis Associated with Artificial Limbs
Allergic contact dermatitis related to a prosthetic device may be caused by several different irritants, such as products used in manufacturing the device, medications, or items applied to the skin. The above-mentioned article lists several different allergens below.
The socket’s inner lining may contain allergens, including:
- varnish
- lacquer
- plastic, particularly if improperly cured during manufacturing
- resin
Sometimes the substance causing the dermatitis is applied to the skin or placed between the stump and prosthetic device, including:
- cushion made of foam or other substance
- pad, including those that may have a plastic covering
- cleansing agents
- creams, lotions, or lubricants (especially lanolin)
- substances used to “toughen” the skin
- over-the-counter (OTC) topical antibiotics (particularly Neomycin)
- adhesives, including tape
- anesthetics (such as Ben-zocaine or Lidocaine)
- nickel
- leather (chromates)
- wool fats
- cement or other substances used to repair a prosthetic
Determining the Source of an Allergy Associated with Prosthetic Device
A healthcare provider may recommend a patch test if an allergic reaction is suspected at the site of amputation. Small amounts of possible allergens are applied to the skin for a certain amount of time. The skin is then evaluated to see if a reaction has occurred. These tests may be quite informative, but sometimes they may be inconclusive. Repeat testing at a later date may give clearer results.
Some people may be able to identify when symptoms started and whether those symptoms were associated with the use of an item such as a topical antibiotic or new cream. These seniors may wish to consult with a healthcare provider regarding alternatives to use to see if the symptoms clear.
Treatment for Contact Dermatitis in Amputated Limb
If the allergen is identified, care should be taken to avoid the substance as much as possible. The allergy should be documented on the senior’s medical chart to avoid future contact with the substance. Once the offending substance is removed, the amputee may experience relief in a fairly short period of time.
Symptomatic treatment might include:
- cold or cooling compresses
- lotions designed to lessen skin itching related to allergies
- sometimes topical steroids are needed to improve symptoms
Senior Amputees May Experience Relief with Proper Treatment of Contact Dermatitis
Older adults who have an amputated limb may not have the typical eczema-type skin reaction of an acute contact dermatitis, but red and scaly skin can indicate a chronic skin allergy that may be more difficult to diagnose. Once an allergen is identified and removed, the skin can begin to heal and the amputee can often enjoy a complete recovery with a new resolve to avoid the offending substance in the future if possible.
Readers may also wish to read:
- Living a Full and Happy Life After Amputation talks about an amputee's ability to remain positive and to even find a new and fulfilling career.
- Guide Dogs and Service Dogs Help Disabled Vets gives information about two organizations that provide these animals for free or a very low cost.
- Caregivers of Aging Parents and Children gives practical advice for those people in the "sandwich" generation of caring for loved ones who are both younger and older.
This article is for informational purposes only and is not medical advice. People who are experiencing dermatological problems related to a prosthetic device should consult their healthcare provider for assessment and proper treatment. Readers are welcome to post comments in the comment box below.
Katrena Wells - Katrena Wells is a RN in NC with 17 1/2 years of experience in oncology, an educator since 1995, and has taught exercise classes since ...
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