Eczema in Full-Thickness Skin Graft

Abstract

Eczema is the most common type of dermatitis.1 The term eczema is applied to specific inflammatory reactions of the skin and covers a set of etiologically highly heterogeneous clinical conditions. Typically, the diagnosis is based only on clinical findings. Here, we present a case of unclassified eczema in full-thickness skin graft, which is a rare condition. The case presented here is of a 22-year-old man who was operated elsewhere because of burn contracture on his right hand. The contracture was released, and full-thickness skin graft harvested from his right groin was applied. Three months after the operation, the patient experienced itching and scaling on the graft. We thought this lesion to be an unclassified eczema and prescribed topical steroids. The skin lesions resolved after a week, and patient complaints subsided. In the presented case, there was no history of allergy, and nothing to indicate contact dermatitis. Yoshiki et al,2 in their study about the immunological state of grafted skin on mice, stated that grafted skin provides a specialized immunological status in which T cells do not respond well to external stimuli such as contactants, as a result of skewed function and a reduced number of Langerhans cells. In this context, contact dermatitis cannot easily develop in the grafted skin. Hopkins JG reported a case of exudative dermatitis confined to split-thickness skin graft, but the patient had autogenous as well as heterogenous grafts. 3 Kim et al4 reported a case in which bullous fixed drug eruption developed only at the previous skin graft sites. Harnack et al5 reported eczema in a split-thickness skin graft. To the best of our knowledge, eczema in full-thickness skin graft has not been reported yet. We advise clinicians to remember any kinds of eczema in their minds on all types of grafts.