case_images: PMC7066679_01
case_images: A, D: Comminuted fracture of tibia and fibula. B, E: X-ray showed some osteotylus across fracture line with good alignment 1 month after TCM treatment. C, F: Union of fracture without replacement after external fixation was removed.
case_images: allergologieselect-3-015-01.jpg
case_images: PMC7066679_01_allergologieselect-3-015-01.jpg
case_images: Figure1
case_images: Considering that the distal tibiofibular fracture was open and comminuted, we performed a unilateral multifunctional external fixation (XY-034, Suzhou Yuxiang Medical Devices Co., Ltd., stainless steel) surgery for the tibia fracture and internal plate fixation for the closed fibula fracture (Figure 1B, E).  TCM treatment, and the external fixation was removed (Figure 1C, F). The skin lesion was healed and the symptoms disappeared completely after the removal surgery (Figure 2D).
case_images: A: Skin allergic to external fixation screws showed eczema-like changes, small blisters, and exudate. B: 2 weeks after TCM therapy, the skin lesion showed scab formation (locally amplified to show scab formation and erythema relief). C: 4 weeks after TCM therapy, scab disappeared and the skin was restored to normal. D: The skin lesion was healed after removing external fixator.
case_images: allergologieselect-3-015-02.jpg
case_images: PMC7066679_01_allergologieselect-3-015-02.jpg
case_images: Figure2
case_images: The skin lesions appeared as an eczema-like reaction and exudate with itch (Figure 2A). After the second week, the eczema-like skin lesion of contact dermatitis formed a scab (Figure 2B). The scab disappeared, and the skin recovered to the normal state at the fourth week (Figure 2C). TCM treatment, and the external fixation was removed (Figure 1C, F). The skin lesion was healed and the symptoms disappeared completely after the removal surgery (Figure 2D).
case_images: A: Patch test (BY-07-I and BY-07- II for orthopedic use, Baiyi Yida Science and Technology Development Ltd., Beijing, China): Blue arrows show No. 14 and 17 from left panel (BY-07-I), which correspond to potassium dichromate and nickel sulfate, respectively; red arrow shows No. 12 from right panel (BY-07-II), i.e., nickel nitrate. B: Arrows show a strongly positive allergic reaction (+++) to nickel and a doubtful reaction to chromium (+-).
case_images: allergologieselect-3-015-03.jpg
case_images: PMC7066679_01_allergologieselect-3-015-03.jpg
case_images: Figure3
case_images: Table 1 and Figure 3. The test result showed a strongly positive reaction (+++) to nickel (No. 17 nickel sulfate from panel A (Figure 3B) (Table 1); No. 12 nickel nitrate from panel B, (Figure 3B) (Table 1) and a doubtable reaction (+-) to molybdenum (No. 14 ammonium molybdate from panel B, (Figure 3B) (Table 1). 