Autoimmune / autoinflammatory syndrome induced by adjuvants (Asia): morphea case report after metallic bone prosthesis

Introduction: The adjuvant-induced autoimmune / autoinflammatory syndrome corresponds to the group of diseases capable of being induced or accelerated by external agents, known as adjuvants that can trigger an immune response in the host. After exposure, several autoimmune diseases can be triggered by such substances, such as rheumatoid arthritis, systemic lupus erythematosus, mixed connective tissue disease and scleroderma. Case Report: Here we report a case of a 69-year-old female patient sought dermatology care due to the appearance of a brownish spot on her right leg 3 years ago, which presented a progressive increase in size and alteration in appearance. The patient reported placing a bone prosthesis made of chromium-cobalt and titanium in his right leg for 12 years. The patient underwent an incisional biopsy of the lesion and histopathological examination revealed an epidermis with slight acanthosis and a densely pigmented brown basal layer, in the dermis proliferation of fragmented and hyalinized collagen fibers, compatible with cutaneous scleroderma. Conclusion: In the present case, our patient presented adjuvant-induced autoimmune / autoinflammatory syndrome 12 years after the surgical procedure. Thus, such pathology must be taken into account in the differential diagnosis of autoimmune diseases, if the patient has a history of invasive procedures.