Perioperative and postoperative complications in arthroplasty patients with dermatologic and autoimmune skin conditions: Long-term outcomes and management strategies

Dermatologic and autoimmune skin disorders pose unique challenges for arthroplasty due to increased susceptibility to surgical site complications, particularly periprosthetic joint infections. Skin integrity is compromised by disorders such as psoriasis, systemic sclerosis, systemic lupus erythematosus (SLE), and eczema, often in the setting of chronic inflammation and immune dysregulation treated with immunosuppressive therapies. These factors collectively impair wound healing and increase the risk of microbial colonization with organisms including Methicillin-resistant Staphylococcus aureus , thus increasing the risk of intraoperative contamination and subsequent postoperative infection. The present narrative review aims to discuss complications in the perioperative and postoperative periods, long-term outcomes, and condition-specific considerations that influence surgical strategy in patients undergoing arthroplasty with dermatologic and autoimmune skin disorders. It also outlines evidence-based strategies for risk mitigation, including preoperative dermatologic evaluation, optimization of immunosuppressive regimens, targeted antimicrobial prophylaxis, lesion control, and interdisciplinary planning. Postoperative surveillance and individualized rehabilitation are crucial for optimal surgical outcomes. Importantly, dermatologic and autoimmune skin diseases should not be considered absolute contraindications to arthroplasty; rather, optimal multidisciplinary preoperative optimization and coordinated perioperative management are key determinants of safe surgical outcomes. Further research is warranted to establish standardized clinical guidelines for managing this vulnerable patient population.