Comment on 'infections post-Nexplanon(R) insertion'.

I was very interested to read about Drs Partridge and Bush’s experiences with subdermal implant infections. In particular the photographic images were strikingly similar in appearance to the features I observed in the case described in my recent letter to the Journal. It is interesting that all three cases described occurred in patients with preexisting eczema. This feature was not shared with my patient who does not have any pre-existing dermatological condition. In particular there seem to be marked similarities between my case and the first two cases described by Drs Partridge and Bush in terms of the delayed presentation, transient period of apparent improvement with antibiotics followed by subsequent recurrence, culminating in eventual breakdown of skin at the insertion site with partial expulsion/selfextrusion. I agree that it would be appropriate to assess the skin at the insertion site and also that attention be paid to maintaining conditions so that fittings are performed using aseptic technique to minimise implant-related infections.