Skin Disease and Musculoskeletal Infection

Background Inflammatory skin disease including psoriasis and eczema predisposes to colonization with Staphylococcus aureus, a known virulent organism and cause of musculoskeletal infection. An association between skin disease and musculoskeletal infection may exist. Methods We evaluated the presence of skin disease in 65 patients who had undergone orthopedic surgery and had either native or surgical site musculoskeletal infection. Surgery was performed either for management of a native bone or joint infection or preceding the development of a surgical site infection. Four variables of interest, procedure, skin diagnosis, infection and organism, were compared with each other. Results Procedure and infection of the axial skeleton (74%) were more common than procedure and infection of the appendicular skeleton (26%). Inflammatory skin diagnoses were found in 45% of patients. Staphylococci accounted for 51% of infections with 38% due to S. aureus. A majority (60%) of S. aureus infections were in patients with inflammatory skin disease, and 48% of S. aureus infections were native spine osteomyelitis. Conclusions Skin disease may be a potentially modifiable risk factor for musculoskeletal infection, in particular infection due to S. aureus.