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All symptoms had resolved by 2.5 months after surgery. After TKA surgery, generalized BP may develop, diagnosed via skin biopsy. A quick diagnosis is important because early treatment can prevent symptom progression and shorten treatment. After TKA surgery, generalized BP may develop, diagnosed via skin biopsy. A quick diagnosis is important because early treatment can prevent symptom progression and shorten treatment. Rectal douching (RD) is widely practiced by men who have sex with men (MSM), and is associated with increased risk of H