Telangiectatic pacemaker erythema [1]
Journal
Clinical and Experimental Dermatology
Journal Volume
28
Journal Issue
4
Pages
447-448
Date Issued
2003
Author(s)
Abstract
A 70‐year‐old man received a pacemaker implant beneath the left clavicle in December 2000 because of arrhythmia. The incision by which the pacemaker was inserted healed without any sequelae. In April 2002, he noticed a symptomless erythematous patch appearing on the skin overlying the pacemaker. One telangiectatic vessel appeared inside this patch subsequently. The telangiectatic patch, along with the telangiectatic vessels, extended gradually toward the sternum in the following months. Several smaller telangiectatic vessels developed later. On physical examination, there was a 13 × 9 cm blanchable erythematous patch on his chest, extending from the pacemaker to the sternum (Fig. 1). There were no discernable epidermal changes. Several 1–2 mm‐wide telangiectatic vessels serpentined on this patch. A vertical scar due to a previous operation for mitral valve replacement is also noted on the presternal area. A skin biopsy specimen was taken from the medial‐lower quadrant of the patch, which included one clinically evident telangiectatic vessel. Histopathological examination revealed many dilated thin‐walled vascular channels in the upper dermis. The epidermis and lower reticular dermis were unremarkable. The inflammatory response was minimal (Fig. 2). Patch tests with European standard series and a panel of metal allergens, including copper sulphate 1% aq., potassium dicyanoaurate 0.002% aq., sodium thiosulphatoaurate 0.5%, ammonium tetrachloroplatinate 0.25% pet., and palladium chloride 1% pet. were negative at 24 and 48 h. Curiously, the telangiectasia somewhat involuted after the procedure of skin biopsy only.
SDGs
Type
letter