Cutaneous Reaction to an Epoxy-Coated Pacemaker

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Abstract
Cutaneous reactions to implanted materials occur, but implanted cardiac pacemakers rarely have been suspected as the triggering agent. Raque and Goldschmidt1 described a patient with circumscribed eczematous dermatitis occurring over the site of a pacemaker within three weeks of implantation. Later, widespread nummular eczema developed. The authors discussed whether it was an irritant dermatitis due to a medicalgrade silicone elastomer or nummular eczema provoked by an irritant dermatitis. Patch tests in a patient and two control subjects with the uncured silicone adhesive gave positive reactions that were thought to be irritant reactions. The patient's dermatitis improved even though the pacemaker was not removed. Recently I suspected a patient to have "pacemaker dermatitis." The cause relationship seemed clear, but the mechanism did not. Report of a Case A 65-year-old man with Stokes-Adams syndrome had an epoxy-coated pacemaker (Medtronic) implanted subcutaneously in the right infraclavicular region in December 1975. There was