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Sternal erythema: a distinctive postsurgical eruption.

Michael B Morgan1, Leigh Ann Scalf, Ruth Hanno

  • 1Department of Pathology, James Haley Veterans Hospital, Tampa, Florida, USA.

Journal of the American Academy of Dermatology
|October 26, 2005
PubMed
Summary
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A rare skin eruption can occur after coronary bypass grafting, presenting as erythema and poikiloderma. This postsurgical complication may be linked to reflex sympathetic dystrophy.

Area of Science:

  • Dermatology
  • Cardiovascular Surgery
  • Pathology

Background:

  • Wound complications are common after surgery.
  • A distinctive thoracic surgical wound eruption after coronary bypass grafting (CABG) was observed.

Purpose of the Study:

  • To describe the clinical and pathologic features of patients with this specific postsurgical wound eruption.
  • To identify potential diagnoses and pathogenesis for this condition.

Main Methods:

  • Detailed chart review of 3 patients, including surgical history and biopsy findings.
  • Reconciliation of findings with conventional etiologies.

Main Results:

  • Three white men (59, 68, 73 years) developed symmetrical, asymptomatic erythema and poikiloderma within sternal thoracotomy wound borders 1-2 years post-CABG.

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  • Biopsies showed epithelial atrophy and capillary telangiectases.

    • Conclusions:

    • Differential diagnoses include cellulitis, hypersensitivity to surgical hardware, and costal fringe variants.
    • Postsurgical reflex sympathetic dystrophy is a potential consideration for this eruption.