Silver-Induced Contact Dermatitis From Electrocardiography Monitoring Electrodes: A Case Report

Twelve-lead electrocardiography is among the most commonly performed and essential investigations in hospitals worldwide. This paper describes the development of suspected silver-induced contact dermatitis in a 57-year-old patient requiring continuous cardiac monitoring in the cardiac intensive care unit (CCU). The patient developed multiple, well-demarcated erythematous annular lesions over the chest following exposure to silver-containing electrocardiographic electrodes. The patient received multidisciplinary care addressing his heart failure, obstructive uropathy, and contact dermatitis before being transferred to a better-equipped national cardiac center for optimal management of his acute cardiac illness. Dermatological manifestations associated with silver-containing electrodes are rarely reported in the literature, further emphasizing the importance of thorough history taking and routine physical examination in daily clinical practice. This case also highlights the need for physicians to maintain a high index of suspicion for contact dermatitis related to medical devices, enabling prompt recognition of complications and the formulation of individualized management plans tailored to each patient's clinical needs. As confirmatory patch testing was not performed, a definitive diagnosis of silver allergy could not be established.