[Circumscribed erythema after cardiac pacemaker implantation]

The pathological reactions of the tissue under the picture of a circumscriptive erythema above the pacemaker-pouch of a 35-year-old patient was noticed and documented for more than 10 years. Repeated appearance of a painful and fluctuating swelling above the silicone-containing implant, as well as non-symptomatic intervals during times without application of silicone-material led to the assumption of an allergic contact dermatitis to the silicone components of the pacemaker. However, patch-testing of the pacemaker's constituents remained negative and could not verify this supposition. The diagnosis of a foreign-body-reaction was histologically set up. In its progress a stenosis of vessels as well as an activation of the T-cell-system can follow. Therefore, it might be possible that different factors meshing with each other can modify the cause-consequence-structure and can lead to the erythematic changes.