Saphenous vein graft donor site dermatitis in Japan

Four cases of saphenous vein graft donor site dermatitis are reported from Japan for the first time. The patients were four Japanese men aged from 57 to 69. They noted pruritic eruptions along the lower extremity scar after coronary artery bypass graft surgery using the autogenous saphenous vein. The eruptions appeared mainly on and around the lower end of the venectomy scars from 1.5 to 9 months after graft operations performed at three different hospitals. All four patients showed an objective sensory deficit of the saphenous nerve around the saphenous vein incision scar, although none of them complained of saphenous neuralgia subjectively. Histologically, two patients showed mild epidermal acanthosis, spongiosis, intraepidermal blisters, and perivascular infiltration of lymphocytes and a few eosinophils around dermal blood vessels. The eruption responded well to topical corticosteroids in all cases, although it recurred again in two patients. The entity is characterized by a subacute (belatedly appearing, then slowly disappearing) dermatitis and a mild sensory deficit of the saphenous nerve. Apparently, mild impediment of the saphenous nerve due to an ablational procedure of saphenous venectomy can play a role in causing saphenous vein graft donor site dermatitis.