["Circumscribed defibrillator erythema": a differential diagnostic and therapeutic problem in differential occult...

Area of Science:

• Cardiology
• Medical Devices
• Dermatology

Background:

• Implantation of automatic cardioverter defibrillators (ICDs) is a common procedure.
• Potential complications include local skin reactions.
• Circumscribed erythema (ICD-E) is a rare adverse event.

Observation:

• Three out of 452 patients (<1%) developed circumscribed erythema after ICD implantation.
• Erythema occurred after initial implantation or pulse generator replacement.
• No clinical signs of inflammation, normal laboratory/technical findings, and ruled-out allergies.

Findings:

• Local or systemic drug treatments did not affect ICD-E.
• Erythema persisted in two patients and improved in one without treatment during follow-up.
• No infections were observed in any patients.

Implications:

• ICD-E is a rare complication of automatic cardioverter defibrillator implantation.
• Specific treatment is often unnecessary if infection or allergy is excluded.
• Distinguishing ICD-E from atypical infections can be challenging.