A Case of Histologically-Diagnosed Pacemaker-Mediated Dermatitis

We report a 90-year-old man, who presented 17 months after his pacemaker implantation with erythema and blistering at site of pacemaker insertion. He was initially treated with non-steroidal anti-inflammatory drugs and anti-allergic agents. After 2 weeks, erythema and blistering at site of pacemaker insertion was cured. However, he had recurrence of erythema and blistering at site of pacemaker insertion after 2 month. To make matters worse, blister had broken with inflammatory granulation tissue and pus, methicillin-sensitive staphylococcus aureus were detected by bacteriological culture. After pacemaker generator and leads removal and administration of antibiotics, new pacemaker generator and leads were implanted another side of chest under greater pectoral muscle. Eosinophilic infiltration was shown in the section of the skin at blister histologically. The histological finding suggest that preexsisting pakemeker-mediated dermatitis cause pacemaker infection.