Retikuläre teleangiektatische Erytheme nach Implantation von elektrischen medizinischen Geräten

Abstract

Reticulated telangiectatic erythema (RTE) is a rare skin reaction to extraneous materials. We present three cases in which asymptomatic persistent erythemas developed in the area of implantation after medical devices were inserted. Topical and systemic treatment did not improve the skin changes. Patch testing including applied materials showed negative results in all cases. Histological investigation of punch biopsy specimens showed moderate dilatated vessels and a slight lymphocytic infiltrate. Due to our findings and in synopsis with the clinical impression we diagnosed RTE. As RTE is asymptomatic in most cases, the devices need not be removed.

A Case Report of Reticular Telangiectatic Erythema Following Intrathecal Drug Delivery System Reservoir Replacement

“…The case presented here of RTE is not well documented in the pain management literature, but has been found in the dermatology and cardiology journals especially relating to implantable cardiac defibrillator (ICD) and pacemaker implantation (3). Presently, literature search yielded only three documented cases of RTE relating to IDDS implantation (3)(4)(5). Moreover, the case presentations were analogous to our own, with development of a pruriginous erythematous plaque nonresponsive to topical steroids and punch biopsy revealing telangiectatic vessels associated with perivascular lymphocyte infiltration (4,5).…”

“…Presently, literature search yielded only three documented cases of RTE relating to IDDS implantation (3)(4)(5). Moreover, the case presentations were analogous to our own, with development of a pruriginous erythematous plaque nonresponsive to topical steroids and punch biopsy revealing telangiectatic vessels associated with perivascular lymphocyte infiltration (4,5). Patch testing for allergic reaction was considered in our case.…”

“…Patch testing for allergic reaction was considered in our case. However, it was ultimately deferred as this patient had not experienced reaction to prior implants of the same composition, biopsy results were not suggestive of allergic reaction, and RTE literature often shows negative results (3)(4)(5).…”