Elsevier

Mayo Clinic Proceedings

Volume 88, Issue 1, January 2013, Pages 117-119
Mayo Clinic Proceedings

Case report
Heat-Triggered Reticular Telangiectatic Erythema Induced by a Spinal Cord Stimulator

https://doi.org/10.1016/j.mayocp.2012.10.019Get rights and content

Abstract

In recent years, cutaneous complications have been reported after implantation of medical devices as a result of their widespread use. We report a case of reticular telangiectatic erythema (RTE) after replacement of a spinal cord stimulator. To date, the pathogenesis of RTE has been poorly understood. Some reports have suggested that heat is involved, whereas others seem to contradict this observation. In our thermographic study, we found that heat can cause RTE.

Section snippets

Case Report

A 72-year-old man with a 4-month history of progressive telangiectatic erythema on his abdomen was referred to our department in December 2010. The erythema had appeared 10 days after replacement of an SCS pulse generator and connector block (PrimeAdvanced Neurostimulator, model 37702). The patient had a history of refractory angina pectoris (third degree according to the grading of the Canadian Cardiovascular Society), which led to implantation of an SCS 8 years earlier. Examination of the

Discussion

Since 1967, spinal cord stimulation has been used in the treatment of many chronic pain disorders including severe angina.4, 5 It is an adjustable, nondestructive neuromodulatory procedure that delivers therapeutic doses of electrical current to the spinal cord.5 Adverse events associated with permanent SCS implantation include paralysis or severe neurologic deficit, infection of the implanted hardware, leakage of cerebrospinal fluid, painful stimulation, and persistent pain at the implant site.

Conclusion

In the present case of heat-triggered RTE induced by an SCS, thermography suggested that a broken extension electrode sheath may have caused leakage of current and consequent overheating of local tissue. After switching off the SCS, the erythema largely disappeared after 10 days. Results of the thermographic study and the observation that no skin changes occurred after replacement of the broken device confirms that heat can cause RTE.

Acknowledgments

The authors thank Dr Etienne Holl, Department of Neurosurgery, Medical University of Graz, for his support.

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There are more references available in the full text version of this article.

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