Case reportHeat-Triggered Reticular Telangiectatic Erythema Induced by a Spinal Cord Stimulator
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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2021, JPRAS OpenCitation Excerpt :The origin of this entity is still not clear. Some of the potential causal factors involved include the generation of an electromagnetic field by pacemakers, implantable defibrillators, spinal cord stimulators and infusion pumps; the heat generated by them9; and the changes in local circulation or the pressure applied to the skin surrounding these devices.7,10 One argument to support the generation of heat and an electromagnetic field of the devices as the cause is the series of cases in which the skin lesions receded after the devices were deactivated,9 as well as the tests with thermographic cameras which show an increase of the temperature of the areas with skin lesions.9
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