Reticular Telangiectatic Erythema Associated With an Implantable Cardioverter Defibrillator

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“…2 Reticular telangiectatic erythema has been reported in conjuction with cardiac devices and an implanted intrathecal infusion pump. [3][4][5] The histopathologic features in these cases showed similar changes to what we observed with epidermal atrophy (ie, papillary dermal telangiectases and a sparse perivascular lymphohistiocytic infiltrate). Common to all referenced cases was the presence of metal either in the form of cardiac devices, pumps, or sternal wires, engendering consideration that the metal itself may have pathogenically contributed to the eruptions.…”

“…This approach was validated and displayed a safe reduction in the number of biopsies performed. 4 Furthermore, more recent data suggest that 3.5 to 4.0g, instead of 1.0 to 1.5 g, of cumulative methotrexate dose should prompt the first liver biopsy in patients without preexisting risk factors for hepatotoxicity. 2,5 Only those patients with one or more risk factors for hepatic fibrosis should be followed using the current AAD guidelines.…”

Telangiectatic Reticular Erythema Unrelated to Cardiac Devices

“…1 To date, RTE has not been associated with the use of other devices or subcutaneously implanted metal devices; therefore, it has been suggested that RTE is exclusively associated with the use of cardiac devices. 2 The present report describes a case of RTE that was unrelated to the use of either pacemakers or implantable cardioverter defibrillators.…”

Is postsurgical sternal erythema synonymous with reticular telangiectatic erythema?

“…Histopathology has consistently shown telangiectasias in the papillary dermis and a sparse to moderate superficial perivascular lymphohistiocytic dermal infiltrate. 3 Recently, an additional case report has described the occurrence of RTE in a patient with an implanted intrathecal infusion pump. 4 Whereas previous reports had attributed RTE to heat or electromagnetic fields generated by the implantable devices, Mercader-Garcia et al 4 stated that the intrathecal infusion pump did not generate enough heat or electromagnetic energy to cause such an eruption, and instead suggested that the mere implantation of subcutaneous metal may have contributed to this unique skin eruption.…”