Annular erythema caused by impending pacemaker extrusion

A 72-year-old patient with an implanted cardiac pacemaker presented with a circumscribed erythematous area on his chest, It was only several months la ter, after he had developed positional, localized pain in this area, that t he diagnosis of an impending pacemaker extrusion became evident. This case illustrates the diagnostic difficulties in patients with pacemaker-associat ed skin lesions, Regular follow-up examinations and close co-operation of d ermatologists, cardiologists and cardiothoracic surgeons are of major impor tance in view of the potentially life-threatening complications.