A case with combination of pyoderma gangrenosum and cardiac sarcoidosis successfully implanted with a dual-chamber pacemaker

Abstract

A patient with ulcerated skin lesions of unknown etiology on his left leg underwent pacemaker implantation for atrioventricular block caused by cardiac sarcoidosis (CS). After initiation of corticosteroid for CS, his skin lesions improved. The lesions were diagnosed as pyoderma gangrenosum (PG) from the findings of a skin biopsy and the reaction to corticosteroid. PG causes skin necrosis associated with immune system disorders after slight stimulation. Although we worried about wound healing after pacemaker implantation, the wound healed well under the corticosteroid treatment. This is the first report of successful pacemaker implantation in a patient with both PG and CS.

Learning objective

Conventional transvenous pacemakers can be implanted for pyoderma gangrenosum patients by early initiation of corticosteroid.