title: [Mid-dermal elastolysis after insertion of a pacemaker].
abstract: BACKGROUND
  Mid-dermal elastolysis (MDE) is a rare acquired disease of elastic tissue histologically characterized by focal loss of elastic fibres within the mid-dermis. While the mechanisms leading to MDE remain unknown, increased degradation of elastic fibres may be involved. Many factors potentially triggering such degradation have been suggested.
  
  
  METHODS
  A 58-year-old man consulted for an asymptomatic reticulated eruption that began in the area of a pacemaker implanted six weeks earlier. The eruption consisted of erythematous polycyclic and coalescing macules with a wrinkled centre. Histopathology with orcein staining revealed focal loss of elastic fibres in the superficial reticular dermis only. Hypersensitivity reaction to any components of the pacemaker was ruled out by means of allergy exploration. Laboratory investigations including autoimmunological and haematological factors were unremarkable. A diagnosis was made of a reticular variant of MDE following insertion of a pacemaker.
  
  
  CONCLUSIONS
  We report the second case of MDE following the insertion of a pacemaker, which could have triggered an inflammatory response directed specifically towards the elastic fibres.
authors.affiliation: Service de dermatologie, centre hospitalier de Valence, 179, boulevard du Maréchal-Juin, 26000 Valence, France. Electronic address: kottler.diane@gmail.com.
authors.forename: D
authors.initials: D
authors.lastname: Kottler
authors.affiliation: Service de dermatologie, centre hospitalier de Valence, 179, boulevard du Maréchal-Juin, 26000 Valence, France.
authors.forename: A
authors.initials: A
authors.lastname: Lefèvre
authors.affiliation: Service de dermatopathologie, centre hospitalier Lyon-Sud, 165, chemin du Grand-Revoyet, 69495 Pierre-Bénite cedex, France.
authors.forename: B
authors.initials: B
authors.lastname: Balme
authors.affiliation: Service de dermatologie, centre hospitalier de Valence, 179, boulevard du Maréchal-Juin, 26000 Valence, France.
authors.forename: V
authors.initials: V
authors.lastname: Martin-Bourret
authors.affiliation: Service de dermatologie, centre hospitalier de Valence, 179, boulevard du Maréchal-Juin, 26000 Valence, France.
authors.forename: D
authors.initials: D
authors.lastname: Zaharia
authors.affiliation: Service de dermatologie, centre hospitalier de Valence, 179, boulevard du Maréchal-Juin, 26000 Valence, France.
authors.forename: F
authors.initials: F
authors.lastname: Skowron
mesh_terms: D020405:Dermis / Q000473:pathology*; D004547:Elastic Tissue / Q000473:pathology*; D004890:Erythema / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010138:Pacemaker, Artificial / Q000009:adverse effects*; D012871:Skin Diseases / Q000209:etiology* / Q000473:pathology*
keywords: Derme moyen; Elastolysis; Mid-dermal elastolysis; Pacemaker; Reticular variant; Stimulateur cardiaque; Élastolyse; Érythème réticulé