Amber Reck Atwater, M.D.Dermatology Residency Program DirectorAssociate Professor of DermatologyDirector, Contact Dermatitis ClinicDuke Dermatology

Contact Allergic Reactions to Implanted Cardiac Devices Interview with:

Amber Reck Atwater, M.D.Dermatology Residency Program DirectorAssociate Professor of DermatologyDirector, Contact Dermatitis ClinicDuke Dermatology

Dr. Reck Atwater

Amber Reck Atwater, M.D.
Dermatology Residency Program Director
Associate Professor of Dermatology
Director, Contact Dermatitis Clinic
Duke Dermatology What is the background for this study? What are the main findings?

Response: We completed an evaluation of our Duke Dermatology patients who underwent patch testing for possible allergy to their cardiac devices – pacemakers and defibrillators.

From March 1, 2012 to September 15, 2017 we saw 11 patients with suspected allergy to their devices.  Concern for allergy, skin eruption, skin symptoms, and concern for infection were common. 73% of patients had erythema at their implant scars; pruritus and pain were also noted.  Six of our patients had relevant reactions, and the most common allergies were metals, silicone and rubber accelerators. What should readers take away from your report?

Response: When there is clinical concern for infection, history of prior device extraction, history of redness at the implant site or negative culture results, allergy testing to cardiac devices should be considered. What recommendations do you have for future research as a result of this work?

Response: I would love to see reports of additional case series from other institutions. Is there anything else you would like to add?

Response: It was a pleasure to work on this project and I’m glad that we were able to contribute our data to the scientific literature. 


Gold M, Nath N, Green C, Atwater AR. Frequency of Contact Allergy to Implanted Cardiac Devices. JAMA Dermatol. Published online April 03, 2019. doi:10.1001/jamadermatol.2019.0036


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Apr 3, 2019 @ 4:11 pm

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1 Comment
  • Anonymous
    Posted at 20:07h, 23 July Reply

    I am writing on behalf of not only myself but thousands of other women that have been implanted with breast implants, that have also experienced contact allergic reactions to BI. Personally, I was tested and found to be allergic to 9 different heavy metals, chemicals etc…and believe that being implanted for so long, the chronic exposure may have destroyed my ability to fend off many allergens/metals/chemicals…I am as well as my doctors, are at a loss. I would love to speak to Dr. Atwater or be involved in any clinical trial she may have. I am suffering terribly… and so are so many other women. Thank you for this article.

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