Pacemaker Lead Erosion Presenting as a Scaly Papule with Electric Shock Sensations

Summary: This case report describes a 72-year-old male patient with a complex cardiac history, including multiple pacemaker revisions for recurrent atrial arrhythmias, who presented with a scaly papule at the site of his pacemaker lead. The patient reported intermittent electric shock sensations localized to the area. Examination revealed lead erosion with overlying infection, confirmed by imaging and clinical evaluation. The patient was treated with IV antibiotics and underwent lead revision surgery. This case highlights the importance of recognizing subtle dermatologic manifestations of pacemaker lead erosion, a rare but potentially serious complication, and emphasizes the need for multidisciplinary care in managing such presentations.