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Visual Treats in Dermatology
2023
:3;
114
doi:
10.25259/CSDM_126_2023

Suction purpura over the chest at the precordial chest leads to electrocardiogram

Department of Dermatology, JIPMER, Puducherry, India
Corresponding author: Logamoorthy Ramamoorthy, Department of Dermatology, JIPMER, Puducherry, India. logamoorthy.r@gmail.com
Licence
This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-Share Alike 4.0 License, which allows others to remix, transform, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.

How to cite this article: Ramamoorthy L, Tirekha S. Suction purpura over the chest at the precordial chest leads to electrocardiogram. CosmoDerma 2023;3:114.

A 28-year-old male presented with ring-shaped purpuric lesions over the upper left chest following an electrocardiogram (ECG). The patterned lesions correspond to the site of ECG leads. Cutaneous examination revealed well-defined petechial purpuric rashes over the chest in a distribution typical of precordial chest leads [Figure 1]. There was no history of itching, pain, or bleeding. Allergic contact dermatitis can be caused by ECG gels or pastes, alcohols found on prepacked gauzes, rubber or metal electrodes, and pads used as a substitute for ECG paste. As there was no significant itching or personal history of allergic reactions, the possibility of allergic contact dermatitis to ECG leads was not considered, and a patch test was also not performed. Complete hemogram, coagulation profile, and platelet count were within normal limits. A clinical diagnosis of purpuric lesions secondary to ECG chest leads suction balls was made.

Figure 1:
Well-defined circumscribed purpuric skin lesions over the chest corresponding to the precordial V1–V6 chest leads.

Suction purpura results from an external source exerting a negative pressure on a circumscribed skin area, producing small grouped petechiae. It is limited to the site of increased negative pressure. It can be caused by ECG leads, therapeutic cups, vacuum extractors, hickeys, gas masks, and neurotic suctions. Suction purpuric lesions make us rule out any underlying hematological disorder. Purpuric lesions secondary to suction do not need any extensive workup or treatment.

The lesions disappear within a few weeks without any treatment.[1] There are no such observations published in the available literature and hence the reporting of the image to alert physicians and ECG technicians.

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent.

Conflicts of interest

There are no conflicts of interest.

Use of artificial intelligence (AI)-assisted technology for manuscript preparation

The authors confirm that there was no use of Artificial Intelligence (AI)-Assisted Technology for assisting in the writing or editing of the manuscript and no images were manipulated using the AI.

Financial support and sponsorship

Nil.

References

  1. , , , . Suction purpura: A playful clue to an acute perioral rash. J Paediatr Child Health. 2020;56:1488.
    [CrossRef] [PubMed] [Google Scholar]

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