Device infection mimicry: Physical examination characteristics and procedural technique for pacemaker-associated skin cancer

•Pocket infection is a serious complication involving cardiovascular implanted electronic devices, typically managed with complete extraction of the device and leads.•It is important to recognize that mimickers of infection exist, which warrant different clinical management.•The physical examination can help distinguish true device infection from other mimickers of pocket infection, and can thereby direct appropriate management strategy.•It is possible to surgically address superficial skin processes over a device pocket without entering the pocket itself, even when minimal subcutaneous fat is present.