Erythema ab igne

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Erythema ab igne
Other namesFire stains, [1] laptop thigh, granny's tartan, Koruda erythema, toasted skin syndrome [1]
Hotbottlerash.JPG
Erythema ab igne in a person with chronic abdominal pain who found some relief from the application of heat.
Specialty Dermatology

Erythema ab igne ( Latin for 'redness from fire')EAI, also known as hot water bottle rash, [2] is a skin condition caused by long-term exposure to heat (infrared radiation). [3] Prolonged thermal radiation exposure to the skin can lead to the development of reticulated erythema, hyperpigmentation, scaling, and telangiectasias in the affected area. Some people may complain of mild itchiness and a burning sensation, but often, unless a change in pigmentation is seen, it can go unnoticed.

Contents

Causes

Reticulated, interlacing, hyperpigmented patches with a few, scattered, erythematous macules at junctions on the medial aspects of the lower legs Erythema ab igne.jpg
Reticulated, interlacing, hyperpigmented patches with a few, scattered, erythematous macules at junctions on the medial aspects of the lower legs

Different types of heat sources can cause this condition such as:

Pathogenesis

The pathogenesis of erythema ab igne remains unknown. It has been proposed that thermal radiation exposure can induce damage to superficial blood vessels that subsequently leads to epidermal vascular dilation. The dilation of vessels presents morphologically as the initially observed erythema. [4] Red blood cell extravasation and deposition of hemosiderin that follows clinically appear as hyperpigmentation, which can occur in a reticular distribution. It has also been proposed that the distribution of affected blood vessels—predominantly in the superficial subcutaneous plexus (found in the papillary dermis)—results in the net-like pattern of erythema ab igne skin lesions.

Diagnosis

Differential diagnosis

Treatment

Discontinuing contact with the heat source is the initial treatment of erythema ab igne. [5] If the area is only mildly affected with slight redness, the condition may resolve after a few months. If the condition is severe and the skin pigmented and atrophic, then it is unlikely to resolve. In this case, there is a possibility that a squamous cell carcinoma or a neuroendocrine carcinoma such as a Merkel cell carcinoma may form. [6] If there is a persistent sore that does not heal or a growing lump within the rash, a skin biopsy should be performed to rule out the possibility of skin cancer. If the erythema ab igne lesions demonstrate pre-cancerous changes, the use of 5-fluorouracil cream has been recommended.[ medical citation needed ] Abnormally pigmented skin may persist for years. Treatment with topical tretinoin or laser treatment may improve the appearance.[ medical citation needed ]

Epidemiology

Erythema ab igne was once commonly seen in the elderly who stood or sat closely to open fires or electric heaters; however, erythema ab igne has been reported in both young and elderly individuals. [4] Women have a higher incidence of erythema ab igne than men. Although wide use of central heating has reduced the overall incidence of erythema ab igne, it is still sometimes found in people exposed to heat from other sources such as heating pads, space heaters, hot water bottles, and electronic devices.

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References

  1. 1 2 Rapini, Ronald P.; Bolognia, Jean L.; Jorizzo, Joseph L. (2007). Dermatology: 2-Volume Set. St. Louis: Mosby. pp. Chapter87. ISBN   978-1-4160-2999-1.
  2. Rudolph CM, Soyer HP, Wolf P, Kerl H (February 1998). "Hot-water-bottle rash: not only a sign of chronic pancreatitis". Lancet. 351 (9103): 677. doi:10.1016/S0140-6736(05)78465-8. PMID   9500360. S2CID   40827390.
  3. Riahi RR, Cohen PR, Robinson FW, Gray JM (Nov 2010). "Erythema ab igne mimicking livedo reticularis". International Journal of Dermatology. 49 (11): 1314–7. doi:10.1111/j.1365-4632.2009.04433.x. PMID   20964656. S2CID   30189490.
  4. 1 2 3 "What Caused This Hyperpigmented Reticulated Rash On This Man's Back?". The Dermatologist. Jan 14, 2013.
  5. 1 2 3 4 Cohen, Philip R.; Riahi, Ryan R. (June 2012). "Laptop-induced erythema ab igne: Report and review of literature". Dermatology Online Journal. 18 (6): 5. PMID   22747929 . Retrieved 21 January 2013.
  6. Tan, S; Bertucci, V (2000). "Erythema ab igne: an old condition new again". Canadian Medical Association Journal. 162 (1): 77–78. PMC   1232235 . PMID   11216204.