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Erythema Ab Igne


Presentation

  • Herein, we report a rare case of EAI presenting on both sides of me neck due to the use of a modem home skincare device.[koreauniv.pure.elsevier.com]
  • A key feature that can distinguish erythema ab igne from other reticular rashes is its presentation in the setting of chronic heat exposure as levido reticularis and cutis marmorata are often present with exposure to cold and other rashes present without[ncbi.nlm.nih.gov]
  • Telangiectasias and hyperkeratosis may also be present. Rarely, EAI can present with bullous lesions. EAI typically occurs on the legs, lower back, and abdomen but may occur on any and all body surfaces.[dermatologyadvisor.com]
  • While these cases have offered diverse presentations, our case demonstrates another novel presentation of erythema ab igne.[scielo.br]
  • On examination, he was icteric with hepatomegaly present. His abdominal wall showed reticulated, erythematous patch on his abdomen distributed in a strikingly rectangular pattern (Figure 1). The patch was b lanchable and nontender.[semanticscholar.org]
Hunting
  • Miller K, Hunt R, Chu J, Meehan S, Stein J. Erythema ab igne. Dermatol Online J 2011;17:28. 4. Arnold AW, Itin PH. Laptop computer-induced erythema ab igne in a child and review of the literature. Pediatrics 2010;126:e1227-30. 5.[jpgmonline.com]
  • J Cutan Med Surg 2011; 15: 347-353 7 Miller K, Hunt R, Chu J et al. Erythema ab igne. Dermatol Online J 2011; 17: 28 8 Arnold AW, Itin PH. Laptop computer-induced erythema ab igne in a child and review of the literature.[thieme-connect.com]
  • Erythema ab igne Kristen Miller MD, Raegan Hunt MD PhD, Julie Chu MD, Shane Meehan MD, Jennifer Stein MD PhD Dermatology Online Journal 17 (10): 28 Department of Dermatology, New York University, New York, New York Abstract Erythema ab igne is a reticulated[escholarship.org]
Anemia
  • Cirrhosis, malnutrition, hypothyroidism, internal malignancy, Hansen disease, and anemia are some of the medical conditions that have been associated with EAI.[scielo.conicyt.cl]
  • Routine blood examination revealed a microcytic anemia with iron deficiency and an elevated ESR, suggesting a diagnosis of livedo reticularis secondary to systemic disease.[dermatologyadvisor.com]
  • A case of bullous erythema ab igne accompanied by anemia and subclinical hypothyroidism. Dermatol Online J. 2014 Apr 16. 20(4):22336. [Medline]. Fischer J, Rein K, Erfurt-Berge C, de Zwaan M.[emedicine.medscape.com]
Hyperthermia
  • The exposure, which need not be of long duration, results in cutaneous hyperthermia in the range of 43 -47 C. The histopathologic changes are however similar to those seen in solar-damaged skin.[mjdrdypu.org]
  • The exposure, which need not be of long duration, results in cutaneous hyperthermia in the range of 43-47 C. Erythema ab igne results in histopathologic changes similar to those seen in solar-damaged skin.[emedicine.medscape.com]
Malnutrition
  • Cirrhosis, malnutrition, hypothyroidism, internal malignancy, Hansen disease, and anemia are some of the medical conditions that have been associated with EAI.[scielo.conicyt.cl]
Abdominal Obesity
  • Erythema ab igne following Sauna belt use for abdominal obesity and cellulite. Int J Dermatol. 2009 Jan. 48(1):94-5. [Medline]. Helm TN, Spigel GT, Helm KF. Erythema ab igne caused by a car heater. Cutis. 1997 Feb. 59(2):81-2. [Medline].[emedicine.medscape.com]
Splenomegaly
  • Occasionally, the first sign of splenomegaly, pancreatitis, pancreatic cancer, and other cancers is erythema ab igne resulting when patients applying external heat to relieve the underlying pain. [8] The condition is also likened to Khagri Cancer, common[mjdrdypu.org]
  • Occasionally, the first sign of splenomegaly, pancreatitis, pancreatic cancer, and other cancers is erythema ab igne resulting when patients apply external heat to relieve the underlying pain. [21] Work exposure to heat (eg, for bakers, silversmiths,[emedicine.medscape.com]
Hypertension
  • Available from: :: Introduction A 72-years-old male patient of Arab origin with hypertension, long-standing type II diabetes and diabetic neuropathy (manifested by long-standing glove and stocking hypo-aesthesia, and the loss of distal proprioception[jpgmonline.com]
Hyperkeratosis
  • Biopsies are relatively non-specific and can show a range of characteristic findings including atrophy, hemosiderin deposition, telangiectasias, hyperkeratosis, and increased elastin.[ncbi.nlm.nih.gov]
  • Over time and with repeated exposures, the lesions become hyperpigmented and fixed, with overlying atrophy and occasional telangiectases or hyperkeratosis in later stages.[escholarship.org]
  • […] space heaters and other localized heat sources. 2 A modern manifestation of the condition has been seen on the anterior thighs of people who use laptop computers. 3 Histopathologic findings of thermal-induced injury include epidermal and dermal atrophy, hyperkeratosis[cmaj.ca]
  • […] erythema confined to the affected geographic area that reflects that shape and size of the heat source. 4 With continued heat exposure, the area then develops into a fixed, reticulated pattern of hyperpigmentation, which can progress to skin atrophy, hyperkeratosis[scielo.br]
  • Hyperkeratosis and dyskeratosis may be seen in some cases, similar to changes in actinic keratosis; as a result EAI has been referred to as “thermal keratosis.” Figure 2.[dermatologyadvisor.com]
Lichenification
  • Figure 1: Typical erythema ab igne lesions with reticulate erythema and brownish hyperpigmentation, with subsequent lichenification in regions repeatedly subjected to thermal injury by a kerosene stove placed between the legs in wintertime Click here[jpgmonline.com]
Macula
  • The reticulated maculae could fade after stopping the heat exposure, persist as hyperpigmentation and in single cases a malignant transformation is possible.[thieme-connect.com]
Alopecia
  • The patient had a history of alopecia totalis for the previous four years, which had been treated with a Janus kinase (JAK) inhibitor for the previous five months.[scielo.br]
Suggestibility
  • The clinicopathological features suggested a diagnosis of EAI. To our knowledge, mere has only been one reported case of EAI on me neck related to a thermal pillow, and diis was the first case of EAI related to the self-skincare devices.[koreauniv.pure.elsevier.com]
  • Tretinoin may be used for more advanced cases, and epithelial atypia might be managed with 5-fluorouracil cream. [2] Our small series suggest that special attention is warranted specifically in diabetics practicing the use of heating devices. :: References[jpgmonline.com]
  • In cancer patients it may be a helpful localizing sign, and in all patients (apart from the anterior lower legs of old people) it is very suggestive of a serious underlying cause.[journals.sagepub.com]
  • Routine blood examination revealed a microcytic anemia with iron deficiency and an elevated ESR, suggesting a diagnosis of livedo reticularis secondary to systemic disease.[dermatologyadvisor.com]
  • The various treatment modalities suggested for erythema ab igne include topical retinoids, with or without topical steroids and 5-fluorouracil cream 3. Progression of the disease can only be halted by the avoidance of further heat exposure.[scielo.conicyt.cl]
Stroke
  • […] patient of Arab origin with hypertension, long-standing type II diabetes and diabetic neuropathy (manifested by long-standing glove and stocking hypo-aesthesia, and the loss of distal proprioception and deep tendon reflexes), presented with hemorrhagic stroke[jpgmonline.com]
  • (This chapter focuses on environmental and sports-related skin disorders, including thermal burns and heat-related illnesses such as: heat edema and heat stroke, burns from fluoroscopy and magnetic resonance imaging, and injury due to electricity, cold[dermatologyadvisor.com]

Workup

  • Malignancy workup may be necessary if there is a high index of suspicion that the heating pad is being used to alleviate pain due to underlying primary malignancy, metastatic disease, or chronic pancreatitis [9].[cureus.com]
Dyslipidemia
  • Past medical history included a possible cardiac murmur, dyslipidemia, and carpal-tunnel syndrome. Medications included aspirin and simvastatin. The patient had retired from the police force approximately seven years ago.[escholarship.org]

Treatment

  • Until today, there has been no effective treatment for erythema ab igne, and removing the heat source is the mainstay of the treatment.[jkslms.or.kr]
  • Erythema Ab Igne (Treatment) Erythema Ab Igne (Treatment) Erythema Ab Igne Treatment & Management: Medical Care, Surgical Care, Activity Edition: No Results No Results Please confirm that you would like to log out of Medscape.[tripdatabase.com]
  • In chronic cases in which premalignant cutaneous dysplasia has resulted, additional treatments may be necessary including topical retinoids, 5-fluorouracil cream, and laser treatments.[ncbi.nlm.nih.gov]
  • TREATMENT OPTIONS The first-line treatment for erythema ab igne is to stop exposure to the offending heat source. The hyperpigmentation may slowly fade over several years.[mdedge.com]
  • The eruption itself is mostly asymptomatic, and treatment is not usually required.[cmaj.ca]

Prognosis

  • Prognosis of EAI is good, with removal of the heat source resulting in complete remission.[ncbi.nlm.nih.gov]
  • Although there is generally a good prognosis when treating EAI, the risk of malignant transformation by various cells is well documented. 4, 5 Identifying and avoiding the offending exposure with continued monitoring of the affected area is important.[scielo.br]
  • Prognosis The prognosis is good, except those cases associated with internal disease or metastatic malignancy. Early changes, such as erythema and little or no hyperpigmentation, may resolve within several months.[emedicine.medscape.com]
  • Although erythema ab igne carries a good prognosis, it is not necessarily a self-limited diagnosis as patients are at long-term risk of developing subsequent cutaneous malignant conditions, which include squamous cell and merkel-cell carcinomas.[escholarship.org]

Etiology

  • They review other reported etiologies and highlight scenarios in which military medical providers may encounter erythema ab igne. Manufacturer: Breakaway Media, LLC[jsomonline.org]
  • Some patients use a heat source (eg, heating pad, hot water bottle, heated recliner, heated blanket) to relieve chronic pain. [5] In these patients, determine the etiology of the pain.[emedicine.medscape.com]
  • Gov't (...) 2013 04 24 United States J Gen Intern Med 8605834 0884-8734 IM Adult Erythema diagnosis etiology Hot Temperature adverse effects Humans Male Marijuana Abuse complications diagnosis Vomiting diagnosis etiology 2012 12 01 2013 03 25 2013 02[tripdatabase.com]
  • Etiology Pathophysiology Although the pathophysiology of EAI is not entirely understood, repeated heat exposure is thought to cause epidermal dysplasia.[dermatologyadvisor.com]
  • Etiology Historically, this rash has correlated with heating sources emitting infrared radiation such as fires, wood burning stoves, and kerosene lamps; however, with the advent of central heating sources, it is seen less commonly.[ncbi.nlm.nih.gov]

Epidemiology

  • The epidemiology may be different too, with younger patients than previously seen. Localized EAI over an area of pain in the abdomen or lower back can be a sign of an underlying disorder, including cancer.[ncbi.nlm.nih.gov]
  • The epidemiology may be different too, with younger patients than previously 2017 International Journal of Dermatology 7.[tripdatabase.com]
  • The section on EAI briefly discusses epidemiology, pathogenesis, clinical and histologic features, and differential diagnosis. The author highlights treatment of EAI, specifically removal of the heat source and 5-FU.)[dermatologyadvisor.com]
  • […] bottles Electric stoves/heater Open fires Coal stoves Peat fires Wood stoves Steam radiators Car heaters Heated reclining chairs Heating or electric blanket Hot bricks Infrared lamps Microwave popcorn Laptop computer Automobile seat heater Hot bathing Epidemiology[emedicine.medscape.com]
Sex distribution
Age distribution

Pathophysiology

  • The pathophysiology of the condition is not fully understood; however, the hypothesis is that the repeated heat exposure damages superficial blood vessels leading to hemosiderin deposition and subsequent hyperpigmentation.[ncbi.nlm.nih.gov]
  • Etiology Pathophysiology Although the pathophysiology of EAI is not entirely understood, repeated heat exposure is thought to cause epidermal dysplasia.[dermatologyadvisor.com]
  • Pathophysiology Erythema ab igne (EAI) is a reticulate hypermelanosis with erythema resulting from repeated heat exposure that induces injury to the epidermis and superficial vascular plexus.[emedicine.medscape.com]
  • Pathophysiologically, erythema ab igne is a reticulate hypermelanosis with erythema resulting from repeated heat exposure that induces injury to the epidermis and superficial vascular plexus.[mjdrdypu.org]
  • The pathophysiology is unknown, but this level of infrared radiation induces changes in dermal elastic fibers that are similar to those observed in actinically-damaged skin [ 1, 3 ].[escholarship.org]

Prevention

  • […] minus' sign Virchow -triad Use Parentheses water AND (cup OR glass) Add an asterisk (*) at end of a word to include word stems Neuro* will search for Neurology, Neuroscientist, Neurological, and so on Use quotes to search for an exact phrase "primary prevention[read.qxmd.com]
  • Erythema ab igne is a preventable skin dermatosis, and the importance of patient education is critical in preventing disease progression. The majority of these patients will present to the primary care provider or nurse practitioner.[ncbi.nlm.nih.gov]
  • Removal of heat exposure can only prevent the progression of disease, but if not removed, pigmentation abnormalities may persist and progress to the severe chronic advanced stage which can develop cutaneous atrophy or malignancy.[jkslms.or.kr]
  • Erythema ab igne Erythema ab igne Erythema ab igne Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy[tripdatabase.com]
  • She avoided the contact with the abdomen to prevent a stimulation of the digestion. Therefore the EAI was located predominantly on the medial thighs.[thieme-connect.com]

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