Erythema Ab Igne

What is Erythema Ab Igne

Erythema Ab Igne is a skin condition that is caused by long term exposure to heat.  It is often referred to as hot water bottle rash, laptop thigh, granny’s tartan, toasted skin syndrome or fire stains. It is an uncommon skin disorder that has a fish net like pattern of hyper pigmentation on the skin. The name means redness from  fire.  Woman have a higher chance then men to contract erythema ab igne.  It was once seen commonly in elderly people who sat too close to open fires or heat sources, but is also seen in young individuals.

Caueses of Erythema Ab Igne

Causes of erythema ab igne include repeated exposure to heated car seats, space heaters, and fireplaces, repeated application of hot water bottles or heated blankets (often used to treat pain), or resting a laptop on the thighs.  Occupations that can cause erythema ab igne include bakers, chefs, blacksmiths and jewelers. The form of heat range to cause damage to the skin is from 43 degrees C to 47 degrees C.

Symptoms associated to Erythema Ab Igne

Lesions on the skin are usually asymptomatic, but can be associated with itching, burning and pain. Often times the condition will go unnoticed until it is seen with the eyes.  The lesions start on the skin as small pink patches but will progress into reddish or brown reticulated patterns.  Multiple stages of the lesions can be present on the skin.  The fish net or lacy patterns on the skin are caused from injuries to the super vascular networks and the outer layers of skin after exposure to heat. The skin will often become thinner as does the underlying tissue, causing the lesions to form.  They are often described as blotchy looking.

Treatments for Erythema Ab Igne

Treatments for erythema ab igne include stopping the contact from the heat source. Often times the condition will resolve itself if there is  a mild case of it. If the skin is severely damaged, there is often not a chance to resolve it. In this case, squamous cell carcinoma or neuroendocrine carcinoma could form. Sores that do not heal, or grow to form a lump with a rash may need a skin biopsy performed to rule out skin cancer. Topical tretinoin can help to improve the appearance of the skin, as can laser treatments. If pre-cancerous changes are being made to the skin, a 5 fluorouracil cream can be prescribed.

The prognosis for treating erythema ab igne (EAI) is very good if the heat source is removed right away. If the heat source is not removed quick enough, there is a chance that pigmentation abnormalities may persist on the skin. Complications of EAI include malignant degeneration, which should be closely monitored.

How to prevent Erythema Ab Igne?

To prevent erythema ab igne, you must stay away from prolonged exposure to heat sources.  Do not sit to close to fires, wood stoves, or space heaters.  If you use water bottles for injuries, limit the amount of time that a water bottle is used.  Try not to place a laptop on the thighs when working as this can cause the thighs to have exposure to heat.   The underside of laptops is often 50 degrees C or higher, which many do not realize. Heated seats should not be used in vehicles all the time.  If you must use a heated seat, only use it until your body has warmed up enough and then switch it off.  If your job requires you to be close to an open heat source, such as a chef or a blacksmith, wear protective clothing so the skin is not exposed to the heat and take frequent breaks.

 

Reference Sources:

1. Medical Dictionary

3 replies
  1. anni
    anni says:

    All my life I have dealt with this strange condition. Whenever I decide to sunbathe, within 10 minutes, blotchy redness starts to form (most commonly on my thighs, neck, and shoulders). I’ve never experienced Erythema Ab Igne with the common causes of excessive contact with heaters, laptops, or other heated objects. Only during the Summer and places/ days with a high UV index. Along with Erythema Ab Igne, I also experience prickly heat. Right before the lacy patterns appear, the tingly sensation associated with prickly heat (also referred to as miliaria or simply as a heat rash) occurs. Not long after the visible symptoms of Erythema Ab Igne appear, the prickly sensation and heat become unbearable and I quickly find shade. Usually in about a minute without sun exposure, the blotchiness fades along with the tingly sensations. While the visible symptoms seemingly disappear, I am left with an intense itch covering my entire body for what seems like hours. I’m not sure if this is to be associated with Erythema Ab Igne, prickly heat, or maybe something entirely else, but whatever it is, it sure is annoying.

    Reply
    • Taylor
      Taylor says:

      I have the exact same thing but it only started this summer. My skin is becoming hyper pigmented from it now too. I went to a dermatologist and they said it was Livedo Reticularis but from what I’ve read that’s more often associated with reactions to cold, although he did say it could be sensitive to UV. I have experienced the mottled reaction on my legs after a cold shower too but it was more blueish purple, whereas the mottling from sun is definitely more red but it still has that same lace like pattern. I’ve had some other abnormal blood work (hs-crp at 12 mg/L, positive ANA w/ speckled pattern, slightly high WBC + platelets etc.) but the feedback was that this wasn’t indicative of anything systemic. I’m curious if sunscreen helps with the mottling? It’s frustrating because I love sitting in my backyard in the sun but now this happens within 5 minutes of being outside in direct Sun.

  2. Jaye
    Jaye says:

    I believe I have developed Erythema Ab Igne on my legs due to repeated prolonged exposure to heat from hot water bottles. I have suffered Raynaud’s Syndrome (first discovered in 2011) secondary to Hashimoto’s Thyroiditis (autoimmune hypothyroidism diagnosed properly in 2013) and it has gotten significantly worse during cold weather. The nerves in my toes have undergone some nerve damage from repeated cold exposure and one of my big toes has developed sores on it. The circulation in my feet/legs is so bad because of how cold I get, and aside from massaging my toes/feet despite the jabbing pins and needles a hot water bottle is the only self-help thing that temporarily resolves it for a longer amount of time. I am at a loss as to how to treat the Raynaud’s because my self-help treatment is now creating another potential condition. :(

    Reply

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