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Revista chilena de pediatría

versión impresa ISSN 0370-4106

Rev. chil. pediatr. vol.85 no.2 Santiago abr. 2014

http://dx.doi.org/10.4067/S0370-41062014000200015 

CRÓNICA / CRHONICALS

 

Radiator-induced erythema ab igne in 8-year-old girl

 

PIOTR BRZEZINSKI1, SAMIR ISMAIL2, ANCA CHIRIAC3

1. Head of Department of Dermatology, 6th Military Support Unit, os. Ledowo 1N, 76-270 Ustka, Poland.
2. Department of Neonatology, I Department of Obstetrics and Gynecology, Hospital of the Infant Jesus, ul. Lindley 4, Warsaw, Poland.
3. University of Apollonia, Department of Dermatology, Nicolina Medical Center, Iasi, Romania.

Correspondencia a:


ABSTRACT

The cutaneous lesion of erythema ab Igne are characterized by a reticulate erythema, hyperpigmentation, fine scaling, epidermal atrophy and telangiectasias, and reticulated erythema. We report a case of erythema ab igne on the hands of a 8-year-old girl, induced by classic homemade radiator.

Key words: erythema; reticulate pigmentation; child.


 

Introduction

The cutaneous lesion of erythema ab Igne (EAI) is characterized by a reticulate erythema, hyperpigmentation, fine scaling, epidermal atrophy and telangiectasias present in areas of chronic mild to moderate exposure to thermal radiation, insufficient to cause burn. The conditions is also termed "ephelis ignealis", erythema a calore, "ephelis ab igne", or " erythema a computatro". It is usually asymptomatic, but sometimes people can refer to it as heat sensation or/and pruritus1,2.

Erythema ab igne (EAI) has been described on the shins of individuals working in front of coal stoves or sitting close to a fireplace or other heating sources. Lately, several cases of laptop-induced EAI have been reported3.

We report a case with erythema ab igne on the thigh of a 8-year-old girl, induced by classic homemade radiator.

Case Report

An 8-year-old girl with no past medical history presented with symptoms of burning experienced on the back of hands (figure 1). Physical examination revealed reticulated, reddish-brown macules with ill-defined border on the back of hands.

 
Figure 1. Erythema ab igne on hands (backs of he hands and part of the wrists).

Family members admitted that for eight months, during October 2012-April 2013, the girl heated her hands by putting them over the radiator, for 15-45 minutes several times a day.

Dermoscopy showed the presence of homogenous, brownish pigmentation with erythema at the edges of the macules. The other tests carried out, including full blood count, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), ANA screening were all within the normal range. The diagnosis was erythema ab igne causae radiator.

Discussion

Erythema ab igne has been reported following the use of various heat sources, including hot pads and electric blankets, laptops, open fires, hot stoves, chulha, space heaters, infrared lamps, steam radiators, car heaters, wood-burning stoves, furniture with inbuilt heating unit, heating blankets, frequent bathing in hot water, and sauna belts4,5.

EIA ("redness from fire") is seen rarely in young patients. We have described a rare case of EAI in child below 10 years of age- so far not reported. An extensive PubMed search did not reveal any report of erythema ab igne in a children below 10 years of age, although cases 12-year-old children (induced by a laptop) have been reported in the literature6,7.

The continuous exposure to infrared radiation initially causes transient erythema, progressing to reticulate pigmentation and keratosis. The lesion of EAI is acquired by repeated and prolonged exposure is infrared radiation at Temperatures up 3-47°C1.

Because EAI is a precancerosis, it has been associated with several different types of cutaneous neoplasms including the Merkel cell carcinoma, squamous cell carcinoma, and cutaneous marginal zone lymphoma2.

Cirrhosis, malnutrition, hypothyroidism, internal malignancy, Hansen disease, and anemia are some of the medical conditions that have been associated with EAI.

The lesion characteristic of EAI associated to a history of excessive exposure to heat in the area of onset facilitates clinical diagnosis of this disease. The duration of the repeated exposure is Necessary provoke alterations in the skin varies from months it several years and the damage Appears to be cumulative.

No effective treatment is available. The various treatment modalities suggested for erythema ab igne include topical retinoids, with or without topical steroids and 5-fluorouracil cream3.

Progression of the disease can only be halted by the avoidance of further heat exposure.

Conclusion

In this case, the cause/effect correlation could be easily established. The diagnosis, therefore, was essentially clinical. This is the first case of EAI in a child so young.

 

References

1. - Gauglitz GG, Ruzicka T, Herzinger T: Erythema a computatro. Case Rep Dermatol 2013; 5: 111-3.         [ Links ]

2. - Brzezinski P, Mansur AT: [Reticulate acropigmentation of Dohi: A case report. Differentiation]. Dermatol Prakt 2011; 1: 45-8.         [ Links ]

3. - Poustinchian BR, Pohlman DJ: Erythema ab igne. J Am Osteopath Assoc. 2012; 112: 808.         [ Links ]

4. - Javed M: Clinical spectrum of neonatal skin disorders at Hamdard University Hospital Karachi, Pakistan. Our Dermatol Online. 2012; 3: 178-80.         [ Links ]

5. - Brzezinski P: [Differential diagnostic of erosions and blisters in the neonate and young child for exaple congenital vesicular erosive dermatosis supple reticulated scarring in 4-years old girl]. Dermatol Prakt 2010; 5: 49-53.         [ Links ]

6. - Giraldi S, Diettrich F, Abbage KT, Carvalho V de O, Marinoni LP: Erythema Ab Igne induced by a laptop computer in an adolescent. An Bras Dermatol 2011; 86: 128-30.         [ Links ]

7. - Arnold AW, Itin PH: Laptop computer-induced erythema ab igne in a child and review of the literature. Pediatrics. 2010; 126: e1227-30.         [ Links ]

 


Corresponding author:

Funding sources: None Conflicts of interest: None Piotr Brzezinski, MD PhD Department of Dermatology, 6th Military Support Unit, os. Ledowo 1N, 76-270 Ustka, Poland.
E-mail: brzezoo77@yahoo.com