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Erythema Ab Igne: Differential Diagnoses & Workup

Author: Robert S Bader, MD, Assistant Clinical Professor, Department of Dermatology, Drexel University College of Medicine; Dermatologist, Section of Dermatology, Department of Medicine, North Broward Medical Center
Contributor Information and Disclosures

Updated: Dec 2, 2009

Differential Diagnoses

Acanthosis Nigricans

Other Problems to Be Considered

Livedo reticularis 
Livedoid vasculitis
Poikiloderma atrophicans vasculare

Workup

Procedures

  • Perform a 3- or 4-mm punch biopsy if the diagnosis of erythema ab igne (EAI) is uncertain.

Histologic Findings

  • In early erythema ab igne lesions, epidermal atrophy with loss of the rete ridges is seen. Later, melanin incontinence occurs with melanophages present in the upper dermis.
  • Collagen degeneration and a relative increase in dermal elastic tissue are seen. In contrast to solar elastosis, this is not basophilic on hematoxylin and eosin–stained specimens.
  • Telangiectasis within the papillary dermis and occasional hemosiderin may be seen more commonly on the legs in patients with erythema ab igne.
  • Some patients show focal or confluent hyperkeratosis, dyskeratosis, keratinocyte atypia, and, occasionally, melanocyte atypia.

More on Erythema Ab Igne

Overview: Erythema Ab Igne
Differential Diagnoses & Workup: Erythema Ab Igne
Treatment & Medication: Erythema Ab Igne
Follow-up: Erythema Ab Igne
References
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References

  1. Roth D, London M. Acridine probe study into synergistic DNA-denaturing action of heat and ultraviolet light in squamous cells. J Invest Dermatol. Oct 1977;69(4):368-72. [Medline].

  2. Arrington JH 3rd, Lockman DS. Thermal keratoses and squamous cell carcinoma in situ associated with erythema ab igne. Arch Dermatol. Oct 1979;115(10):1226-8. [Medline].

  3. Kokturk A, Kaya TI, Baz K, Yazici AC, Apa DD, Ikizoglu G. Bullous erythema ab igne. Dermatol Online J. Aug 2003;9(3):18. [Medline].

  4. Dellavalle RP, Gillum P. Erythema ab igne following heating/cooling blanket use in the intensive care unit. Cutis. Aug 2000;66(2):136-8. [Medline].

  5. Ashby M. Erythema ab igne in cancer patients. J R Soc Med. Nov 1985;78(11):925-7. [Medline].

  6. Mok DW, Blumgart LH. Erythema ab igne in chronic pancreatic pain: a diagnostic sign. J R Soc Med. Apr 1984;77(4):299-301. [Medline].

  7. Mucklow ES, Freeman NV. Pancreatic ascites in childhood. Br J Clin Pract. Jun 1990;44(6):248-51. [Medline].

  8. Meffert JJ, Davis BM. Furniture-induced erythema ab igne. J Am Acad Dermatol. Mar 1996;34(3):516-7. [Medline].

  9. Helm TN, Spigel GT, Helm KF. Erythema ab igne caused by a car heater. Cutis. Feb 1997;59(2):81-2. [Medline].

  10. Donohue KG, Nahm WK, Badiavas E, Li L, Pedvis-Leftick A. Hot pop brown spot: erythema Ab igne induced by heated popcorn. J Dermatol. Mar 2002;29(3):172-3. [Medline].

  11. Bilic M, Adams BB. Erythema ab igne induced by a laptop computer. J Am Acad Dermatol. Jun 2004;50(6):973-4. [Medline].

  12. Jagtman BA. Erythema ab igne due to a laptop computer. Contact Dermatitis. Feb 2004;50(2):105. [Medline].

  13. Mohr MR, Scott KA, Rariser RM. Laptop Computer-Induced Erythema Ab Igne:A Case Report. Cutis. 2007;79:59-60.

  14. Bachmeyer C, Bensaid P, Begon E. Laptop computer as a modern cause of erythema ab igne. J Eur Acad Dermatol Venereol. Jun 2009;23(6):736-7. [Medline].

  15. Fite C, Bouscarat F. [Laptop computer-induced erythema Ab Igne]. Presse Med. Jul-Aug 2009;38(7-8):1164-5. [Medline].

  16. Sesay M, Dhanji S. Case report: erythema ab igne in a patient with diabetic neuropathy. Am Fam Physician. Aug 15 2009;80(4):322. [Medline].

  17. Radmanesh M. Erythema ab igne following Sauna belt use for abdominal obesity and cellulite. Int J Dermatol. Jan 2009;48(1):94-5. [Medline].

  18. Dvoretzky I, Silverman NR. Reticular erythema of the lower back. Erythema ab igne. Arch Dermatol. Mar 1991;127(3):405-6, 408-9. [Medline].

  19. Finlayson GR, Sams WM Jr, Smith JG Jr. Erythema ab igne: a histopathological study. J Invest Dermatol. Jan 1966;46(1):104-8. [Medline].

  20. Hardy JD, Stolwijk JA, Hammel HT, Murgatroyd D. Skin temperature and cutaneous pain during warm water immersion. J Appl Physiol. Sep 1965;20(5):1014-21. [Medline].

  21. Howe NR, Bader RS. Erythema ab igne. Clin Dermatol. 1998;2:7-8.

  22. Peterkin GA. Malignant change in erythema ab igne. Br Med J. Dec 31 1955;2(4956):1599-602. [Medline].

  23. Sahl WJ Jr, Taira JW. Erythema ab igne: treatment with 5-fluorouracil cream. J Am Acad Dermatol. Jul 1992;27(1):109-10. [Medline].

  24. Shahrad P, Marks R. The wages of warmth: changes in erythema ab igne. Br J Dermatol. Aug 1977;97(2):179-86. [Medline].

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Further Reading

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Keywords

erythema ab igne, erythema ab igne elastosis, EAI, ephelis ab igne, erythema à calore, toasted skin syndrome, erythema a calore

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Contributor Information and Disclosures

Author

Robert S Bader, MD, Assistant Clinical Professor, Department of Dermatology, Drexel University College of Medicine; Dermatologist, Section of Dermatology, Department of Medicine, North Broward Medical Center
Robert S Bader, MD is a member of the following medical societies: American Academy of Dermatology, American Society for Dermatologic Surgery, American Society for MOHS Surgery, and Florida Medical Association
Disclosure: Nothing to disclose.

Medical Editor

Marjan Garmyn, MD, PhD, Professor, Faculty of Medicine, Katholieke Universiteit Leuven, Belgium; Chair and Adjunct Head, Department of Dermatology, University of Leuven, Belgium
Disclosure: Nothing to disclose.

Pharmacy Editor

David F Butler, MD, Professor of Dermatology, Texas A&M University College of Medicine; Chair, Department of Dermatology, Director, Dermatology Residency Training Program, Scott and White Clinic, Northside Clinic
David F Butler, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Medical Association, American Society for Dermatologic Surgery, American Society for MOHS Surgery, Association of Military Dermatologists, and Phi Beta Kappa
Disclosure: Nothing to disclose.

Managing Editor

Edward F Chan, MD, Clinical Assistant Professor, Department of Dermatology, University of Pennsylvania School of Medicine
Edward F Chan, MD is a member of the following medical societies: American Academy of Dermatology, American Society of Dermatopathology, and Society for Investigative Dermatology
Disclosure: Nothing to disclose.

CME Editor

Catherine M Quirk, MD, Clinical Assistant Professor, Department of Dermatology, University of Pennsylvania
Catherine M Quirk, MD is a member of the following medical societies: Alpha Omega Alpha and American Academy of Dermatology
Disclosure: Nothing to disclose.

Chief Editor

Dirk M Elston, MD, Director, Department of Dermatology, Geisinger Medical Center
Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology
Disclosure: Nothing to disclose.

 
 
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