In March of 2020, an otherwise healthy 12-year-old boy developed a unilateral patch of reticulated erythema limited to his left lower extremity. The child could not be examined in the clinic due to limited in-person appointments during the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic, so he was examined via a telemedicine visit. The diagnosis of erythema ab igne was made as his mother verified that the child was spending approximately two hours per day playing video games in the cold basement of his house, with a space heater positioned close to his left leg. Our case of erythema ab igne is unique due to the relatively young age of the affected child, and it provides an example of how this diagnosis can be made via a telemedicine visit. Being able to recognize the classic appearance of erythema ab igne through the scrutiny of photographs and obtaining pertinent history can preclude the need for an in-person visit during times when home sequestration may be a necessity.
Subcutaneous emphysema (SE) and pneumomediastinum are rare complications of air beneath the skin layers and in the mediastinal space, respectively, following routine dental procedures. A few cases exist in the literature. A 53-year-old female presented to the emergency department shortly after a cavity filling, with marked swelling of her right orbit, face, and neck. Physical examination and computed tomography (CT) revealed subcutaneous emphysema and pneumomediastinum. The patient was treated with prophylactic antibiotics for one week and Peridex rinse twice daily. Subcutaneous emphysema and pneumomediastinum cases have been associated with potentially life-threatening sequelae and infections. Although these conditions are almost exclusively benign and self-limiting, physicians should consider the associated fatal complications and manage accordingly. Dental providers should be able to recognize this complication and provide patients with appropriate guidance.
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