Erythema Ab Igne in a 12-Year-Old Boy Diagnosed via Telemedicine

Abstract

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.

Erythema Ab Igne: A Rare Presentation of Toasted Skin Syndrome With the Use of a Space Heater

“…Though it is a benign rash that resolves quickly within a few weeks to months, rare complications decades after exposure include transformation into cutaneous squamous cell carcinoma, Merkel cell carcinoma, and heat-induced basal cell carcinoma in regions of the body without direct sun exposure, such as the perineum [ 5 - 7 ]. Common differential diagnoses include livedo reticularis, autoimmune connective tissue disorders, cutis marmorata, and livedo racemosa [ 8 ].…”

Erythema ab igne in pediatric patients remote schooling during the COVID‐19 pandemic: A case series

“…The required transition to schooling and working from home during the pandemic has had numerous unintended consequences including an apparent increased incidence of EAI. 2 , 5 Medical personnel should be alert to changes in routines that may contribute to behaviors that result in conditions such as EAI.…”

“…Livedo reticularis and livedo racemosa may have similar presentations. Unlike EAI, livedo reticularis occurs transiently with cold exposure rather than chronically with heat exposure, and livedo racemosa is associated with underlying systemic disorders 5 . Physicians should be aware of EAI and ask about a history of heat exposure to reduce unnecessary laboratory testing and medications.…”