Chronic Heat-Induced Skin Lesions (Erythema ab Igne): Ultrastructural Studies

Cavallari, Vittorio; Cicciarello, Rocco; Torre, Valerio; Gagliardi, Maria; Albiero, Francesca; Palazzo, Rosaria; Siragusa, Maddalena; Schipis, Carmelo

doi:10.1080/01913120117614

Cited by 24 publications

(19 citation statements)

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“…Recently, the condition has become more common in intensive care unit patients using heating blankets and the elderly who are in close proximity to heaters for prolonged periods of time. Women have been found to have a higher incidence of erythema ab igne than men 6 . The condition has also been observed in patients with chronic abdominal and back pain who find relief with the application of heat.…”

Section: Discussionmentioning

confidence: 98%

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Erythema ab igne mimicking livedo reticularis

et al. 2010

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Section: Discussionmentioning

confidence: 98%

“…Rarely, erythema ab igne can have bullous lesions 7 . While all body surfaces are susceptible, the condition typically occurs on the legs, lower back, and/or abdomen 6 …”

Section: Discussionmentioning

confidence: 99%

Erythema ab igne mimicking livedo reticularis

et al. 2010

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“…Exposure to infrared (IR) radiation has been described to contribute to skin photo-ageing and to the development of precancers or skin cancers [16][17][18][19] . Controversially, their beneficial effects [20,21] , including a cell-protective action [22,23] , separate the scientific community in their judgement about the role of IR light for human health.…”

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The Missing Link – Light-Induced (280–1,600 nm) Free Radical Formation in Human Skin

Zastrow

Groth²,

Klein³

et al. 2008

Skin Pharmacol Physiol

200

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The recent European recommendation on the efficacy of sunscreen products requests now a minimum ratio of UVA/UVB protection. However, the visible and the infrared (IR) parts of the sun spectrum have received little attention concerning their possible contribution to skin damage. A common biophysical answer for the different wavelengths of the sun spectrum can be found in the creation of excess free radicals – mainly reactive oxygen species (ROS). Thanks to electron spin resonance spectroscopy applied to skin biopsies, we determined for the first time the free radical action spectrum covering UV and visible light (280–700 nm). Convolution of the action spectrum with sunlight spectral irradiance showed that 50% of the total skin oxidative burden was generated by visible light. Creation of ROS by visible light was experimentally confirmed by varying the illuminance of a spotlight. We also evidenced the creation of excess free radicals by near-IR radiation. In that case, free radical generation does not depend exclusively on the dose, but also on the skin temperature increase initiated by near-IR light. Some phenomena which are still unclear, such as the question about the deleterious or beneficial role of sunlight, are reviewed, implying the research on new protection strategies for the prevention of skin cancer.

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“…Erythema ab igne appears as a reticulated, erythematous, hyperpigmented eruption that may occur after prolonged and repeated skin exposure to mild heat or infrared radiation, but under the threshold of thermal burn [1]. It can be also characterized by skin atrophy, telangiectasia and subepidermal bullae, and it is usually asymptomatic.…”

Section: Discussionmentioning

confidence: 99%

“…The histopathologic characteristics of erythema ab igne are nonspecific and include epidermal atrophy, hyperkeratosis, abundant melanophages in dermis, elastic fibres alterations and perivascular infiltration of inflammatory cells, mainly composed of lymphocytes, and dilatation of dermal blood vessels [1].…”

Section: Discussionmentioning

confidence: 99%

Erythema ab igne

et al. 2010

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An 86-year-old woman was referred to our Clinic because of a new onset of anaemia. She was under treatment with warfarin for chronic atrial fibrillation. The INR at admission was 4.1. Her caregiver excluded hematemesis or melena, and assured no NSAID had been taken. She appeared pale and was haemodynamically stable. A wellmarked, reddish-brown, netlike discoloration of the skin, with clear-cut margins was present on the anterior and medial surfaces of both thighs (Fig. 1). This kind of lesion was not present in any other body areas. Physical examination was otherwise normal.Routine blood examination revealed the presence of a microcytic anaemia (haemoglobin 7.8 g/dL; mean corpuscular volume 60.8 fL) with iron deficiency (serum iron 20 lg/ dL; serum ferritin 30 lg/L). The erythrocyte sedimentation rate appeared high (75 mm/h). Lupus anticoagulant panel, antinuclear antibodies, Coombs tests, cryoglobulins and anti-HCV antibodies were normal. Haptoglobin levels were normal. Esophagogastroduodenoscopy showed a sliding hiatal hernia with erosive esophagitis.The patient reported that the skin discoloration had appeared on her thighs many years before, and was chronic and stable. She added she would usually keep a hot water bottle on her thighs. It is to be noted that the extension of the lesion corresponded to the surface of the water bottle.Therefore, the skin discoloration and anaemia likely had no relationship. In fact, the anaemia was secondary to erosive esophagitis, and was treated with iron supplementation and proton pump inhibitors. DiscussionErythema ab igne appears as a reticulated, erythematous, hyperpigmented eruption that may occur after prolonged and repeated skin exposure to mild heat or infrared radiation, but under the threshold of thermal burn [1]. It can be also characterized by skin atrophy, telangiectasia and subepidermal bullae, and it is usually asymptomatic. Distribution and contour of the skin lesions depend on the direction of the incident radiation, and the interposition of clothing.

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Chronic Heat-Induced Skin Lesions (Erythema ab Igne): Ultrastructural Studies

Cited by 24 publications

References 1 publication

Erythema ab igne mimicking livedo reticularis

Erythema ab igne mimicking livedo reticularis

The Missing Link – Light-Induced (280–1,600 nm) Free Radical Formation in Human Skin

Erythema ab igne

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