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Toasted Skin Syndrome (Erythema ab igne)

There’s been a lot of buzz about “toasted skin syndrome” this week at the hospital and in the media. For those unfamiliar with the condition, toasted skin syndrome, also known as erythema ab igne, is a skin condition that occurs after repeated exposure to heat at temperatures lower than those that cause noticeable burns on the skin.

Erythema ab igne, or toasted skin, is not a new condition. We have been seeing cases stemming from people using heat packs or electric blankets for years. What makes this condition noteworthy is the fact that most people only see their skin changing color in one location, and they don’t understand why. This can be scary.

Toasted skin made it in to the media spotlight this week following a report in an academic journal discussing the rise in cases due to people using laptops for extended periods of time.

So what does toasted skin syndrome look like, and is there a chance you are suffering from the condition? Toasted skin starts off appearing as a lacy or net-like (reticulated) discoloration of the skin. This may be a transient pink or red in color initially but eventually becomes a gray or brown discoloration if the heat exposure continues,

It is not really known how or why the skin discoloration seen in erythema ab igne occurs. Causes of this condition include open fires, space heaters, radiators, heating pads used for chronic pain, and electric blankets. There have been increasing recent reports of erythema ab igne associated with the use of laptop computers directly on the lap.

There is no reliable treatment for the discoloration seen in erythema ab igne. Removing the causative heat source early in the course of the skin changes is the most important step you can take, and it usually results in complete resolution over months. Longstanding lesions from repeated long-term exposure may, however, be permanent. In some cases, the lesions improve with topical agents such as retinoids or the chemotherapy agent 5-fluorouracil. Some people may respond to treatment with certain types of lasers as well.

Although rare, skin cancers have been known to arise from areas of erythema ab igne, usually from longstanding lesions, twenty or even thirty years later. The majority of these are squamous cell carcinomas, although other types of skin cancers have also been reported. In general, the risk of skin cancer arising from erythema ab igne, while higher than that of unaffected skin, is very low.

To prevent erythema ab igne resulting from laptop use, keep your notebook on a desk or use a laptop cooling pad (with or without a fan).
 

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