Erythema e calore L59.0

Author: Prof. Dr. med. Peter Altmeyer

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Last updated on: 17.01.2024

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Synonym(s)

caloric erythema; Erythema ab igne; fire stains; toasted skin syndrome

Definition
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Erythema caused by heat or infrared radiation (see infrared rays below), usually reticular erythema at the point of contact, which occurs mainly with prolonged (usually habitually overheated) regularly or irregularly repeated heat stimuli. The repeated application of heat (e.g. hot water bottles, heating pads, seat and car heaters, but also laptops or cell phones) initially leads to the red-colored reticular livedo image, later to increasing hyperpigmentation in the given livedo pattern (see hyperpigmentation, caloric).

Etiopathogenesis
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The precise cause is unclear. It is assumed to be a paralysis of the deep vascular plexus (located at the corium-subcutaneous border).

Localization
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Varies depending on where the temperature source is applied on the body

Clinical features
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Reticular erythema detectable at the heat contact points (no increase in consistency on palpation), each forming self-contained circular formations. In the case of prolonged damage, brown discolorations are increasingly mixed into the red color. In the late stage, only reticular hyperpgimentations are found.

Histology
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Under largely normal or slightly to distinctly atrophic surface epithelium, dilated capillaries and deposits of melanotic or hemosiderotic pigment are found. Little or no inflammatory symptoms.

Differential diagnosis
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Complication(s)
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Squamous cell carcinomas and Merkel cell carcinomas have been described as long-term complications (after approx. 30 years).

A higher incidence of carcinoma has been found, for example, with repeated heat applications using charcoal burning elements that are in direct contact with the skin as heat sources. The Tibetan or Indian "Kangri ulcer", the Japanese "Cairo cancer" and the Chinese "Kang carcinoma" (Kang = Chinese stove bed) have become well known.

Therapy
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Avoidance of the damaging temperature influences; otherwise harmless; no therapy necessary

Note(s)
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The overheating caused by regular heat applications is below the pain threshold (<45C°) and does not lead to real burns. The reticular erythema develops after months or even years. Later reticular pigmentation may occur (see below hyperpigmentation, caloric).

Literature
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  1. Beneke J et al. (2014) Erythema ab igne in a patient with bulimia nervosa. Act Dermatol 40:347-349
  2. Bücker H (1961) On the erythema effect of optical radiation. UV erythema, heat erythema. Radiation therapy 115: 136-143
  3. McCulloch HD (1910) "KANGRI CANCER": A physiological aspect. Br Med J 2: 912-913. PMCID: PMC2336016.

Disclaimer

Please ask your physician for a reliable diagnosis. This website is only meant as a reference.

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Last updated on: 17.01.2024