Erythema ab igne or stove legs: symptoms and treatment

Erythema ab igne or stove-legs symptoms consist of local red-brown discoloration of the skin, with an irregularly branched pattern. This may be accompanied by itching and burning. Erythema ab Igne (chicken legs) is a skin reaction caused by chronic exposure to heat sources. It was once a common condition among the elderly, who huddled close to open fires or electric heaters. Nowadays it is more commonly seen in people who are exposed for long periods of time to hot water bottles, warm cherry stone pillows, electric blankets and laptops placed on their laps. Erythema ab igne means redness due to heat.

  • Erythema ab igne or stove legs
  • Causes of erythema ab igne
  • Risk factors
  • Who gets it?
  • Symptoms of erythema ab igne
  • Phenomena
  • Different heat sources
  • Examination and diagnosis
  • Treatment of erythema ab igne
  • Case of a woman with cleft legs
  • Prognosis
  • Complications
  • Prevention
  • Avoid prolonged direct exposure to heat
  • Wear appropriate protection
  • Occupational health and safety rules
  • Regular check-up

Erythema ab igne in a person with chronic abdominal pain who found some relief from the symptoms with the application of heat / Source: James Heilman, MD, Wikimedia Commons (CC BY-SA-3.0)

Erythema ab igne or stove legs

Erythema ab igne (literally: ‘redness due to heat or fire’) is a skin disorder caused by prolonged and repeated exposure of part of the skin to a heat source, such as stoves, fireplace, wood-fired ovens, patio heaters, fire pits, hot water bottles , warm cherry stone pillows, electric blankets and laptops. In Western countries with central heating, this condition is becoming rare. The laptop variant is more common. Initially, the skin is often slightly erythematous, but after repeated exposure to a heat source, the classic blue, purple or brown (fish) reticular hyperpigmentation appears. Other names of erythema ab igne are: erythema caloricum, stove legs, stove back, pigmentation reticularis and calore, fire stains and laptop dermatitis.

Causes of erythema ab igne

Erythema ab igne is caused by chronic exposure of the skin to high(er) temperatures, which eventually causes vasodilation that does not disappear on its own. The discoloration is caused by an increase in pigment (hyperpigmentation).

Risk factors

The risk factors for Erythema ab igne include any factor that leads to heat exposure. These include:

  • Sit near electric heaters, fireplaces and other heat sources.
  • Using heating pads for shoulder pain or back pain.
  • Exposure to heat in workplaces including cooks, blacksmiths, etc.
  • Heated car seats.
  • Placing hot electronic devices on your lap; hold such hot devices.

Who gets it?

Erythema ab igne was once commonly seen in the elderly who stood close to open fires or sat near electric heaters; however, erythema ab igne has been reported in both young and elderly people. Women have a higher incidence of sciatica than men. Although common use of central heating has reduced the overall incidence of this skin condition, it is still sometimes found in people exposed to heat from other sources such as heat pad heaters, hot water bottles and electronic devices.

Symptoms of erythema ab igne

Phenomena

Limited exposure to a heat source causes a mild and transient red rash, in a jagged pattern resembling a fishing net. Prolonged and repeated exposure causes marked redness and discoloration of the skin (hyperpigmentation). Some patients may experience mild itching and/or a burning sensation. If the heat source is not removed in time, permanent pigmentation changes, skin atrophy (thinning of the skin) and even malignant changes can occur.

Different heat sources

Localized lesions today reflect the different heat sources to which people may be exposed. Examples of this are:

  • Repeated application of hot water bottles or heat pads or heat plasters for the treatment of chronic pain, for example chronic back pain (persistent back pain);
  • Repeated exposure to car heaters or furniture with built-in heaters;
  • Occupational risk for silversmiths and jewelers (where the face is exposed to heat), bakers and chefs (poor).

Examination and diagnosis

The diagnosis can normally be made on the basis of the clinical picture and the patient’s story. The condition should not be confused with:

  • livedo reticularis;
  • livedo racemosa;
  • livedo reticularis vasculitis;
  • cutis marmorata; and
  • poikiloderma vasculare atrophicans.

Treatment of erythema ab igne

The treatment consists first and foremost of omitting or avoiding the heat source. With mild redness, the skin abnormality will disappear within a few months. Recovery can possibly be accelerated by applying a cream containing 5-fluorouracil (Efudix ®) or vitamin A acid (Acid a Vit ®). Remains can possibly be treated with pigment lasers. At a later stage, permanent pigmentation changes, skin atrophy and even skin cancer, usually squamous cell carcinoma, may develop. Other treatments are indicated for these abnormalities.

Case of a woman with cleft legs

A case of a 35-year-old woman with erythema ab igne:

Mrs. She recently noticed that she had an unusual rash on her thighs that started as a light red discoloration and slowly developed into a darker, brownish spot. She had no pain or itching, but was concerned about the rash and sought medical advice from her GP.

After a physical examination, the GP diagnosed erythema ab igne, also known as stove legs. In Mrs. Mrs. The doctor assured her that in most cases the rash would disappear on its own if the cause of the heat exposure was removed.

Mrs. After several months, Mrs.

Prognosis

Erythema ab igne has a favorable prognosis when the heat source causing the complaints is removed and repeated exposure is limited or avoided. The rash then disappears within a few months to years. If there is long-term exposure, the risk of permanent discoloration of the skin increases, as well as the possibility of transformation into (a precursor of) skin cancer.

Complications

Complications are rare, but in some people the rash transforms into (a precursor of) skin cancer.

Prevention

Preventive measures of erythema ab igne may include:

Avoid prolonged direct exposure to heat

Avoiding prolonged direct exposure to heat; Avoid sitting too close to such sources, especially during the cold seasons.

Wear appropriate protection

Persons who are constantly exposed to heat sources as part of their profession must take appropriate protection against such heat radiation sources.

Occupational health and safety rules

Ensure that your employer strictly adheres to applicable legal requirements for occupational safety measures, especially regarding heat exposure in the workplace.

Regular check-up

Conducting routine screening of individuals working in environments where such exposures are present.

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