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LETTER TO EDITOR
Year : 2019  |  Volume : 20  |  Issue : 4  |  Page : 352-353

Erythema ab igne over soles in a young boy


Department of Dermatology, Government Medical College, Jammu, Jammu and Kashmir, India

Date of Web Publication30-Sep-2019

Correspondence Address:
Dr Sabha Mushtaq
Department of Dermatology, Government Medical College, Jammu - 180 001, Jammu and Kashmir
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijpd.IJPD_46_19

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How to cite this article:
Mushtaq S. Erythema ab igne over soles in a young boy. Indian J Paediatr Dermatol 2019;20:352-3

How to cite this URL:
Mushtaq S. Erythema ab igne over soles in a young boy. Indian J Paediatr Dermatol [serial online] 2019 [cited 2019 Nov 14];20:352-3. Available from: http://www.ijpd.in/text.asp?2019/20/4/352/268397



A 12-year-old boy, resident of a rural area, was brought by his parents with complaints of a brownish rash noted over his feet for 2 months. The rash was noticed towards the end of winter season over the sole of right foot and gradually involved the left foot. There was no history of itching, burning, pain, or ulceration over the lesions. The boy was otherwise well, with no systemic complaints. Cutaneous examination revealed brown-colored reticulate pigmentation over both the soles, predominantly involving the instep of the right foot [Figure 1] and [Figure 2]. The surface of the lesion did not show any blistering or ulceration. A thorough mucocutaneous examination revealed no other abnormalities. Peripheral pulses were normal. The parents denied using hot water bottle or any heating appliance by the child. On further probing, it was found that owing to the extremely cold weather in their area, the child often used to sit near an open fireplace and warm his feet. A diagnosis of erythema ab igne was thus made. The patient was advised to avoid sitting near fire or other heating devices, and the parents were counseled about the benign nature of the condition.
Figure 1: Reticulate hyperpigmentation over bilateral feet

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Figure 2: Predominant involvement of the instep

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Erythema ab igne is a cutaneous reaction to thermal stimuli, resulting from repeated or prolonged exposure to infrared radiation. Females are more commonly affected than men. It presents as reticular, telangiectatic, or pigmented lesion. Subepidermal blistering can rarely develop on the affected skin.[1] The source of heat radiation may include various body-warming techniques such as the use of kangri in North India, hot water bottles, and other heating appliances. Although the incidence of erythema ab igne has reduced in the developed world with the use of central heating, it is still seen in developing countries like India, especially in the rural areas where people often stand or sit close to the fires.[1],[2] It has also been reported among rural Indian women who cook in front of earthen ovens.[3] The site of affection is determined by the heat source, the direction of incident radiation, the contour of the skin, and the interposition of clothing. Legs are commonly affected although it can occur on any site.[1] We could not find any previous report of erythema ab igne involving the sole. Long-standing cases may develop squamous cell carcinoma and other malignancies.[3] The diagnosis is usually straightforward, but sometimes, it may be confused with livedo reticularis. In livedo reticularis, the changes are symmetrical and telangiectatic rather than pigmented. Management involves strict avoidance of heat and in some cases, 5-fluorouracil has been tried.[1]

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Kennedy CT, Burd DA, Creamer D. Mechanical and thermal injury. In: Burns T, Breathnach S, Cox N, Griffiths C, editors. Rook's Textbook of Dermatology. 8th ed. Oxford: Blackwell Science; 2004. p. 28.72-28.73.  Back to cited text no. 1
    
2.
Basavaraj KH, Kanthraj GR, Shetty AM, Rangappa V. Erythema abigne in a rural Indian women. Indian J Dermatol Venereol Leprol 2011;77:731.  Back to cited text no. 2
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3.
Teli MA, Khan NA, Darzi MA, Gupta M, Tufail A. Recurrence pattern in squamous cell carcinoma of skin of lower extremities and abdominal wall (Kangri cancer) in Kashmir valley of Indian subcontinent: Impact of various treatment modalities. Indian J Dermatol 2009;54:342-6.  Back to cited text no. 3
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